I am not alive today because of the Australian Health Care System, I survived despite it. Actually I
haven’t just survived, I have restored a quality of health that in many ways is better than what I had
before I became sick. Based on the severity of my mental illness and comorbid conditions,
statistically my life expectancy is age 49. In April of this year I turned 47, and I’m having the best year
of my life. Hands down, there is not another person on this planet who has experienced anything
like what I have over the last 7 years. It’s not a happy story, it’s one that isn’t over by a long way, and
it is one that people need to hear.
I survived because I refused to believe that the treatment solutions offered in Australia are the best
options worldwide. I reached a point when my doctors told me that my life was as good as it was
going to get, I told them that I’d be my own Doctor from here. I researched and I travelled the world.
I found out very quickly that Australia doesn’t have the best mental health treatments, in fact the
best options exist in only one country, the USA. Why ? The World’s Biggest Health Care Economy
demands the best. I could list out 10 different treatments, that people wouldn’t believe exists, but
they do. Today, I only want to talk about my favourite one – Ketamine.
Ketamine is a synthetic compound that has been used since the 1970s as an general anaesthetic. It is
widely used in Australia in Hospitals and Ambulances (and Vets). As well as its long track record as a
safe anaesthetic, ketamine is also safely used off-label for the treatment of chronic pain conditions
such as fibromyalgia and complex regional pain syndrome (CRPS). Many people know of ketamine as
a hallucinogenic and addictive street drug, which, when abused, can put people in medical peril.
However it is similar to the medical version in name only. Illegal versions may contain ketamine, but
they generally contain a number of other illegal drugs. Let’s just be clear that nobody is talking about
this drug mix being used to treat anything medically.
Ketamine provides rapid relief from depressive and suicidal symptoms in almost 70% of treatment
resistant depression (TRD) patients. Remember that TRD is used to describe the forms of depression
that do not respond to conventional treatments. So we are talking about providing relief to 70% of
people who currently suffer ! Symptoms can improve within minutes, with minimal side effects.
Treatment involves an intravenous micro-dose of ketamine given over about 40 mins. Remember
that existing antidepressant drug treatments have a therapeutic lag of 3–4 weeks, and about a third
of patients do not respond (Singh et al. 2018).
The benefits of a treatment can last up to several weeks, these include; a general sense of well-
being, and a much greater ability to cope with the daily stresses in life (Weinstock 2019). It can also make the patient more resilient to symptoms if a relapse occurs, and it can reduce the risk of future
suicide ideation (Weinstock 2019) (Andrade 2018). This is a really big deal, unless you live in
Australia. The use of ketamine for mood disorders is technically allowed here. In practice the rules
make it almost impossible for someone like me to get treated here. So I fly to the USA, to get treated
with the same drug as we have in Australia. The only difference is that in the USA they know it works
brilliantly, in Australia, the leaders of the mental health research organisations dispute the need for
Prozac in the 1970’s (US) and 1980’s (Australia) was last time we had a big impact medication for
mental illness hit the market. Big Pharma has been investing heavily into ketamine based products
since 2012. Ketamine is out of patent, 2 year’s supply of ketamine for my treatments cost $30. It also
reduces the need for other forms of antidepressants. Instead of promoting ketamine IV treatments,
the pharmaceutical industry has focused on developing a version of ketamine that they can obtain a
patent for, and thus make a larger profit on.
It’s been a long wait, but now the breakthroughs are happening in the USA. SPRAVATOTM by Jansen is
a version of Ketamine that they have patented. It is administered via a nasal spray in the doctors
office. It is marginally more effective than antidepressants for Treatment Resistant Depression (TRD),
but it is not as effective as ketamine IV. It was approved on 5th March 2019 in the USA. Cost$70,000 AUD a year !
Yes you read that right. Let me explain it a little differently. Jansen took a
drug that costs $15 a year, modified it to get a patent, and are selling it for $70,000 a year. It doesn’t
work as well but Jansen don’t hide that fact.
Our National Mental Health & Suicide Prevention Plan does not have a single strategic action on
improving the medication on the PBS ! Actually the PBS isn’t mentioned once. The plan is focused
on areas like Early intervention, Awareness, School Education, Media Guidelines, Headspace Clinics,
Speaking Therapies and Stigma reduction. The plan has excluded finding new medications, I can
barely write this without wanting to cry. People are suffering every day, but nobody in Australia is
looking for a better medication.
Jansen are close to an announcement on the use of SPRAVATO in Emergency Department’s for
people who are at a high risk of suicide. We can all guess the price. However let’s be very clear about
the problem we now have. We have made a conscious decision to hand the lead on medication
advancements to the pharmaceutical giants. Sage Therapeutics invests almost $400 million AUD a
year into the development of new medications. My calculation is that Australia in total invests
around $4 million.
There is a lot more to this story, but the point of my article today is this. Jansen, Pfizer and nearly all
other pharmaceutical companies worldwide, are only working on ketamine based drugs. You might
not like what Spravato offers to you as a patient, however it is what the medication future looks like.
The good news is that people are more aware that they have choices in society. We no longer blindly
follow advice, we like facts, we like to have a voice and we like to be heard. Suicide is the leading
killer of young Australians. Ketamine IV is the most effective treatment that mankind has ever had
for mental illness. I’ve not got this far in my recovery to turn my back on those sufferers who are not
as fortunate as me. I’ve got 7 years of experience in killing mental illnesses, but I have very little
experience in changing health systems. To do that I am going to need others who feel like fighting to
save lives. This is a battle we have to win, lives depend on it, maybe even yours.