Abstract
Since the first reporting of ketamine's antidepressant effects in 2000, there has been growing public interest in this novel rapid-acting treatment for depression despite its abuse potential. Online media is an increasingly popular way for the general public to source information. Our objective was to examine how online news outlets have portrayed ketamine as an antidepressant by ascertaining the volume and content of relevant articles and trends over time. In this semi-quantitative study, we identified articles regarding ketamine's use in depression from the 30 most popular English-language online news-generating sources over 18 years (2000-2017). Articles were then blindly assessed by 2 independent raters, who analysed the texts by quantifying the presence/absence of 12 content items. We identified 97 articles, the number of which has increased since the first online news report in 2006. Most (69%) came from the USA and nearly all correctly stated the indications for ketamine. About half of the most recent articles mentioned abuse potential and 27% of articles referred to risks of unregulated use of ketamine. Just under 20% of articles referred to the lack of evidence regarding direct comparisons between ketamine and other currently available antidepressants. There was no difference in the overall level of detail within the articles during the study time period. Online news media articles have been generally positive about ketamine for treating depression but need to be interpreted with caution as many of them did not discuss negative aspects of ketamine and made unsubstantiated claims about ketamine.
Highlights
Ketamine is a dissociative anaesthetic drug that was approved by the Food and Drug Administration (FDA) in 1970 and is used routinely in both adult and child anaesthesia
Using Amazon.com’s Alexa web ranking service, we identified the 30 most popular English-language online news sources in July 2018
Popularity was determined by Alexa web ranking, which is based on the average daily time spent on each general site, the number of daily page views per visitor, the percentage of referrals the site receives from web searches and the total number of sites linking to the news site
Summary
Ketamine is a dissociative anaesthetic drug that was approved by the Food and Drug Administration (FDA) in 1970 and is used routinely in both adult and child anaesthesia. Since the initial reporting of a single slowly infused sub-anaesthetic dose of ketamine (0.5mg/kg) as a rapid-acting antidepressant in 2000 (Berman et al 2000), there has been growing interest in this potentially novel antidepressant. There have been multiple clinical trials of both single and serial sub-anaesthetic doses of ketamine that have supported its antidepressant effect (Kishimoto et al 2016). Ketamine acts as a noncompetitive antagonist of the N-methyl-D-aspartate (NMDA) receptor and targets the excitatory amino acid neurotransmitter glutamate (Maeng & Zarate, 2007). The precise antidepressant action of ketamine is not yet understood and may involve its metabolites, downstream signalling events and other receptor types, including α-amino-3-hydroxy-5methyl-4-isoxazolepropionic acid receptors as well as opioid receptors (Williams et al 2018; Zanos et al 2018)
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