It's a chameleon in a bottle. A drug with a spotty, not so pleasant history.
Ketamine became a potent pain reliever for soldiers in Vietnam. The drug then became known as a date rape drug, and most recently, the psychedelic club drug, Special K.
Dr. Malone is head of Adult Psychiatric Services and Director of the Psychiatric Neuromodulation Center at The Cleveland Clinic.
He also serves as the president of the Cleveland Clinic's Lutheran Hospital, where Ketamine treatments, for those suffering from severe depression, are taking place right now.
"We would go to the pharmacy at Lutheran. The nurse would go get the medication and then provide the infusion," Malone said. "You would have a certain amount of monitoring during the treatment and for some time after the treatment."
Malone said without FDA approval, Ketamine is considered an innovative treatment option and part of ongoing research at The Cleveland Clinic.
"Now we have a large study underway looking at it in severely depressed patients," he said.
It is not a standard there or anywhere.
"The jury is still out. It's important not to overstate what we know and how comfortable we are yet," he added.
That's why Malone and others, are critical of the Ketamine clinics popping up just about everywhere. Some right here in Ohio.
"Right now, Ketamine should be used in places that are used to treating severe depression, that are used to using medications like this, treating severely ill patients and who are doing it under carefully controlled circumstances. Anything other than that? I would not recommend," he said.
"Patients are desperate. Suicide is the leading cause of death in a number of different age groups. Depression is a serious illness and people who have it feel hopeless and desperate and they will do anything to feel better. But as a medical community also have the obligation to make sure we aren't giving treatments that have no valid reason. To assure that we have to study them carefully, he added.
To become a standard depression treatment, a lot more research needs to be done. The Cleveland Clinic is a part of that but warns that in the wrong hands, the drug is still considered dangerous.