Emerging Uses Of Ketamine Depression Treatment For Improving Mood
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Low-dose ketamine is a controlled substance initially discovered as an anesthetic and pain reliever. Since its discovery, doctors have found it may be an effective alternative for treatment-resistant depression. If you’ve been considering the possibility of ketamine-assisted therapy, it can be helpful to look at the origins of this treatment and how it may be effective. However, talk to your doctor before considering ketamine for depression.
History of ketamine in medicine
Ketamine was synthesized by a professor at Wayne State University in Detroit, Michigan, in the 1960s. After receiving FDA approval for use in humans in 1970, ketamine was used as an analgesic and sedative during the Vietnam War. In large doses, ketamine can be an effective anesthetic and has been used for many years on humans and animals. Compared to other anesthetics, ketamine had fewer side effects on breathing and blood pressure.
However, doctors discovered that ketamine has some psychoactive properties, causing hallucinations or a "spaced-out" sensation. This discovery prompted ketamine's use as a recreational substance, which resulted in stricter rules regarding its distribution and use. Outside of medical settings, unregulated use of ketamine can cause serious side effects to a person’s physical and mental health. Nonetheless, a recent findings suggest that ketamine may be able to treat depression.
What is depression?
There are several depressive disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Major depressive disorder (MDD) is one of the most prevalent and severe of these conditions, and over 280 million people live with depression worldwide. When individuals refer to “depression,” they are often referring to MDD.
Symptoms of depression can include but are not limited to the following:
Prolonged sadness and a low mood
Difficulty finding motivation
Appetite changes
Sleep changes
A loss of interest and pleasure in previously enjoyed activities
A sense of apathy or a lack of emotions
Difficulty caring for oneself
Suicidal thoughts
Current depression treatments
Current mainstream antidepressants, selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs) were discovered around 60 years ago. These medications change the way serotonin is produced and used in the brain.However, only about 35% of patients on SSRIs may achieve complete remission, leaving as many as five million people in the US with what’s known as “treatment-resistant depression.”
For individuals who experience therapeutic benefits from SSRIs, the effects may take several weeks to be noticed, and there can be a high rate of symptom relapse. For some individuals, depression can come back. For this reason, there has been an unmet need for antidepressants with more rapid relief, particularly for individuals with treatment-resistant depression or those with suicidal thoughts.
Note that medications can work differently for everyone, and many people find benefit in antidepressants. If SSRIs or other medications have been prescribed to you by a doctor and work well for you, it may not be necessary to change your treatment. Consult your doctor or psychiatrist before stopping or changing your medication.
The BetterHelp platform is not intended to provide any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.
Ketamine and depression: Understanding a new treatment possibility
Ketamine may be effective at improving symptoms of depression. Research suggests that a sub-anesthetic dose of ketamine may be effective in lessening suicidal thoughts and in improving treatment-resistant depression. One study found that 60% to 70% of clients with treatment-resistant depression responded to ketamine almost immediately. Effects were seen within hours of administration and were sustained for up to two weeks in some patients.
Ketamine depression treatment
Healthcare providers can still prescribe and use ketamine off-label with clients if they have a license to prescribe medication and offer medical care. However, there may be a few safety concerns to keep in mind, which is why ketamine should only be used with a doctor’s supervision. These safety risks may include the following:
Additionally, healthcare providers can still prescribe and use ketamine with clients if they have a license to prescribe medication and offer medical care. However, there may be a few safety concerns to keep in mind, which is why ketamine should only be used with a doctor’s supervision. These safety risks may include the following:
Sedation and sleepiness
Dissociation
Changes in heart rate and blood pressure
Racing thoughts
Potential for substance misuse or addiction
Urinary incontinence
Respiratory depression
How does ketamine depression treatment work for mood?
Evidence is unclear about how ketamine might support depressive symptoms. The anesthetic properties of ketamine are thought to occur by its blockade of N-methyl-D-aspartate (NMDA) glutamate receptors in the brain. Glutamate is one of the brain's major neurotransmitters and fast-acting excitatory molecules. This neurotransmitter contrasts with monoaminergic systems such as serotonin, which are more localized and slow-moving. Ketamine works through the fast-acting glutamate system, consistent with its rapid onset of action.
Studies suggest that ketamine's antidepressant effects may be due not only to a blockade of NMDA receptors but also its simultaneous enhancement of another type of glutamate receptor: α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors. The blockade of NMDA and the enhancement of AMPA receptors together may cause a rapid release of glutamate in the brain, which is thought to kick-start neuroplasticity (the ability of the brain to grow new neurons and new connections).
Contemporary theories of depression suggest that neuroplasticity is impaired in people with depression and that interventions that promote neuroplasticity may alleviate depression. Conventional antidepressants, as well as behavioral interventions (such as exercise), have also been shown to increase neuroplasticity and are considered to be safer by the FDA. However, because ketamine appears to work on the glutamate system, it may work more quickly. These results are not confirmed, and more studies are required to understand this treatment fully.
