How Yale researchers helped create the ketamine industry

The clinical trial that set the stage for today’s fast-growing ketamine industry runs just three pages long and involved only eight patients. It was published, not in the New England Journal of Medicine or The Lancet, but in a specialized journal called Biological Psychiatry.

Psychiatrists at the Yale School of Medicine did the research. They were seeking to understand the basic biology of depression, and in particular the role of glutamate, a chemical that carries electrical impulses in the brain. Knowing that ketamine, an anesthetic, triggers glutamate production, they gave ketamine to patients with major depression.

To the amazement of the researchers and the patients, patients given ketamine felt better right away. The study, titled Antidepressant Effects of Ketamine in Depressed Patients, was published in 2000.

Nothing much happened, for a time.

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That’s the opening of my latest story for Medium. It grew out of an encounter with Dr. John Krystal, the chair of the department of psychiatry at Yale Medical School and perhaps the world’s leading expert on ketamine. Ketamine has been around as an anesthetic since the 1970s; it was used on the battlefield of Vietnam.

I heard Dr. Krystal, a careful and soft-spoken scientist, speak at the Psychedelic Science 2023 conference in Denver in June, and followed up with a phone interview. With his colleagues at the Yale school of medicine, Dr. Krystal discovered its anti-depressant qualities by accident. Their research laid the groundwork for today’s sprawling and largely unregulated ketamine industry. It’s remarkable to me how little we know today about ketamine—although there’s no doubt that it has brought relief to thousands of people suffering from depression.

Dr. Krystal is also the co-founder of a startup that aims to improve the durability of ketamine treatments, which would have the effect of lowering their costs and improving safety. You can read the full story here.