Ketamine is an anesthetic agent, used off-label as a novel, rapid-acting antidepressant. For many people with treatment-resistant depression, ketamine and Spravato (an FDA-approved version of ketamine) are life-changing. But isn't ketamine that drug people take at raves? Isn't it addictive?

When ketamine is delivered in a controlled clinical environment, the risk of addiction is extremely low. However, ketamine does have abuse potential, with misuse occurring primarily outside medical settings—recreationally, at high frequency, and at doses far above antidepressant doses. Fortunately, there have been no cases of ketamine addiction developing within clinical trials for depression. Furthermore, long-term follow-ups show no development of physiologic dependence, even after months to years. Studies have also shown that ketamine's addiction potential is markedly lower than benzodiazepines, stimulants, cocaine, and opioids.

However, the risk of ketamine addiction is not zero. The tragedy surrounding Matthew Perry’s death is a grave reminder. Perry had a long history of polysubstance dependence, and sadly began using more and more ketamine........

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