That’s a very inconsistent logic. LSD failed due to its uncontrolled mass distribution which should have never happened. Early lab experiments were very promising, and LSD is slowly coming back (check out MAPS).

Ketamine has been in production for decades as an anesthetic, so saying that it’s a fad because it won’t make companies rich is nonsense.

Delivering ketamine will make a lot of people rich. It probably already has for a few people. Opening a depression clinic will simply involve having a bunch of rooms (or maybe just a bunch of chairs) for people to trip in, a nurse on duty, and a doctor somewhere on the letterhead. Medicare et al. will be charged hundreds an hour for each occupied room.

have you checked out the prices for esketamine, the FDA-approved version? the markup is about 10000%.

The nasal spray? An anesthesiologist told me that it's 1/10th as effective as IV therapy due to some aspect of bioavailability and how it ultimately didn't produce the same sort of norketamine levels required.

edit: For context, he subsequently complained of how big pharma was conspiring to destroy ketamine iv therapy access in order to better control the "legal ketamine" market.

IV is not 10x more effective than intranasal - it's maybe twice as effective.

IV bioavailability is 100%, intramuscular 93%, intranasal around 50%, and oral around 20%.

This is something I just don't understand about IV ketamine therapy - IV protocols vary wildly, and I haven't been able to find any reasons why IV would be more effective than any other route of administration with an increased dose.