Ketamine is becoming increasingly popular for treating depression, anxiety, and post-traumatic stress disorder (PTSD). Ketamine has been found to be more effective than other treatments for these conditions such as antidepressants and cognitive-behavioral therapy (CBT).
“This is a game-changer,” says John Krystal, MD, chief psychiatrist at Yale Medicine and one of the first pioneers of ketamine research in the country. Ketamine works differently than previously used antidepressants, he notes, calling ketamine “the anti-medication” medication. “With most medications, like valium, the anti-anxiety effect you get only lasts when it is in your system. When the valium goes away, you can get rebound anxiety. When you take ketamine, it triggers reactions in your brain’s cortex that enable brain connections to regrow. This means that ketamine could be a new way to treat depression and anxiety, offering patients a cure versus just a short-term treatment.
Ketamine was first synthesized in 1962. Ketamine is a short-acting general anesthetic (a drug that can keep you asleep while surgery is performed). The Drug Enforcement Administration (DEA) FDA approved its use in humans only in 1977. It is also used widely today mostly by veterinarians for sedation.
In the early 1970s, it began to be studied for its off-label uses in humans. Ketamine is a dissociative anesthetic drug, which means that it produces the sensation that you are disconnected from your body. This can feel like being in a dreamlike state or out of your body.
Ketamine has recently been found to be an effective treatment for depression and other mental health conditions, including post-traumatic stress disorder (PTSD). In some cases, it has been shown to be more effective than traditional antidepressant treatments. Several studies have shown that ketamine can be effective in treating MDD, particularly when other treatments have failed. It is relatively short-acting, so it can be administered multiple times over the course of a day or week.
It is believed that ketamine has a few mechanisms of action which produce its benefits. Ketamine therapy works by reducing the amount of anxiety and stress hormones in the brain, which can help to improve mood and relieve symptoms of depression. Ketamine is believed to work by breaking down the connection between neurons, leading to decreased feelings of anxiety and depression.
Ketamine’s antidepressant effects may also be due to its action as a norepinephrine re-uptake inhibitor and serotonin re-uptake inhibitor. It has also been shown to increase levels of the neurotransmitter glutamate in the brain. The anxiolytic effects of ketamine may be due to its ability to modulate the corticotropin-releasing factor, which is responsible for the release of the stress hormone cortisol.
Ketamine primarily works by blocking the NMDA receptors on nerve cells. The drug is classified as an NMDA receptor antagonist, which means that it reduces the activity of certain brain chemicals or receptors. NMDA (N-methyl-D-aspartate) is a neurotransmitter that has been found to be important in pain perception. The NMDA receptor is activated when the body is exposed to a high amount of glutamate. Glutamate is a neurotransmitter that causes pain and can cause nerve cells to fire. Glutamate plays a role in regulating mood, cognition, appetite, memory, and other functions. Ketamine blocks the NMDA receptors by binding with them, preventing normal nerve cell communication and the effects of glutamate.
By blocking nerve cells from communicating with each other, it leads to feelings of euphoria, decreased anxiety and decreased pain. When used in an IV form, ketamine travels quickly to the brain and can produce rapid relief for people who are suffering from major depressive episodes or any type of anxiety disorder.
In the last few years, ketamine has emerged as a promising treatment for a variety of psychiatric conditions. The drug is a phencyclidine derivative that has been shown to be effective in treating conditions like depression, anxiety, chronic pain, and post-traumatic stress disorder (PTSD). It may be helpful for those who have suicidal ideation. Ketamine is administered as an IV injection and has a short half-life, so it is typically used in combination with other medications or treatments.
In 2012, ketamine was approved by the U.S. Food and Drug Administration (FDA) for the treatment of depression in patients who have failed to respond to other treatments.
Not only have the benefits of ketamine been documented for depression, anxiety, and PTSD, it has been shown to be helpful for migraine headaches. Anecdotal reports of ketamine’s use in migraine headaches have been published since 2004. Ketamine has been shown to decrease the severity, duration, and frequency of migraines. The American Migraine Foundation has noted that migraine sufferers who use ketamine experience a significant reduction in migraine symptoms. It has been used for over 50 years to treat severe pain.
