Elon Musk is the world's richest person. He runs Tesla, SpaceX, and X. He also uses ketamine. This isn't a secret anymore, though the way people talk about it makes it sound like a back-alley deal. Honestly, it’s more complicated than the headlines suggest.
Musk has been surprisingly open about his prescription. During a tense interview with Don Lemon in early 2024, he basically told the world that he uses the substance to manage a "negative chemical state." He called these episodes "chemical tides." If you've ever dealt with depression, you know exactly what that feels like—that sudden, heavy fog that rolls in without any external reason. For Musk, ketamine is the tool he uses to clear the air.
But the narrative took a sharp turn in 2025. Reports from the New York Times and Wall Street Journal alleged that his usage had escalated far beyond a bi-weekly prescription. They claimed he was using it on the 2024 campaign trail and even suggested it was causing physical health issues, like bladder problems. Musk, in typical fashion, fired back on X. He denied the reports of "serious" drug use, calling them flat-out lies. He maintains that he only uses a small amount under a doctor's care.
Why Elon Musk and Ketamine became a Wall Street obsession
Investors are a nervous bunch. When the guy holding the keys to a $1 trillion ecosystem starts talking about dissociative anesthetics, people start checking the stock price. Musk’s argument is simple: execution is the only metric that matters. He famously told Lemon that if he’s taking something that helps him build the most valuable car company in history, then investors should probably want him to keep taking it.
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It’s a bold stance. Most CEOs would hide a prescription for a "mind-altering" substance. Musk leans into it. He frames it as a matter of efficiency. He claims he works 16-hour days and can't afford to be "wasted" because he wouldn't be able to get his work done.
From a business perspective, the concern isn't just about his health. It’s about government contracts. SpaceX is a vital partner for NASA and the Department of Defense. These agencies have strict drug-free workplace policies. Musk has pointed out repeatedly that he underwent three years of random drug testing after his infamous "one puff" on Joe Rogan’s podcast. According to him, not even a trace of anything was found.
The medical reality of the "Special Medicine"
Ketamine isn't just a party drug called "Special K." It’s a powerful tool in modern psychiatry. In 2019, the FDA approved Spravato, a nasal spray version of esketamine, specifically for treatment-resistant depression.
Traditional antidepressants like SSRIs (Selective Serotonin Reuptake Inhibitors) can take weeks or even months to work. For some people, they just "zombify" the user—a term Musk himself has used to describe why he prefers ketamine. Ketamine works differently. It targets the glutamate system in the brain, often providing relief within hours.
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- Rapid Relief: It’s used in emergency rooms for suicidal ideation because it works almost instantly.
- Neuroplasticity: Some studies suggest it helps "rewire" the brain by encouraging the growth of new neural connections.
- Off-label use: While Spravato is FDA-approved, many clinics provide IV infusions of generic ketamine "off-label," which is a perfectly legal medical practice.
The problem arises with frequency and dosage. Chronic, heavy use of ketamine is known to cause "ketamine-induced cystitis," which is essentially severe bladder damage. This is likely where the 2025 rumors about Musk’s health originated. If someone is using it recreationally and frequently, the risks of cognitive impairment and organ damage are real.
The Don Lemon fallout and the transparency trap
The interview that started it all ended up costing Don Lemon his partnership with X. Musk reportedly canceled the deal shortly after the sit-down. Why? Because Lemon pushed. He asked if Musk ever abused the drug. Musk said no. He asked how often he took it. Musk said maybe once every other week.
It was a rare moment of a billionaire being interrogated about his medicine cabinet. Musk argued that asking about a medical prescription is "pretty private," yet he chose to discuss it on X because he thought it might help others. This is the "transparency trap." By being open about it, he invited the scrutiny that he now finds intrusive.
What this means for the future of mental health in business
Whether you love him or hate him, Musk’s admission has moved the needle on how we view mental health in the C-suite. For decades, executives hid their struggles behind alcohol or "exhaustion." Musk is saying out loud that his brain chemistry sometimes fails him and he uses modern medicine to fix it.
There is a huge difference between a "K-hole" at a party and a clinical dose in a doctor's office. The former is a dissociative trip where you can't move; the latter is a controlled experience designed to reset your mood. Musk claims he's in the latter camp. His critics, citing anonymous sources, claim he's in the former.
The reality? It’s probably somewhere in the middle. High-performance individuals often seek out high-performance solutions. If ketamine allows him to maintain the "manic" energy required to run five companies, he sees it as a win.
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Actionable insights for those following the story
If you’re looking at the Elon Musk and ketamine saga and wondering what the takeaway is for your own life or business, consider these points.
1. Don't DIY your mental health.
If you're feeling that "negative chemical state," talk to a professional. Musk uses a "real doctor" for a reason. Ketamine is a powerful anesthetic that can be dangerous if the dosage isn't precise.
2. Focus on "Execution" but watch the cost.
Wall Street might only care about results, but your body cares about the toll. If you're using any substance—even caffeine or Adderall—to keep up with a 16-hour workday, there's eventually a bill to pay.
3. Understand the legal landscape.
If you work in a regulated industry (like aerospace or defense), be aware that even legal prescriptions can sometimes trigger "fitness for duty" reviews. Transparency is a double-edged sword.
The "Elon Musk and ketamine" conversation isn't going away. As more research comes out in 2026 regarding the long-term effects of the drug, the line between "bio-hacking" and "substance abuse" will become clearer. For now, Musk remains the ultimate test case for whether a CEO can be publicly "medicated" and still be trusted with the future of humanity.