Ketamine: Now By Prescription

On the FDA approval of esketamine for treatment-resistant depression. Explains the drug-repurposing/patent economics (you can't fund FDA trials for an unpatentable existing chemical, so pharma patents a trivial variant — here the left-handed stereoisomer, 'sinister ketamine'), then two critiques: esketamine's efficacy is shaky (mixed trials; the FDA bent its two-positives rule to count a withdrawal trial), and the delivery restrictions (specialty-clinic-only, 2-hour monitoring) negate the whole point of a convenient nasal spray while patients 'go home and use Ecstasy.' Insider psychiatry + sharp FDA/regulation critique.

Quality 67 · Strong. 67 — low Strong. A clear, engaging, genuinely educational explainer of a real pharma/regulatory dynamic with insider credibility and memorable framing. Held low-Strong because it's topical 2019 commentary rather than a deep or lasting contribution.

Claude’s paradigm shift 46 · Moderate. 46 — Moderate. The drug-repurposing/patent-game critique is a known Scott theme applied to a new case; modest novelty.

Real-world impact 2 · Minor. 2 — minor/within-blog. A pointed FDA critique, but no material policy change.

Humor 2/5 · Man of One Study. 2 — gate PASSES (a serious piece with a genuine, notable, intentional comedic set-piece). The 'pharma has lobbyists in Heaven → sinister ketamine' etymological riff is a crafted comedic passage, not a mere aside — the Man-of-One-Study tier of pervasive-wit-in-a-serious-essay (cf. Adderall), distinct from the ambient-wit-=0 cases. Below 3 because the bulk (trial analysis, delivery critique) is straight argument.