Reacción a "Ketamine in pill form is effective and safe against depression resistant to other treatments"

The place of ketamine in the pathway for treatment resistant depression is unclear.  Two recent studies show that, when given intravenously it is at least as effective as ECT in people under 50 years.  Unlike ECT, it does not cause memory problems.  Whilst the cost of intravenous ketamine is about £10 per dose, administering it in clinic is itself costly and inconvenient.  Esketamine nasal spray is licensed for people who have not responded to at least two antidepressants but is not available on the NHS because of the cost of the drug (up to £489 per dose). This study confirms that oral ketamine, like intravenous ketamine, is an antidepressant but that the effect depends on the dose.  The results are good enough to justify the larger phase 3 trials that will be necessary for a licence for the 180mg twice weekly dose.  Given the ease with which people may choose to take two tablets if they do not benefit from one tablet, regulators may be interested in the benefits and risks of higher doses.