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Elon Musk and Ketamine: Mental Health or Chaotic Decisions?

Since Elon Musk, the richest man in the world, stated in an interview that he regularly takes ketamine to treat depression, a ketamine craze has swept across the North American continent. Some are curious about what ketamine does to Musk’s brain and how it affects or could affect his behavior and decisions, while others are interested in how to obtain a drug that can be abused. Musk stated that he takes it every other week, and when asked by a journalist if he has ever abused the drug, he replied:

– If you use too much ketamine, you can’t get the job done. I work sixteen hours a day, so I can’t be mentally checked out for too long. There are moments when I have some kind of negative chemical state in my brain caused by depression, and ketamine is useful for clearing that negative state of mind.

Investors want this

He added that investors in his companies should want him to continue taking the drug.

– From Wall Street’s perspective, the result is what matters. Tesla is worth about as much as the rest of the automotive industry combined, and as far as investors are concerned, if there is something I take, I should continue taking it – Musk stated.

However, not everyone is convinced. The Wall Street Journal reported that Musk recreationally uses the drug, while the New Yorker noted that Musk’s associates are concerned that ketamine, along with his isolation and deteriorating relationship with the media, could contribute to his tendency for chaotic and impulsive decisions. Musk responded in a post on X that it is tragic that the New Yorker journalist who wrote this is a lackey of the political lobby that controls part of American society and works against the people. This was last year.

Ketamine is a drug primarily used in hospitals as an anesthetic, and it has recently been increasingly researched as a potential therapy for depression, anxiety, and other mental health issues. It is also a dissociative drug because people can feel detached from their bodies and emotions and lose their sense of time during the elevated state, which lasts about an hour after taking it. This realization has prompted many Americans to question how ketamine use affects Musk’s decisions, especially since he became one of the main collaborators of American President Donald Trump.

Musk, the head of the newly established American Department of Government Efficiency, or DOGE for short, possesses not only economic but also global political power, which is why his cognitive and mental health concerns not only the shareholders of his companies but also his fellow countrymen. Musk tirelessly posts on X late into the night, emails government employees, and makes unusual statements to the media, raising questions regarding his potential drug abuse. However, it is questionable how much ketamine use actually plays a role in Musk’s decisions and statements, and how much his political orientation and power do.

Epidemic of Mental Illness

Ketamine is reportedly popular among the tech elite of Silicon Valley, and it is also used in some wellness-centers, such as those for leadership development, corporate team building, or couples counseling. According to a report by Globe Newswire, the value of the ketamine market in the U.S. is expected to reach $6.90 billion by 2030. Just two years ago, this market was valued at $3.5 billion, and its growth has been driven by increased awareness of the importance of mental health, especially since the coronavirus pandemic, the ongoing opioid crisis in America where addiction to strong painkillers is rising, and the increasing number of ketamine clinics across the U.S., resulting from the growing number of individuals with mental health issues. According to SAMHSA (Substance Abuse and Mental Health Services Administration), approximately 19.86% of adult Americans, nearly 50 million people, had some form of mental illness in 2022, with 4.91% experiencing severe mental health issues.

Far from Reality

Research has yet to determine the consequences of long-term ketamine therapy, but older studies on recreational users show concerning effects. Professor of psychopharmacology at the University of Exeter in the United Kingdom, Celia Morgan, tracked 120 recreational ketamine users throughout 2010. According to the study’s results, even rare users, those who took ketamine only three times a month, were more delusional (detached from reality) than former ketamine users, those who used other drugs, and those who did not use any drugs at all – they believed they were the only recipients of secret messages or that the world and the people around them were specially tailored to them. Morgan also created a psychological profile of frequent ketamine users: they had significant impairments in short-term and long-term memory and were extremely detached from reality. The fact that ketamine can lead to addiction is confirmed by an example from the United Kingdom, where more than two thousand people sought treatment for ketamine addiction in 2023.

