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Type R-Ketamine is a form of ketamine that has rapid onset and sustained antidepressant effects without psychotomimetic side effects. It is more potent and has a more beneficial effect on decreasing dendritic spine density. R-ketamine is a safe antidepressant, with a longer-lasting effect than S-ketamine, without psychotomimetic side effects or abuse liability.

Esketamine has an extremely rapid onset, and symptoms of depression can improve within 4-72 hours compared to the gradual improvement of traditional antidepressants, which can take 6-12 weeks. Ketamine has an 85% success rate, which is almost double the success rate of traditional antidepressants (45%). It is highly effective for patients with treatment-resistant depression, even if they have had persistent symptoms for decades. Ketamine is the first emergency “anti-suicide” drug as it reliably and rapidly abolishes suicidal thoughts. Its antidepressant effects can last up to 30 days from a single intranasal spray.

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Administering the optimal quantity of ketamine is important as it can cause side effects even at subanesthetic dosage levels. In a recent study, four different dosage levels were tested in patients with treatment-resistant depression: 0.1, 0.2, 0.5, and 1 mg of intravenous ketamine per kg of body weight. The study found that single doses of 0.5 and 1 mg/kg were notably more effective in reducing depression symptoms over three days than an active placebo. However, after monitoring the patient for 30 days, there was minimal evidence of therapeutic benefit after the 5th day. The effects of the drug lasted between 15 and 30 days at 1mg/kg, but the effects were modest.

Some researchers believe that a non-psychedelic form of ketamine is needed, while others consider its psychedelic effects to be unique and crucial for treatment. Ketamine psychedelic therapy (KPT) uses the dissociative state of ketamine to address the underlying psychology of addiction. Companies like Buy MDMDA Canada, which are opening ketamine clinics across Canada, believe that the psychedelic effects are essential to their treatments.