Musk said that K-powder is used to treat depression?

We must not ignore the many problems and risks of ketamine and continue to strictly regulate it. However, the health benefits of this drug must also be balanced.

通讯员 | 张婷婷 戴希安 简文杨

The Sixth Affiliated Hospital of Sun Yat-sen University

Recently, the Wall Street Journal said that people close to Musk, the world's richest man, revealed that Musk has been taking drugs for a long time, especially ketamine (K powder), and they are worried that this will trigger a health crisis for Musk. As early as June last year, the media disclosed the matter, but Musk posted a response saying that taking K powder was just to "treat depression".

Source: Ruijing

It is still difficult to determine whether billionaires smoke K powder or not. However, ketamine is really not simple, it was once recommended as a "must-have drug" by the World Health Organization as a commonly used narcotic and painkiller; it was later abused as a psychedelic drug, and was on the blacklist of strictly controlled drugs in various countries; in recent years, it has made a comeback and become the "new favorite" of antidepressant drugs, and has been called "the most important discovery in the field of mental illness in the past half century". Regarding those things about ketamine, Chief Physician Ruan Xiangcai, Director of the Pain Department of the Sixth Affiliated Hospital of Sun Yat-sen University, came to popularize science.

Deterioration: Commonly used drugs become drugs

Ketamine is an intravenous anesthetic, according to Ruan Xiangcai, a small amount of ketamine has a strong analgesic effect, increasing the dose can induce general anesthesia, has been widely used in a variety of superficial, short surgical anesthesia, sedation and a variety of general compound anesthesia for non-cooperative pediatric examinations, since 1985 by the World Health Organization included in the list of "essential drugs".

However, it can make people enter a rare state of anesthesia, which is manifested as staring at the eyes, but the response to painful and other nocical stimuli is sluggish, and it is unable to move, as if the body is separated from consciousness, and there is a strong sense of "out-of-body" experience and hallucinatory stimulation, which is called "dissociative anesthesia", and therefore, it is quite favored by criminals.

Criminals process it into "K-boy" to sell, turn it into psychedelic drugs, and K powder has also become the darling of some entertainment venues. As a result, ketamine quickly made it to the list of strictly controlled drugs in various countries.

As early as 2004, the State Food and Drug Administration included ketamine preparations in the management of Class I psychotropic drugs, and strictly controlled the production and sales of ketamine. In recent years, ketamine has been completely stopped for anesthesia in China. A good medicine that could have cured and saved people just walked into its dark moment, and became a "K fan" and was spurned.

Rise again: Leap into the miracle drug of antidepressants

In October last year, Matthew Perry, one of the leading actors of the well-known American sitcom "Friends", died at the age of 54. According to media reports, the Los Angeles County Medical Examiner's Office released information about Matthew's cause of death, saying that high levels of ketamine were found in his blood samples, and that he died from "acute effects of ketamine," and that the fatal factors also included drowning, coronary artery disease and the effects of buprenorphine, and that the manner of death was ruled an accident.

Ketamine again, Matthew also took drugs? It is reported that Matthew Perry had been receiving ketamine infusions for depression before his death.

Depression affects more than 300 million people worldwide, and nearly 800,000 people with depression commit suicide each year. Conventional antidepressants, which mostly act on the monoaminergic nervous system, require weeks or even months of continued use to take effect, and have no effect on one-third of patients with treatment-resistant depression.

Scientists have found that in the case of only one-fifth or one-sixth of the commonly used anesthetic dose, ketamine can significantly improve the negative symptoms of patients' low mood and low self-esteem within a few hours, weaken or even eliminate patients' suicidal ideation, and the effect on treatment-resistant depression is particularly prominent. This has brought ketamine back to life, and even become a new hope for the treatment of depression, with some commentators calling it "the most important discovery in the entire field of mental illness in half a century".

Nguyen explained that previous antidepressant treatments, such as drugs such as Prozac and Zolofu, usually took more than a month to alleviate the condition, and not everyone was effective. The outstanding advantages of small dose and fast action have made ketamine a star drug in psychiatry. In 2019, the U.S. Food and Drug Administration approved Janssen Pharmaceutical's nasal spray, Sukailang, a new ketamine-based antidepressant, which was subsequently approved by the National Medical Products Administration.

At the same time, scientists are trying to further expand the use of ketamine, which has been shown to be a potential treatment for refractory mental disorders such as post-traumatic stress disorder. A recent study in France showed that ketamine can not only have a rapid effect on patients with refractory chronic pain, but also alleviate negative emotions such as anxiety and depression caused by chronic pain, and greatly improve the quality of life, which is quite promising.

One-third of the pain-focused palliative care population has a depressive disorder, and if conventional antidepressants were used, the patient may die before the medication is effective. There is a lot of evidence that ketamine has a powerful antidepressant effect in palliative care, as well as a reduction in analgesic opioid consumption and side effects.

Fatal: The risk of abuse is extremely high

When used medically, ketamine separates anesthesia from hallucinogenic properties and is not too worrying because medical staff will ensure the safety of patients. Because a single small dose can produce results for months or even more than a year, ketamine is used as an antidepressant treatment and is not addictive.

However, ketamine abuse can lead to a variety of clinical problems. The side effects of excessive ketamine use are very serious, especially in the state of drinking, respiratory depression, cardiac arrest and so on. Long-term ketamine use in addicts can also cause damage to the urinary system, kidneys, heart, and brain. People are under deep or shallow anesthesia after inhaling ketamine, and if he is driving, he is prone to car accidents, and if he is in the water like Matthew, he is prone to drowning.

Nguyen explained that we must not ignore the many problems and risks of ketamine and must continue to strictly control it. However, the health benefits of this drug must also be balanced, and for depressed patients with acute suicidal ideation or behavior, where conventional treatment is difficult to take effect immediately, ketamine is a last straw to combat suicidal ideation and behavior quickly and effectively.

It is a three-part poison of medicine, and there are also these drugs and poisons

Drug addiction, also known as a substance use disorder, refers to uncontrollable patterns of substance or drug use and is a behavioral disorder. Common alcoholism and tobacco addiction can also be considered drug addiction.

The first step in drug addiction may be to try recreational or recreational drugs in social situations, while people who become addicted to opioids like morphine generally start by taking certain prescription medications. The risk and rate of addiction to each substance varies, and the risk and rate of addiction to opioid painkillers is much higher than that of ketamine. As time goes on, addicts increasingly need to increase the dosage of the drug to get euphoria, and trying to stop the drug can trigger intense cravings and extreme physical discomfort, which are also known as withdrawal symptoms.

Common addictive drugs include:

• Opioid analgesics. These drugs are often used for pain relief, such as codeine, tramadol, morphine, oxycodone, fentanyl, etc.

• Central nervous system depressants. These include benzodiazepines, such as lorazepam, diazepam, and alprazolam, which are commonly used for sedation, anxiety, and insomnia, and barbiturates, such as phenobarbital, isoamobarbital, and secobarbital, which are used to anesthetize and treat seizures.

• Stimulant. It is used to improve alertness, energy and concentration, and is often used to treat conditions such as asthma, obesity, ADHD, depression and narcolepsy, including dextroamphetamine, lysine amphetamine, methylphenidate and adella.

Source: The Sixth Affiliated Hospital of Sun Yat-sen University (O31)