Ketamine is now being used to help people with treatment-resistant depression in Newcastle, marking a new era in medicine and providing fresh hope for those suffering with mental illness.
The medicine is being offered to people who have tried many other treatments without lasting success.
The drug, called Spravato (esketamine), is a derivative of ketamine.
Nicknamed "Special K", ketamine has long been used as a party drug and anaesthetic. Researchers have found that it also has rapid antidepressant effects.
Fletcher's Justin Scanlon, 42, is among the first people in Australia to access the nasal spray treatment through psychiatrist Stuart Saker at his Brain Save clinic in Broadmeadow.
Dr Saker said the ketamine treatment was going well and the patients were "pioneers".
"Our first patient said she laughed for the first time in six years. It's really nice to hear something like that," Dr Saker said.
Mr Scanlon, diagnosed with depression in his early 20s, said the ketamine treatment was going "really good".
He said the treatment made him think "it's all right and I can keep going" and "what will be will be".
During a treatment session, he self administers a spray in each nostril three times over a 15-minute period, with a mental health nurse observing him and checking his blood pressure.
Mr Scanlon said the drug gave him a "nice feeling", put him in a "good place" and acted as "a reset" for the mind.
"It stops the mind having all the thoughts at the same time. I'm able to just be, which is good," he said.
Mr Scanlon had tried more than 20 antidepressants but the side effects, such as weight gain and nausea, were often difficult to live with.
"There's not an antidepressant I haven't taken. There's none of those icky side effects with this treatment, which is great," he said.
Dr Saker said ketamine was a "widely used anaesthetic agent, particularly where ventilators are not readily available in developing countries and in veterinary medicine".
The drug gives people "a pleasant dissociative experience".
"It's called going down the k-hole. Esketamine has a similar effect. But it's not being used for that purpose. It's being used for its antidepressant purpose," he said.
Dr Saker trained in Israel to use psychedelic drugs for therapy. Before patients take the medication, he discusses their mindset and "what they want to change".
The patients continue talking therapy after the experience, going through a process called "integration".
"This is about what they're going to take from the medication into their normal life," he said.
Patients being given the medication in Newcastle have "very significant treatment resistant depression".
"They've all had 10 to 20 antidepressants, TMS [transcranial magnetic stimulation] and ETC [electroconvulsive therapy] and are frequently suicidal."
The patients are part of an early access program, which involves the manufacturer paying for the medication.
Ketamine is known as a "dissociative" drug in the psychedelic class of substances.
Spravato, sold by pharmaceutical company Janssen, costs about $11,000 over four months.
The psychiatric community hopes costs for psychedelic medicine will fall, as more drugs are approved for mental health treatment.
Other psychedelics - such as psilocybin and LSD - are increasingly being used for mental health treatment in the US and other countries, with clinical trials showing remarkable results for conditions such as depression, PTSD and anxiety.
The Therapeutic Goods Administration [TGA] is considering MDMA [ecstasy] and psilocybin [magic mushrooms] for the treatment of mental, behavioural and developmental disorders in Australia.
Esketamine is approved in Australia for treatment resistant depression in adults who have not responded adequately to at least two different antidepressants.
Dr Saker said patients often have more than one condition.
"We deal a lot with military veterans. They often have PTSD and treatment resistant depression," he said.
Dr Saker is pleased that the Department of Veterans' Affairs approved the treatment for one of his patients.
Esketamine is given twice a week for four weeks, then once a week for the same period and then maintenance treatment.
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