A patient with bipolar I disorder and a long history of substance dependence used large daily doses of ketamine (1-3 g) for five years. He reported acute antidepressant effects and reduced cravings for alcohol. Although his use was unsustainable and led to inpatient admission, he experienced no withdrawal syndrome and showed no observable cognitive deficits after stopping. This unique profile suggests that further research into ketamine's risks and therapeutic potential for mood and addiction disorders is warranted.
The text discusses the tension between the urgent need for effective treatments for substance use disorders and the uncertainty surrounding the efficacy and safety of psychedelic-assisted therapy. It highlights the potential benefits of using psychedelics in therapeutic settings while emphasizing the lack of conclusive evidence and the need for rigorous research to address gaps in knowledge. The authors call for a balanced approach that acknowledges both the promise and the risks, urging careful consideration of ethical, clinical, and regulatory challenges before widespread implementation.