Stat News reports on a rise in ketamine prescriptions via telehealth companies and the risk these prescriptions pose. Telehealth can save patients time and get them access to medical help they might otherwise struggle to get. But, ketamine prescribing through telehealth comes with several concerns.
One woman who suffers from depression, Kathy Wallace, had tried several prescription drugs, but none were working. Then, her psychiatrist prescribed a nasal spray, Spravato, that is similar to ketamine, which is a hallucinogen. But, Wallace couldn’t get to a clinic that offered Spravato, and off-label infusions of ketamine through a clinic cost $1,000 each!
Wallace discovered that she could use an online telehealth company, Peak, to get five doses of ketamine lozenges delivered to her home for $500. The Covid-19 pandemic loosened telehealth regulations to permit online prescribing of controlled substances such as ketamine. Peak, like several other companies, promotes ketamine for a variety of ailments and claims it is “proven safe, effective and affordable.”
Wallace had an ok episode with her first lozenge, but swallowed it instead of putting it under her tongue because no one had instructed her how to take it. She ended up feeling a bit nauseous. Then, Peak closed down, and Wallace was left wondering about the company.
Experts are concerned about the misleading way online companies are marketing ketamine. Ketamine might not deliver good outcomes. Patients who take ketamine without medical supervision could be putting themselves at serious risk. Of note, the FDA has only approved ketamine for anesthesia, not for treatment of psychiatric disorders.
On top of that, little is known about whether ketamine taken at home in lozenge form is effective or safe. In lozenge form, ketamine does not metabolize in your body in the same way as a nasal spray or an injection. And, many online telehealth companies prescribing it do little if any patient monitoring during the sessions.
What is known is that if you have high blood pressure or a psychosis diagnosis, you should not be taking ketamine.
It’s not yet clear whether online prescribing of ketamine will continue without an in-person patient visit first. Unless Congress or the DEA intervene and the law changes, as of the end of the public health emergency–now scheduled for January 11, 2023–online telehealth prescribing of ketamine is expected to come to a halt.
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