A commendably to-the-point article in the Guardian last December put it like this: “A radical ketamine-like drug has been licensed for use in the UK for severe depression, a decision that offers hope to the millions of patients for whom conventional treatments have failed. Esketamine, taken as a nasal spray, is one of the first rapid-acting drugs for depression and the first in decades that is thought to work in a fundamentally different way in the brain. However, psychiatrists are divided on the benefits, with some hailing esketamine as a game changer and others raising fears about the potential for addiction and abuse.”
There’s only one word out of these 89 that I’d quibble with, and that’s the ugly, made-up adjective “ketamine-like”. If you believe the drug’s supporters – the ones hailing it as a game changer – esketamine has significant chemical differences to ketamine. These mean that it’s metabolised faster, while, unlike its prefix-free parent, it doesn’t bind to sigma receptors in the brain. As for those raising fears about the new treatment’s potential for addiction and abuse, many are inclined to see the difference between the two drugs in terms of profit margins.
“Some hail esketamine as a game changer, while others raise fears about the potential for abuse”
The analogy here might be with Spice. Yup, Spice: the fake weed you see homeless people monged out on. You’ll remember that Spice was introduced as a so-called legal high, before the government tightened up legislation to make tweaking illegal intoxicants to render them technically legal, um, illegal.
I’m sure Janssen, the company pushing esketamine, won’t thank me for the comparison, because one of the biggest PR problems it faces is that its potential money-spinner sounds very much like a recreational drug currently popular among Brit yoof. A drug of which it’s said, when people take too much, “Ooh, he’s in a K-hole.” How can this down-and-dirty description be squared with the shiny, happy world of marketing Big Pharma?