Anesthetic and Analgesic

However, ketamine is very useful as an anesthetic drug that has a wide application in abdominal surgeries, which are the most common of all surgeries, especially in the case of cancer patients, as noted by Croatian scientists. In the scientific paper ‘Application of Lidocaine and Ketamine in Abdominal Surgery,’ authored by Dr. Helena Ostović, MD, and colleagues from the Department of Anesthesiology, Resuscitation, and Intensive Care at Dubrava Clinical Hospital in Zagreb, it states: ‘Ketamine exerts its anti-inflammatory effect at subanesthetic doses, acting directly on the immune system and indirectly as an analgesic. Its direct action is achieved by reducing levels of C-reactive protein (CRP) and IL-6 in serum and inhibiting nuclear factor-kappa B (NF-kappa B) and activator protein 1 (AP-1) that regulate the transcription of genes responsible for the production of pro-inflammatory factors. Acting as an analgesic, ketamine enhances analgesia with opioids while reducing overall opioid consumption. The standard treatment procedure in abdominal surgery involves the use of minimally invasive surgical techniques and ERAS protocols with an emphasis on multimodal analgesia. Lidocaine and ketamine make a useful adjunct therapy to opioids, and since they are inexpensive and long-established drugs in anesthetic practice, they are easy to implement clinically. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, is an intravenous anesthetic with analgesic properties. Unlike other intravenous anesthetics, it has gained traditional popularity due to its cardiostimulatory effect, making it the best choice in emergency interventions for patients in shock. In recent years, like lidocaine, it has gained importance as an adjunct to opioid therapy. It has been shown to reduce the need for opioid analgesics, the intensity of acute pain, and the occurrence of residual pain six months after major abdominal surgical procedures. However, the downside of ketamine is that it has psychomimetic activity with neuropsychiatric manifestations, which is the main reason for its limited use.’

Additional Effects

Ostović also notes that ketamine was synthesized in 1962 by chemist Calvin Stevens (1923 – 2014) in the Parke-Davis research laboratory in Detroit, Michigan, under the identification name CI-58145. She continues: ‘It entered clinical trials in 1964 under the guidance of pharmacologist Edward Domino (1924 – 2021) and anesthesiologist Guenter Corssen (1916 – 1990). As ketamine hydrochloride, it was patented under the brand name Ketalar, and this was the first ketamine preparation that the U.S. Food and Drug Administration (FDA) officially approved for clinical use in humans in 1970. After that, it gained wider application as an anesthetic for treating soldiers in the Vietnam War, having previously been primarily used in veterinary medicine. It appears on the market as a racemate and as an isolated S(+)-enantiomer of ketamine. The racemic mixture contains equal parts of R(–)-ketamine and S(+)-ketamine and is characterized by sympathomimetic properties and causing dissociative anesthesia. The characteristics of the isolated S(+)-ketamine include nearly four times the affinity for NMDA receptors and almost double the analgesic effect with fewer side effects related to cognitive dysfunction.

Pharmacologically, in addition to primary NMDA antagonism, ketamine has additional polyreceptor activity that contributes to its unique effects. It can be administered in various ways, and in abdominal surgery, its application in subanesthetic doses via continuous infusions is extremely useful. Ketamine possesses anti-inflammatory properties that it exerts by acting directly on the immune system and indirectly as an analgesic. The basis for this mechanism is the potentiating interaction of the immune and neurological systems, where postoperative pain resulting from neural transmission of incisions in somatic and visceral tissue increases the production of pro-inflammatory cytokines and vice versa. The direct anti-inflammatory effect of ketamine encompasses various segments of the immune response, among which its inhibitory effect on stimulated macrophages, the function of activated neutrophils, and their diapedesis to the site of inflammation, as well as the production of pro-inflammatory cytokines are important…’ Part of the text from the scientific paper is reproduced with the permission of the author, Dr. Helena Ostović.

From Daydreaming to Amnesia

In Croatia, ketamine is also used as a drug, especially among the youth. According to the Office for the Suppression of Drug Abuse of the Government of the Republic of Croatia, it is classified as a club drug, a pharmacologically heterogeneous group of psychoactive substances often used by teenagers and young people during night outings; it is most commonly snorted or injected intramuscularly. Intoxication at lower doses causes reduced attention, learning, and memory abilities. In larger quantities, ketamine can cause daydreaming and hallucinations, as well as delirium and amnesia, and can also impair motor functions, cause high blood pressure, and potentially fatal respiratory problems. Its trafficking and production are criminal offenses in Croatia.