Safety implications of using the anesthetic ketamine as an antidepressant medication
Although the use of ketamine in treating depression may seem promising, individuals may have remaining questions and challenges. While some studies suggest ketamine is a safe treatment for depression in the short term, questions remain about the long-term risks and potential side effects of ketamine treatment.
Because the FDA does not recommend ketamine treatment, be cautious when interacting discussing this treatment with clinics or doctors who claim to offer it. Although licensed doctors can prescribe ketamine, it has been associated with some challenging symptoms and long-term impacts, such as addiction.
In addition, ketamine's effects may be temporary, as some individuals may experience a relapse in depression symptoms. For this reason, regular infusions of ketamine may be required, which could lead to more significant side effects. Because the treatment is not FDA-approved, insurance companies may not cover it, meaning individuals may have to pay $400 to $800 per infusion. However, talk to your doctor before exploring these options in more detail, and note that there are FDA-approved and evidence-based treatments for treatment-resistant depression that do not include ketamine.
Therapy for better mental health
For those who have exhausted contemporary antidepressants or treatment options and still struggle with severe depression, it may be beneficial to consider evidence-based treatments, such as therapy. Many forms of therapy are effective in reducing depression symptoms and can be an option while you explore other treatments.
Some people with depression may struggle to leave home, making meeting with a mental health professional like a counselor or therapist in person challenging. In these cases, online therapy through a platform like BetterHelp may be beneficial. With internet-based counseling, you can discuss your symptoms with a licensed therapist from the comfort of your home and choose between phone, video, or live chat sessions. You can also try other resources like group sessions and journaling prompts.
Online therapy in clinical trials
Researchers in the mental health field have been investigating the effects of online counseling for more than a decade. One study found that individuals undergoing remote therapy for depression experienced more significant symptom reduction compared to participants on a waitlist.
Takeaway
Frequently asked questions (FAQs)
Below are some of the most frequently asked questions about Ketamine treatments for depression.
What does psychedelic therapy treat?
Psychedelic therapy or psilocybin therapy uses hallucinogens to treat mental health conditions like depression and post-traumatic stress disorder (PTSD). This psychedelic-assisted therapy, also known as MDMA-assisted psychotherapy, may support serious mental health conditions.
In some cases, psychedelics may be effective. However, none of these medications are FDA-approved, so they must only be administered with the support of a medical doctor in a state or country where these treatments are legal. Do not start, stop, or change any medication or substance without consulting a doctor, and note that there may be some unwanted side effects from using substances or medications not approved by the FDA.
When is psychedelic therapy available?
According to some researchers, psychedelics like magic mushrooms or lysergic acid diethylamide (LSD) could change the course of mental health treatment in the United States. Explicitly used to treat post-traumatic stress disorder and depression, this realm of behavioral sciences is growing to include psychedelics in mental health treatment. However, these medications and substances are not currently approved in the US for the treatment of mental illnesses, so talk to your doctor to learn more.
Is psychedelic therapy good?
Rolan Griffiths, Michael Pollan, and Amy Morin are a few doctors and professors who have thoroughly studied the impact of psychedelics and have suggested they hold promise for treating a range of mental health conditions, including but not necessarily limited to depression, PTSD, OCD, alcoholism, and cocaine addiction. Learning more about the products and benefits of substances like cannabis and cannabinoids (THC) is essential before taking them. Talk to a doctor to learn more information on the benefits and ingredients of these substances, and note that none are currently FDA-approved and may have safety risks.
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.
Additional questions
Here are some additional questions about ketamine treatment:
How does ketamine, originally an anesthetic, impact mood and mental health?
Ketamine can swiftly improve mood and sadness by modifying brain chemicals, unlike other medications.
What do clinical trials suggest about the use of ketamine in therapy for depression?
Ketamine can relieve depression quickly, especially in people who haven't responded to conventional therapies, according to clinical investigations.
How effective is ketamine as a medication for treating depression compared to traditional therapy?
Ketamine is often more effective for people with treatment-resistant depression, offering quicker results than traditional antidepressants. It is usually considered when other methods haven’t worked.
What role does ketamine play in improving mood for those undergoing depression treatment?
Ketamine can quickly elevate mood, making it a useful depression treatment.
What are the potential risks and benefits of using an anesthetic like ketamine for treating depression?
It relieves depression symptoms quickly, but dissociation and overuse are dangers, thus it should be administered under medical supervision.
How do clinical trials support the use of ketamine in treating depression?
Clinical investigations demonstrate that ketamine helps alleviate depression, especially in difficult situations where other therapies have failed.
Can ketamine be combined with another medication or therapy for more effective depression treatment?
Ketamine can be combined with other drugs to boost its efficacy and broaden treatment.
What should patients know about the mental health implications of using ketamine as an antidepressant?
Patients should realize that ketamine can provide temporary respite but is not a cure and should be part of a therapy strategy. Long-term impacts are being explored, and medical oversight is essential.
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