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LAST week, the US Food and Drug Administration approved a form of ketamine for use in treatment-resistant depression. This is a landmark moment. Esketamine, as it is known, is the first novel drug therapy for depression to emerge in over 50 years.

People will administer the esketamine themselves, under the supervision of a healthcare professional, by squirting it up their nose. At first they will take it a few times a week, then monthly.

Given that ketamine use can escalate to addiction, there are fears that people taking the drug medicinally could turn to illegal recreational suppliers, as has happened in the US with opioids, leading to a crisis. Will we soon have a ketamine epidemic too?

Thankfully, the evidence so far suggests that people treated with esketamine don’t go on to become addicted to ketamine. And none of them developed the severe consequences seen in some daily ketamine users like bladder dysfunction and psychosis.

Janssen, the company that developed the drug therapy, conducted trials with people who have depression that is resistant to treatment, which is about 30 per cent of cases. This kind of severe depression often renders people unable to speak, get out of bed or engage with the world. Yet within minutes of being given ketamine, many are transformed: smiling and full of life.

When prescribing any drug, there is a cost-benefit analysis. The rapid action of ketamine means it can save lives when given to people having suicidal thoughts.

But there are important caveats: repeated doses of ketamine are needed to maintain effects, and some people may stop responding to it. The clinical trials treated people for up to a year, but we don’t know what happens if treatment extends beyond that.

What we do know is that, as depression is increasingly common globally, there is an urgent need for new treatments.

Forewarned by the opioids crisis, we must not be complacent. Clinicians, carers and those taking the drug should vigilantly monitor ketamine treatment. And we should study all outcomes, so we see this exciting therapy safely given to the people in direst need.