What Do We Know About Depression? Update

Since I wrote my first blog about this question, the FDA has in fact approved the nasal-spray form of ketamine for treating severe depression.  But as I stated in the blog it has been little studied and we certainly do not know its long-term effects and efficacy.  Thus it is with some dismay that almost immediately after the announcement I read a New York Times article by a psychiatrist advocating, on the basis of his own admittedly scanty evidence, that it be used as part of therapy for severe anxiety.  This seems like jumping the gun.  The lobotomy craze of the 1940’s and 1950’s which I detail in my memoir Examined Lives was just such a rushing into a possible solution.  Obviously taking ketamine is not equivalent to having a lobotomy, but the same mechanism of seeking an answer to a very serious problem without a full understanding of the answer is at work.  Walter Freeman himself, the popularizer of lobotomies in the United States, even late in life suggested patients be given a lobotomy as a help in the talk therapy process.  Thank goodness common sense prevailed at the time.

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