[aarontait]

FYI: Johnson & Johnson patented the S(+) enantiomer of ketamine and sells it as a nasal spray called Spavato. It's been FDA approved for depression since 2019. Although Spravato costs more on paper than regular ketamine, it's often less expensive for patients since it is covered by insurance (regular ketamine treatments are considered an off-label use and are usually not covered).

[blurbleblurble]

It's pretty awful though for a lot of people. Researchers outside of the US have published studies showing that s-ketamine has higher risk of dependency in animal experiments and lower long term efficacy for depression, like on par with placebo. If I'm remembering right there are a number of reasons for this and one of them is that r-ketamine seems to simulate neuroplasticity better, something related to BDNF in certain parts of of hippocampus I think?

While it probably works for some people, it's likely dangerous for many others.

Kenji Hashimoto and others have published numerous papers about this. It's not exactly under-researched. The incentives in the US are horribly misaligned.

Quite honestly it's upsetting that spravato even exists and there ought to be a huge class action lawsuit about this.

A few papers: https://pubmed.ncbi.nlm.nih.gov/32224141/ https://pubmed.ncbi.nlm.nih.gov/26327690/

[aarontait]

Yea, I agree. I wish there was some kind of organization that would seek FDA approval for racemic ketamine treatment of depression. It's cheap, and widely available. Unfortunately, without the incentive for a patentable product, it's unlikely to ever happen.