Ketamine is an anesthetic and painkiller that has been in use for over 50 years. It is not covered by the Narcotics Act. There is a broad range of studies on the use of ketamine in mental illnesses, especially in the treatment of treatment-resistant depression. The esketamine-containing nasal spray Spravato® is currently the only product approved as an add-on for treatment-resistant depression. It is currently still very expensive and is not covered by all health insurers. We use ketamine i.v. via perfusor under anesthesiological supervision. This allows a patient-specific dosage to be administered and the treatment can be discontinued at any time. Ketamine i.v. is used here as an “off-label” drug, which is explicitly explained. In contrast to conventional psychopharmacotherapy, ketamine is only used in a few targeted individual doses as part of the therapy; there is no substitution treatment with continuous intake, as is the case with antidepressants, for example.

Ketamine has been used for over 50 years. It has few side effects and is safe to use. For example, there are no changes in respiratory drive. There is a low dependence potential, which mainly affects people with existing substance use disorders. This risk is explicitly clarified in the preliminary discussions.