Having been through chronic suicidal depression, the idea that we're now going to be treating it with yet another psychoactive medication, this time way more powerful and costing significantly more money, doesn't sit right.
Because this is the US we're talking about, I've had to change doctors pretty frequently in my life and there are only a small handful I would say wouldn't react negatively. I'm pretty sure the proliferation of Epic has made it worse too.
Certainly something to be concerned about. I've read ketamine abusers can often end up with kidney issues (presumably proportional to dosage as its related to elimination), but I'd also think monitoring kidney health with chronic dosing, even at low levels, could be prudent - especially in individuals with pre-existing kidney issues.
It does not have to be the case. In some European countries it is ridiculously cheap, as cheap as any other basic/necessary medications, medications that are super expensive to the Americans.
However, years of experience have led me to believe that throwing drugs at this problem does nothing but mask some of the symptoms temporarily, while often having somewhat undesirable side effects. I think we just keep doing it because depression is not well understood, doctors (like the rest of us) are lazy and incentivized to get you out of their office as quickly as possible, and phrama is big business.