Thursday, 28 Mar 2024

Opinion | Debating the Merits of a Psychiatric Treatment

To the Editor:

Re “Can We Stop Suicides?” (Sunday Review, Dec. 2):

Moises Velasquez-Manoff rightly highlights the tragic epidemic of suicides but overstates the use of the anesthetic ketamine.

While ketamine has serious side effects, the greatest drawback of its use for depression and suicide may be in raising false hopes of a quick fix.

There are numerous reasons people become desperate. The job of psychiatrists and other mental health professionals is to understand why life became unbearable, which may involve in-depth interviews, review of medical records and corroboration from families and caregivers.

If depression is diagnosed, there is hope amid an array of proven and highly effective interventions, including psychotherapy, medications and even electroconvulsive therapy.

Although it may prove to offer temporary relief for selected individuals, the effectiveness of ketamine remains an open research question. Promotion in the media as a breakthrough therapy is premature and likely to foster unregulated prescribing and profiteering by some professionals and industry.

Stanley N. Caroff
Philadelphia
The writer is a professor of psychiatry at the Perelman School of Medicine, University of Pennsylvania.

To the Editor:

My son suffered from chronic pain, depression and thoughts of suicide for 15 years, until his psychiatrist researched and recommended ketamine as a treatment. He started off with five infusions over a period of a week, and then followed up with an additional infusion once every five or six weeks after that.

I would often sit with him during the treatment, and we would talk from time to time during or immediately after the infusion — about a hallucination, or how close he got to solving the problems of the world. But he was always perfectly fine about half an hour after the treatment, when I would assist him to a cab to take him home.

He knew immediately after his very first treatment that the infusion was working, and continued to feel better thereafter. Controlling the depression allowed him to focus on controlling his pain, where he made progress as well.

It takes an open mind to look outside the box of “on label” medical treatment; thank goodness his psychiatrist had that vision.

Eli F. Bleich
New York

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