tibuma

> What if racemic ketamine performs better than esketamine? We'll never know because they won't test that.

It's quite likely some public institutions (e.g., universities, public research labs, etc.) or other countries (e.g., in India, China) will test exactly that. It's also in their interest to pubblish the results. So we'll get to know the differences between racemic ketamine, esketamine and arketamine.

The question is if different variants will also be approved, which is much more expensive.

> Pharma companies don't benefit from getting Ketamine approved (since it's no longer patent protected), so no one is putting it through FDA for depression.

This is incorrect.

There are ongoing phase 3 clinical trials for nasally applied esketamine that will lead to FDA approval if succesfully reviewed. These trials are conducted worldwide and are very encouraging. The specific application seems to be patentable. First results should be available around 2019ish or 2020.

You can find the trials here:

https://clinicaltrials.gov/ct2/results?term=esketamine+depre...

And one of the patent applications here:

https://patents.google.com/patent/US20130236573A1