Hopes versus reality
Between You and Me

Hopes versus reality

Lawrence Grouse1, Guangqiao Zeng2, Nanshan Zhong2

1Department of Neurology, University of Washington School of Medicine, Seattle, Washington 98195-6465, USA; 2Journal of Thoracic Disease, China State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China

Correspondence to: Lawrence Grouse. University of Washington School of Medicine, 1959 NE Pacific Ave., Rm RR650, Box 356465, Seattle, Washington 98195-6465, USA. Email: lgrouse@uw.edu.

Submitted Apr 23, 2014. Accepted for publication Apr 23, 2014.

doi: 10.3978/j.issn.2072-1439.2014.05.13

We have noticed the publication of a series of small, short-term studies using the ketamine for such varied conditions as suicidal ideation in depression (1), post-traumatic stress disorder (2), and treatment-refractory depression (3). These brief and inconclusive reports have been picked up throughout the internet portraying these uses as “a cure for depression” and “promising therapy for mental illness.” Stories about these preliminary findings have been published with an uncritical eye in such large global internet portals as Huffington Post (4), National Public Radio (5), and CBS (6) for the public and MedPage (7) for physicians.

We believe that this widespread, uncritical coverage of ketamine use could be misleading and damaging for patients, particularly since the drug is readily available worldwide as the illegal club drug “Special K”. As a result of overly positive reports about the drug in such common conditions, the risks of the epidemic of “Special K” use could be greatly increased. Because of the wide illegal access to the drug, patients could self-medicate and incur the serious side effects and long-term effects of the drug.

“Special K’s” active ingredient, the anesthetic ketamine, is an NMDA receptor inhibitor, which still finds some legal use in the US in spite of its prominent hallucinogenic and cognitive impairment side effects; however, by far the broadest use of the drug in the US is from preparations of “Special K” smuggled illegally from Mexico.

We would like to point out an important article concerning “Special K” in a column in the Journal of Thoracic Disease (JTD) (8), for which we are editors. This column, “Between You and Me”, publishes articles from practicing physicians and patients with their observations, thoughts, and experiences concerning medicine.

Dr. Peng Wu of Guangzhou wrote concerning several of her urologic patients who had severe psychiatric and urologic sequelae from long term “Special K” use. His urgent warnings about these problems with the recreational club use of the addictive “Special K” produce a very different view of the widespread, uncritical promotion of small, short-term, inconclusive studies of this agent in situations in which its specific mechanism of action in treating these conditions is certainly not well understood. Since these studies were industry-supported and the authors acknowledge conflicts of interest, the appropriateness of global promotion of the findings at this early stage is questionable.

The purpose of the “Between You and Me” column is to publish such important observations and perspectives of physicians and patients about the realities of medical care and not just the hopes for possible benefit. Dr. Wu’s observations have great value for all, and we welcome others’ views that will provide valuable information for our readers. Clinical trials are not the only kind of article that needs to be published in a medical journal.

Acknowledgements

Disclosure: The authors declare no conflict of interest.

References

  1. Price RB, Iosifescu DV, Murrough JW, et al. Effects of ketamine on explicit and implicit suicidal cognition: a randomized controlled trial in treatment-resistant depression. Depress Anxiety 2014;31:335-43. [PubMed]
  2. Feder A, Parides MK, Murrough JW, et al. Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder: A Randomized Clinical Trial. JAMA Psychiatry 2014;71:681-8. [PubMed]
  3. Murrough JW, Iosifescu DV, Chang LC, et al. Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial. Am J Psychiatry 2013;170:1134-42. [PubMed]
  4. Ketamine Depression Cure? ‘Special K’ Treats Symptoms Within Hours, Study Reports. Available online: http://www.huffingtonpost.com/2013/05/22/ketamine-cures-depression-study_n_3322006.html
  5. Growing Evidence That A Party Drug Can Help Severe Depression. Available online: http://www.npr.org/blogs/health/2014/04/03/298770933/growing-evidence-that-a-party-drug-can-help-severe-depression
  6. Ketamine, or “Special K,” effectively treats severe depression in study. Available online: http://www.cbsnews.com/news/ketamine-or-special-k-effectively-treats-severe-depression-in-study/
  7. IV Ketamine Rapidly Effective in PTSD. Available online: http://www.medpagetoday.com/Psychiatry/AnxietyStress/45314?xid=nl_mpt_guptaguide_2014-04-17&utm_source=guptaguide&utm_medium=email&utm_content=mpt&utm_campaign=04|17|2014&userid=500170&eun=g5625789d10r&email=lgrouse@uw.edu&mu_id=5625789
  8. Wu P. Stories of Special K patients. J Thorac Dis 2014;6:E37-8. Available online: http://www.jthoracdis.com/article/view/2169/html [PubMed]
Cite this article as: Grouse L, Zeng G, Zhong N. Hopes versus reality. J Thorac Dis 22014;6(6):E139-E140. doi: 10.3978/j.issn.2072-1439.2014.05.13

Article Options

Download Citation

Share