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Elon Musk's Ketamine Use

<ѻý class="mpt-content-deck">— Musk says his prescription for the drug helps him get out of a "depressive mind state"
MedpageToday
A photo of Elon Musk

Earlier this week, Elon Musk told Don Lemon in an that he has a prescription for ketamine that he uses when he experiences a "negative chemical state in my brain."

Musk said he uses "a small amount once every other week, or something like that," and insisted it's "a real prescription from a real doctor."

"There are times when I have ... a negative chemical state in my brain, like depression, I guess," Musk told Lemon. "Depression that's not linked to any negative views. And then ketamine is helpful for getting one out of a negative frame of mind."

While he doesn't consider himself to have "a case of extended depression," he said that "once in a while I get into sort of a depressive mind state," which he blamed on his genetics and on "chemical tides in your brain."

Musk insisted he doesn't drink alcohol, and referenced an earlier interview with podcast host Joe Rogan where he says he attempted to smoke pot: "Anyone who smokes pot can tell I don't know how to smoke pot," he said.

When Lemon pressed him on whether he abused ketamine, Musk said, "I don't think so. If you use too much ketamine, you can't really get work done. I have a lot of work," noting it's typical for him to work 16-hour days. "I don't have a situation where I can be not mentally acute for an extended period of time."

He insisted his use of ketamine has no detrimental effects on investors or his big government contracts, noting how Tesla is "worth about as much as the rest of the car industry combined, from nothing."

"So from an investor standpoint, if there's something I'm taking, I should keep doing it," Musk said.

Last summer, the that Musk was taking ketamine. Musk subsequently tweeted that he believed ketamine was a better treatment for depression than more commonly prescribed antidepressants, according to an updated version of the article.

"The reason I mentioned the ketamine prescription on the X platform was because I thought, maybe this is something that can help other people," Musk told Lemon.

While ketamine is growing in popularity, its place in treating depression is still not established. Earlier this month, the American Psychiatric Association told ѻý that the proliferation of ketamine clinics in the U.S. has veered far off course from the association's recommendations when it comes to treating mood disorders.

Only one ketamine product -- the nasal spray esketamine (Spravato), made by Johnson & Johnson -- has been approved for treating a mood disorder by the FDA. It's for use in adults in conjunction with an oral antidepressant for treatment-resistant depression or major depressive disorder with acute suicidal ideation or behavior. In addition, it's only available through a Risk Evaluation and Mitigation Strategy (REMS) program.

Regardless, physicians can write off-label for any medication that they want, including ketamine, Smita Das, MD, PhD, MPH, of Stanford University in California and a spokesperson for the APA, told ѻý.

While she couldn't comment directly on Musk's treatment, she noted that more clinics are now also offering ketamine in sublingual or oral formulations, adding that "with any drug or medication, there are many ways people can use it."

While ketamine has long been perceived to be a safe drug, Das said there are risks, including -- albeit rarely -- paranoia and suicidal ideation.

"The real risk is a bad trip," Das told Medpage Today. "It can also sometimes lead to worsening of psychiatric conditions."

Indeed, when actor Matthew Perry died last year, the Los Angeles County medical examiner determined his death was chiefly due to the "acute effects of ketamine."

Das said that she was "encouraged" that recent media attention on ketamine is "increasing the dialogue around mental health, where people can speak openly about depression, and we can start to break down barriers to care."

However, she said, that care should stick to evidence-based guidelines, and patients should first try evidence-based treatments before going to ketamine, including cognitive behavioral therapy and selective serotonin reuptake inhibitors (SSRIs) "or a combination of those -- before people spend their time and energy on a solution that's not proven yet."

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    Kristina Fiore leads ѻý’s enterprise & investigative reporting team. She’s been a medical journalist for more than a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW, and others. Send story tips to k.fiore@medpagetoday.com.