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I don't think I am exaggerating the noticeable effects of i.v. ketamine. Patients given i.v. ketamine are advised not to operating an automobile hours after administration. This level of impairment would be noticeable to the patient and the staff administering the treatment.

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Advice not to operate an automobile is for minimizing risks. It doesn't mean that most would be unable to handle a car, although it could mean that their reaction times would be slower. The standard way to administer ketamine is to give 0,5 mg/kg under 40 minutes. It would in no way be immediately obvious to everyone in, if someone began to receive ketamine or not. At least I couldn't differentiate them at that point.

Maybe you have more experience with patients at this specific dose range than I do. I remain skeptical this could be double blind, but do have less certainty than I originally started with.

I do agree with your skepticity. A better study design could use midazolam as placebo. And I think a good idea would be to ask the participants amd their physicians, which one do they think they received. That would give some idea about how well the double blind design did. Also, many commenters seem to disagree with me, which I also have to be take into consideration. My n is very low as my hospital has just started ketamine treatments.

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