With Elon Musk in the White House, it’s important for all Americans to have a clear understanding of the effects, risks, and potential benefits associated with the use of the drug ketamine.
In his interview with Don Lemon, Musk claims to have used ketamine at least on a monthly basis, perhaps more. He claims his ketamine was prescribed by a “real doctor” and that he typically takes micro-doses of the drug, which would be about 0.1 to 0.2 mg ketamine/kg bodyweight if administered intravenously, roughly a 10 mg dose; this would be about 10-20% of the dose required for human anesthesia. Musk has admitted to trying larger doses occasionally.
We have no reliable information about the frequency, dosage, or route of administration associated with Musk’s actual ketamine use. Tolerance to ketamine builds quickly, and repeat users tend to progress towards higher doses over time. The late Matthew Perry also got his ketamine from a real doctor.
While it is true that ketamine therapies have helped people dealing with major (suicidal) depression or trauma, it is important to understand the caveats associated with its use. Since we are talking about a drug that occupies receptor sites in Musk’s brain at least part of the time, what are the risks—both to Musk and to The United States of America? Understanding ketamine’s action and risks requires a basic understanding of its neuropharmacology. We’ll get back to the potential benefits of this drug at the end.
Ketamine, a dissociative anesthetic, was originally synthesized in the 1960s. Even today it is used to immobilize animals in veterinary medicine, and in human anesthesia, where it has the significant benefit of not being a respiratory depressant like most other anesthetics. Ketamines are structurally and functionally related to phencyclidine (PCP or “angel dust”). Both drugs act in the brain as blockers at the NMDA type of glutamate receptor, which is an obligatory participant of many molecular processes critical for learning and memory.
This receptor blockade is activity-dependent, which means that the particular NMDA receptors being used by the brain at the time of ketamine exposure are blocked preferentially over the inactive ones. The main difference between the street drug PCP and the pharmaceutical ketamine is that PCP interacts more strongly with the receptor, so the effects last much longer, and side effects develop faster. A cursory search of the internet will turn up horrific case reports of PCP overdose and abuse. When a wave of PCP abuse broke out in the Washington DC area in the late 1970s, the drug was nicknamed “The key to St. Elizabeths’”— a reference to the historic psychiatric hospital in DC, formerly known as The Government Hospital for the Insane.
Attempts to model schizophrenia in animals have a long neuropharmacological history. In experiments performed in laboratory animals, chronic treatment with ketamine or PCP is used as a model for schizophrenia because the blockade of NMDA receptors with PCP or ketamine in animals reproduces many of the symptoms. Some researchers claim that chronic treatment with dissociative anesthetics is the single best animal model for schizophrenia.
The negative effects of acute ketamine use are also borne out in the streets or in clubs, where unknown doses and formulations of ketamine are taken by various routes of administration. The negative effects of high-dose ketamine are well established. If one wishes his brain to function optimally, the K-hole is not be a good place to visit frequently. While it is difficult to overdose fatally on ketamine, the cases of Matthew Perry and others illustrate how this can occur in some circumstances. Large acute doses of dissociative anesthetics cause pathological changes in the brain. These lesions are famous enough to have a Wikipedia page.
Perhaps worse are the chronic effects of dissociative anesthetic use. In animal models and in humans, ketamine unequivocally causes damage to the brain, kidneys, and urinary tract and it negatively affects thinking processes. Ketamine literally reduces the amount of brain gray matter, leading to outward neurological symptoms, such as slurred speech. Such changes can occur even in people using sub-anesthetic doses chronically. With repeated ketamine use, some of the changes to the body can become irreversible.
Some might speculate that Musk’s thinking processes are already showing signs of such degradation. During the Don Lemon interview, Musk’s eyes exhibit bouts of nystagmus (rapid back-and-forth movements). Musk’s nystagmus is especially obvious in the parts of the interview when he lies—such as when he denies he is planning to donate to Trump. The nystagmus reappears when Musk discusses his ketamine use.
Musk claims that ketamine helps him to repair his “negative chemical state” and treat his depression. According to Elon, it’s good when he takes ketamine. Investors in Tesla and other Musk ventures should be happy because the head of the company is seeking treatment for his mental issues, empowering him to make the best decisions on their behalf—rather than do something suicidal and tank the stock.
Musk likes to mention that some people struggling with suicidal depression or trauma have tried traditional antidepressants and other types of therapy, with no relief. Nothing helped them get out of their dark place until they got a dose of ketamine. And, unlike other therapies for depression, relief comes quickly.
I’m not condemning ketamine when it is used as a maneuver to prevent suicide or other harm. Sometimes, ketamine infusions bring a rapid anti-depressive benefit that no other therapy can replicate. The positive effects can persist for days or even weeks afterwards, but later “maintenance doses” are eventually required. Once a ketamine tolerance has developed, users tend to take more to alleviate withdrawal symptoms, similar to other addictive drugs.
If Musk’s brain is in a state of major depression so severe that it merits ketamine therapy, then he is not fit for further employment by the US government. Such types of low-performance employees should not be awarded government contracts, nor should they be retained among the best and brightest within the Department of Government Efficiency. They should be terminated and deleted from government employment.
UPDATE: thanks to all of the commenters. I changed the last sentence so that it cannot be misconstrued. I came across a new factoid that appears to be relevant to the subject(s) of this diary. Alexandria Beynon has been named as one of the DOGE staffers employed by Musk to ransack our government. According to this article, Beynon’s other job is “Head of Engineering” at her husband Dylan’s company Mindbloom.com, which specializes in at-home ketamine therapy. Probably just a coincidence. Many more details about this can be found in a subsequent diary, The American Disease, Season 2025