Ketamine is also showing promise in treating addiction, says Dr. Krystal. This is a new way to get at the underlying issues of anxiety and depression. It is also showing promise in treating drug and alcohol addiction, says Dr. Krystal.
Research into ketamine as an antidepressant began in the 1990s with Dr. Krystal and his colleagues at the Yale School of Medicine. At the time (as is still mostly true today) depression was considered a “black box” disease, meaning that little was known about its cause.
One popular theory was the serotonin hypothesis, which asserted that people with depression had low levels of a neurotransmitter called serotonin. This hypothesis came about by accident—certain drugs given to treat other diseases like high blood pressure and tuberculosis seemed to drastically affect people’s moods. Those that lowered serotonin levels caused depression-like symptoms; others that raised serotonin levels created euphoric-like feelings in depressed patients. This discovery ushered in a new class of drugs meant to treat depression, known as selective serotonin re-uptake inhibitors (SSRIs). The first one developed for the mass market was Prozac.
But eventually, it became clear that the serotonin hypothesis didn’t fully explain depression. Not only were SSRIs of limited help to more than one-third of people given them for depression, but growing research showed that the neurotransmitters these drugs target (like serotonin) account for less than 20 percent of the neurotransmitters in a person’s brain. The other 80 percent are neurotransmitters called GABA and glutamate.
GABA and glutamate were known to play a role in seizure disorders and schizophrenia. Together, the two neurotransmitters form a complex push-and-pull response, sparking and stopping electrical activity in the brain. Researchers believe they may be responsible for regulating the majority of brain activity, including mood.
Ketamine treatment is administered as an IV infusion and produces a fast onset of antidepressant effects that last about four hours. Side effects are generally mild and include sedation, dizziness, and hallucinations. Ketamine iv infusion therapy can be used to treat major depression or major depressive disorder, bipolar disorder, and other moods disorder.
Interestingly, studies from Yale research labs showed that ketamine, which is widely used as anesthesia during surgeries, triggers glutamate production, which prompts the brain to form new neural connections. This makes the brain more adaptable and able to create new pathways and gives patients the opportunity to develop more positive thoughts and behaviors. This was an effect that had not been seen before, even with traditional antidepressants.
For the last two decades, researchers at Yale have led ketamine research by experimenting with using sub-anesthetic doses of ketamine delivered intravenously in controlled clinic settings for patients with severe depression who have not improved with standard antidepressant treatments. The results have been dramatic: In several studies, more than half of the participants show a significant decrease in depression symptoms after just 24 hours. These are patients who felt no meaningful improvement on other antidepressant medications.
Ketamine is administered based on a person weight which determine the milligrams given. An IV catheter is inserted into a vein and then ketamine is given as a slow infusion. Patients feel sleepy and relaxed during the infusion. The treatment lasts about an hour or more based on the amount of ketamine given. Afterwards, patients feel drowsy so it is advisable that they do not drive home but have someone to pick you up or Uber home. Patients are encouraged to stay for observation for at least thirty minutes or until the sedation effects wear off.
The number and frequency of treatment vary based on the severity of depression or anxiety. Most individuals start off with two treatments a week until the effects are more long lasting then may go to once a week until symptoms completely resolve. Usually a minimum of six treatments is required to achieve the best results. Monthly maintenance may be needed as well.
Ketamine is well-tolerated, with few side effects. In humans, ketamine produces feelings of euphoria, relaxation, and peace. Like all medications, ketamine has side effects. For example, it can induce vomiting and make you feel dizzy. There is also a risk of abuse and dependence. Ketamine should not be used when you have kidney problems or if you have recently had a heart attack. The drug can cause people to feel drowsy, which makes driving dangerous.
Ketamine IV therapy is the newest breakthrough in the treatment of depression. It is helpful for those who have not responded to traditional psychiatric medications and therapy. Taylor Medical Group offers several IV therapy treatments to improve brain function and mood. Every IV is administered by a physician in a spa-like environment.