News reports detailing Elon Musk’s drug use have prompted renewed attention to ketamine, a powerful anesthetic that has become increasingly popular as a therapy for treatment-resistant depression and other mental health issues.
Although Mr. Musk has acknowledged using ketamine in the past to treat depression, he has denied suggestions that he is currently using ketamine — or any other drug.
“I am NOT taking drugs!” he wrote last week in a social media post following the publication of an article in The New York Times that described reports of his use of drugs on the campaign trail last year. Those drugs included ketamine and other psychedelic compounds, among them MDMA and psilocybin mushrooms.
Mr. Musk left the White House last week. Since then, he and President Trump have traded barbs on social media over the president’s domestic policy bill and have mentioned government contracts with Mr. Musk’s companies and Mr. Musk’s relationship to the White House.
Mr. Trump, who was briefed on the article in The Times, has been telling associates in the last day or so that Musk’s “crazy” behavior is linked to his drug use, according to a Times report citing two people with knowledge of Mr. Trump’s private conversations.But later on Friday, Mr. Trump told reporters he did not want to comment on Mr. Musk’s drug use.
The very public feud between the two men has once again drawn unflattering attention to ketamine, a drug that has become increasingly available at legal clinics across the country. It is also used recreationally and can be dangerous when misused.
What is ketamine, and is it legal?
Ketamine is an injectable, short-acting dissociative anesthetic that can have hallucinogenic effects at certain doses. It distorts perceptions of sight and sound and makes users feel detached from pain and their surroundings.
Developed as a battlefield anesthetic in the 1960s, ketamine has been legal since 1970 for use in both people and animals. It is frequently used as an anesthetic for children, especially in the developing world.
In 2019, the Food and Drug Administration approved a derivative of ketamine called esketamine in a nasal spray for treatment-resistant depression.
But the psychiatric use of ketamine is largely unregulated, and the drug is increasingly used off label to treat depression, suicidal ideation and chronic pain.
Ketamine has the potential for abuse, which may lead to moderate or low physical dependence or high psychological dependence, but experts consider it a safe medication.
“It’s a drug that I’m convinced has saved people’s lives, undoubtedly,” said Dr. Gerard Sanacora, the director of the Yale Depression Research Program. “But it has real danger if it’s not used with caution.”
People who use the esketamine nasal spray in accordance with F.D.A. guidelines do so in clinical settings, Dr. Sanacora added, and not at home. “It should very, very, very rarely ever be considered a drug that can be used outside of a health care setting,” he said.
Can ketamine be lethal?
Ketamine is rarely lethal, but an overdose can cause unconsciousness and dangerously slowed breathing, according to the Drug Enforcement Administration. Side effects like increased blood pressure and paranoia are rare and typically occur at very high doses.
The F.D.A. has issued warnings about the dangers of using compounded versions of ketamine. Compounded drugs are those that have been modified or tailored in a lab for the specific needs of an individual patient.
“A huge amount of data shows that it changes your cognition,” Dr. Sanacora said. “Your ability to calculate things, your ability to think clearly, is altered while you’re on the medicine.”
Those who use ketamine recreationally often snort the drug in powder form or administer it by nasal spray.
The F.D.A., citing adverse incident reports, warned that the unsupervised use of compounded ketamine heightened the risk of dangerous psychiatric reactions and health problems like increased blood pressure, respiratory depression and urinary tract issues that can lead to incontinence.
The risks associated with the drug came into sharp relief after the death of the actor Matthew Perry in 2023. An autopsy the following year found that he had died of “acute effects of ketamine.”
What is known about Mr. Musk’s drug use?
In an interview with the journalist Don Lemon in March 2024, Mr. Musk said he took only “a small amount” of ketamine, about once every two weeks, as a prescribed treatment for depression. “If you’ve used too much ketamine, you can’t really get work done, and I have a lot of work,” he said.
But according to people familiar with his consumption, Mr. Musk had been using ketamine often, sometimes daily during the campaign, and mixing it with other drugs, The Times found.
It is unclear whether Mr. Musk, 53, was taking drugs when he became a fixture at the White House this year. But he has exhibited erratic behavior, insulting cabinet members and gesturing like a Nazi.
Chronic ketamine use is also associated with bladder problems. According to The Times article, Mr. Musk told people he was taking so much ketamine that it was affecting his bladder.
Andrew Jacobs is a Times reporter focused on how healthcare policy, politics and corporate interests affect people’s lives.
Jacey Fortin covers a wide range of subjects for The Times, including extreme weather, court cases and state politics across the country.
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