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The Vitals | Pioneering Ketamine Treatment for Depression

The Vitals episode brings together Mount Sinai psychiatrists to discuss ketamine’s emergence as a fast‑acting antidepressant and its expanding role in treating depression and PTSD. Dr. Dennis Charney recounts the mid‑1990s Yale experiments that showed a single sub‑anesthetic ketamine infusion lifted mood within hours, a finding later replicated at NIMH and validated by larger, multi‑site trials that used midazolam as an active placebo. These studies demonstrated efficacy in patients who had failed conventional monoamine‑based drugs, leading to FDA approval of the intranasal formulation Spravato. Clinicians share vivid patient anecdotes—a 50‑year‑old woman who felt “a weight lifted” after one infusion and a 9/11 responder whose trauma‑triggered anxiety subsided after repeated doses—illustrating ketamine’s rapid impact on both depressive and PTSD symptoms, including nightmares and intrusive memories. The data reshapes psychiatric practice by offering an alternative to weeks‑long antidepressant regimens and electroconvulsive therapy, prompting ongoing research into optimal dosing schedules and broader indications, while raising questions about long‑term safety and accessibility.