I've been intrigued to read more and more about ketamine being used as a short acting anti-depressant for elderly people. And while I have quite mixed feelings about this, my gut reaction is that it is wrong.
Why the mixed feelings? Old age is depressing in our culture. Elderly people tend to be institutionalized in nursing homes, and elder abuse is increasingly recognized as a problem. Nursing homes are typically run to make a profit by undertrained and underpaid staff. With little respect in our society, minimal contact with the outside world, and very little to occupy themselves, it is no wonder that depression is rampant in the elderly.
And in today's culture of treating mental health problems with pharmaceuticals, anti-depressants often take weeks or even months to improve mood, leaving elderly people languishing in a state of hopelessness. The discovery that ketamine works almost instantly to lift the mood, with sometimes long term positive effects after a single dose, seems like a quick fix. So why the hesitation?
Firstly, not everyone has positive effects from ketamine. Falling into a k-hole can be a terrifying experience, in which you are unable to communicate with those around you. Even slightly over-shooting a ketamine dose can result in the heart stopping. And perhaps more importantly, I can't help thinking that ketamine is a very convenient way to control elderly people in a drugged state, in which they are unable to move, speak, or resist whatever is done to them.
I also have serious reservations about the ability of many elderly people to make an informed decision about use of ketamine -- how much are they told about the drug, its effects, and why it is being offered to them? How able are they to understand what they are consenting to? And are they even given the opportunity to refuse drugs such as ketamine?
We need to think seriously about these issues and carefully explore other options for therapeutic approaches to supporting our elderly, before we run headlong into the mass drugging of a whole generation.