Ketamine, How an anesthetic alleviates Depression and Anxiety.

Ketamine, an anesthetic once used mainly for the operating room or on the battlefield, is now being used to treat major depression, anxiety and Post Traumatic Stress Disorder (PTSD). Depression is a common illness worldwide and the leading cause of disability. In the US about 16 million adults have suffered from a major episode of depression in the course of a year. When depression is long-lasting and severe it can lead to suicide. An estimated number of 10.3 million adults in the US are having suicidal thoughts, which is an increase of almost half a million people from last year’s data.

Ketamine was developed in the 1960’s and used to operate on soldiers during the Vietnam War. In 2000, researchers started studying ketamine as a treatment for depression, they discovered that it improved mood of patients much faster than antidepressant drugs. Also because of its rapid effect, researchers found that it helped to reduce suicidal ideation (life-threatening thoughts and acts) relieving depressive symptoms. It has also been used for chronic pain, anxiety, obsessive-compulsive disorder, panic disorder, simple phobia and social anxiety disorder.

How does Ketamine work?

Studies from Yale research labs showed that ketamine triggers glutamate production, stimulating growth of synapses and prompting the brain to form new neural connections. This increases the plasticity of the brain, creating new pathways and regenerating synaptic connections between brain cells that had been damaged by stress and depression. Brain plasticity allows patients to develop more positive thoughts and behaviors.

After just one dose of ketamine patients who have suffered from depression and have been resistant to treatment, experience immediate relief from their symptoms. The improvement of symptoms happens just hours after the ketamine treatment and it lasts for a week up to 10 days.

A study on the therapeutic effects of ketamine found that it changes the theta brainwaves in the right frontal area of the brain. Ketamine has a very wide range of effects on brain rhythms and their power, it increased fast ones and decreased slow ones. It reduced delta and theta brainwaves, which are related to the states of dreaming and meditation (theta) and the deep dreamless sleep (delta). It increased the gamma brainwaves, rhythms related to large scale brain network activity and cognition, like memory and attention. Altered gamma activity has been observed in many mood disorders and cognitive disorders.

Ketamine therapeutic treatment, safety and side effects.

A therapeutic treatment with ketamine is done in a clinical setting, with professionals experienced in providing a safe and supportive environment. It usually includes various infusions over the course of weeks depending on the effect achieved and the relief of symptoms. After that some patients may continue receiving boosters on a monthly basis. Since it may be possible to develop a dependency to ketamine, treatments focus on observing the efficacy and tolerance in each patient. 

Ketamine for therapeutic treatment may be used in lower doses producing a mild state of hypnosis, pain relief, and alters the perception of sight and sound. Moderate doses may also be used for treatment, with effects of creating illusions of separation from the environment or oneself and mild paralysis. Higher doses of ketamine can cause complete paralysis, amnesia, and sedation.

There are two types of ketamine treatments available:

  • Racemic ketamine, which is most often given as an infusion into the bloodstream. This is sometimes called intravenous, or IV, ketamine. There are various clinics that have started providing ketamine treatments in the US.
  • Esketamine (Spravato), which is FDA approved, is given as a nasal spray. Prescribed by doctors that follow a protocol to approve patients.

Ketamine may cause side effects like elevation in pulse and blood pressure, nausea, vertigo and vomiting, that’s why it’s important to be treated in a clinical setting. Most side effects are usually mild and temporary. Other side effects are dissociation, an out-of-body experience, lack of coordination and relief of physical pain.

Ketamine therapy is dramatically improving the lives of veterans who suffer from PTSD, chronic pain, depression and anxiety. In a recent study, veterans suffering from PTSD and major depressive disorder experienced a sharp reduction in suicidal thoughts after receiving IV infusions of ketamine over a 12-day period, finding immediate relief and restoring their sense of clarity and hope.