Since depression comes in many forms, treating this mental health issue is not a one-size-fits-all approach. With a wide variety of treatment methods, finding the right one for you can take time.
One type of therapy that is gaining traction in the medical community is ketamine therapy. But what is ketamine? Originally used as an anesthetic for many years, ketamine is now recognized for its ability to improve mental health.
In fact, researchers at the Yale School of Medicine found that a sub-anesthetic dose of ketamine reduces symptoms of depression and in some cases lead to almost full recovery in less than a day.
What is Ketamine Therapy?
Ketamine has been widely used around the world as an anesthetic for 60 years and is still widely used today for this purpose. About 20 years ago, growing evidence showed that ketamine was an effective drug and fast-acting antidepressant.
At doses much lower than the dose used for general anesthesia, ketamine has now been shown to be effective for depression, anxiety, PTSD and other mental illnesses, Dr. Mike Dow, PhD, PsyD, Field Trip psychotherapist, explains. Initially, ketamine for depression was mostly given intravenously. Then, scientists found that different methods of administering ketamine allowed simultaneous psychotherapy.
In ketamine-assisted psychotherapy (KAP), intramuscular injection (a quick, fairly painless shot with a small needle) and oral administration (taken by mouth) of ketamine allows for concomitant psychotherapy with the drug and does not require nor that the needle remains in the patient’s arm throughout the session. This combination of ketamine and psychotherapy solved one of the biggest drawbacks of ketamine therapy – while IV ketamine therapy is remarkably effective, research shows it only lasts about a month. Combined with psychotherapy, it lasts three to four times longer, adds Dr. Dow.
Related: 21 Things You Should Never Say To Someone With Depression (And What To Say Instead)
Ketamine has been used primarily for anesthesia, which is why it will also benefit people with anxiety. Ketamine treatment is a preventive treatment for anxiety, so it will be best used to treat generalized anxiety disorder, Dr. Julian Lagoy, MDa psychiatrist from Mindpath Health, explains.
There are various approaches available today for ketamine therapy, including IV infusion, intranasal spray, sublingual, intramuscular, and oral or rectal injection. IV infusion is the most common ketamine therapy, as it is the most studied and safest method of administering ketamine.
How Ketamine Therapy Works to Treat Depression
In many ways, ketamine is a functional approach to depression.
The ancient monoamine hypothesis of depression was formulated in the 1950s and states that depression is the result of low levels of monoamine neurotransmitters: serotonin, dopamine and/or norepinephrine, says Dr. Dow. This is the philosophy behind most major psychotropic drugs such as SSRI antidepressants (which “boost” serotonin), SNRI antidepressants (which “boost” serotonin and norepinephrine) and Wellbutrin (which “boost” dopamine).
Ketamine works very differently. First, it does not target the serotonin pathway.
It works via the glutamate pathway, says Dr. Dow. Glutamate is the most abundant excitatory (“come-up”) neurotransmitter in the central nervous system. But like these older antidepressants, ketamine has “downstream” effects on monoamine neurotransmitters; it will increase dopamine and serotonin levels.
In terms of targeting the root cause, Dr. Dow explains how ketamine therapy works:
1. It relieves brain inflammation and neuroinflammation has been linked to many mental illnesses.
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2. It helps the brain form new connections.
3. It helps create new brain cells by stimulating brain-derived neurotrophic factor (BDNF) which has been dubbed “Miracle-Gro for the brain”. Brain atrophy (which is the result of everything from poor diet to aging itself) has been linked to depression.
4. It is a mild empathogen and “heart opening”. When combined with psychotherapy, it can allow a patient to lower their defenses and get to the root of their mental illness with their therapist.
Related: 82% of People Now Believe Mental Health is Just as Important as Physical Health, So Here’s How to Find the Right Therapist for You
Ketamine Side Effects and Risks
The most common side effects are nausea and increased blood pressure.
That’s why Zofran (an anti-nausea drug) and ginger tea are usually offered to patients, says Dr. Dow. Blood pressure is also monitored and is not used when a patient has uncontrolled hypertension. As it rapidly increases dopamine, Dr. Dow says they do not treat psychotic people (eg, schizophrenia, bipolar) because increased dopamine will make psychosis worse (psychosis is associated with excess dopamine).
Most of the other “side effects” like dissociation (feeling of leaving the body), “dreaming” or hallucinations are actually harnessed as part of the psychedelic experience which can help people with depression and mental illness. other mental illnesses.
There may be some anxiety along with the new psychedelic experience, but doctors help people manage this with personalized and dose discovery (for example, if a person has never taken a psychedelic and feels anxious at this subject, she would start with a very low dose for session one and gradually increase the dose). The other major side effect seen in recreational high-frequency ketamine users is bladder damage, but this isn’t seen often, adds Dr. Dow.
How long does it take to see results on ketamine?
“We recently surveyed patients and reported that it helped 93% with anxiety and 92% with depression. There were lasting improvements in their symptoms immediately after one session, with benefits lasting up to 120 days” , shares Dr. Dow.
One of the best things about ketamine is that the reduction in depression is evident within four hours of the first session. Think of how many people suffer during a depressive episode: with most antidepressants and standard talk therapy, they have to wait weeks or months for relief. This is one of the most game-changing differences — ketamine therapy can help people find fast relief from depression, says Dr. Dow.
Are some people more likely to benefit from ketamine therapy than others?
Ketamine is a proven effective treatment for mental health conditions like depression, anxiety, and PTSD, and can help heal trauma. It’s even effective for treatment-resistant depression and works when multiple prescription antidepressants have failed.
“We believe everyone can benefit from ketamine-assisted therapy because it can aid in self-discovery, help improve your relationship with yourself and others, help break unhealthy thought patterns, stimulate creativity and so much more,” says Dr. Dow.
Interestingly, some research shows that people with certain personality traits can tolerate higher doses more quickly. A person with low levels of neuroticism and high levels of openness is likely to tolerate a higher dose in the first session than a very neurotic person, for example. There are IV ketamine clinics that dose by weight, but Dr. Dow says they spend time getting to know their patients before the first session and finding that personalized dose for each person.
It’s important to note that ketamine therapy is contraindicated in those who have had a bad reaction to the drug in the past, and it’s not recommended during pregnancy or breastfeeding, says Dr. Lagoy. Ketamine treatment is also contraindicated in schizophrenia.
Next step: here’s what major depressive disorder really is and how it differs from “regular” depression
