Can You Use Ketamine For Depression Treatment?

Ketamine was originally used as a general anesthetic beginning in the 1960s. Still, thanks to further research that began in 2000, it is now also seen as a promising treatment for mental health conditions such as anxiety, bipolar disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and treatment-resistant major depressive disorder.
This article will describe whether ketamine can be used for depression treatment. Continue reading to learn more about this treatment and whether it may be right for you.

What is ketamine, and how does it work?

Ketamine is a drug that has sedative, pain-relieving, reality-altering, and hallucinogenic effects. It is used medically for purposes such as sedation and pain relief.

Still, it is used recreationally for its ability to cause users to feel disconnected from reality and have hallucinations.

Another illegal use of ketamine is as a date-rape drug. The Food and Drug Administration (FDA) has only approved ketamine as an anesthetic for medical procedures.

To be able to be prescribed esketamine, you must have a major depressive disorder that has not gotten better after trying at least two antidepressant medications or have attempted or plan to attempt to commit suicide. In addition to its off-label use to treat psychiatric conditions, ketamine can also be used off-label to reduce severe physical pain due to injuries and control and also ketamine can reduce seizures caused by status epilepticus.

Ketamine treatment for depression works because it binds to receptors in your brain that produce the chemical glutamate.

Glutamate helps regulate your mood, so low glutamate levels can cause you to develop symptoms of depression. Ketamine also aids in producing brain-derived neurotrophic factor, a protein that allows your brain to adapt to new things. By supporting your brain’s adaptability, ketamine can reduce and change negative thought patterns associated with depression.However, ketamine can be prescribed for “off-label” (non-FDA-approved) use to treat depression, and “esketamine,” a more potent form of ketamine, is FDA-approved for depression treatment and to stop or reduce suicidal thoughts before or after a suicide attempt.

Esketamine nasal spray is given twice a week for 1-4 weeks, then once a week for the next five weeks, and then once every week or two after that.

Although it is not FDA-approved, IV ketamine is the most commonly researched form. If you are given ketamine infusions, you will get two infusions each week for three weeks, followed by one infusion each week, and eventually one or two infusions each month.

Each infusion lasts about 40 minutes, and dissociation will go away about 15 or 20 minutes after the infusion is finished. Your doctor will stay nearby to monitor you while receiving the infusion.

Ketamine lozenges are usually prescribed to maintain the antidepressant effects between infusion treatments.

Ketamine can be given in several forms:¹

• Injections in your arm (non-FDA-approved)
• Intravenous (IV) infusion (non-FDA-approved)
• Nasal spray (FDA-approved)
• Oral lozenges (non-FDA-approved)

How effective is ketamine at treating depression?

Ketamine for depression is effective for many patients. One study ² reported that 85% of patients had their depressive symptoms reduced by at least half due to ketamine infusions. However, relapses did occur. Some patients experienced depressive symptoms again after three months, and other patients’ symptoms returned on average nearly three weeks after treatment.

An analysis of three studies ³ on the effectiveness of treating acute suicidality and suicidal ideation with 0.2 mg/kg of ketamine in the emergency department concluded that ketamine effectively reduced these severe depressive symptoms. Additionally, there were no notable negative effects in any of the 61 patients who participated in the three studies.

A small study done in 2022  found that receiving three IV ketamine infusions in a week made it easier for people with treatment-resistant depression to exchange some negative self-images and negative self-talk with more positive and optimistic imagery and thoughts. Changing these thoughts led to reduced depression symptoms overall.

However, as a reminder, esketamine (SPRAVATO) nasal spray is the only form of ketamine that is currently FDA-approved to treat depression. More research must be done to prove the safety and effectiveness of other forms of ketamine for depression treatment before the FDA approves them.

The importance of medical guidance

You need to have an experienced healthcare professional administer ketamine infusions.

The strong pain relief associated with ketamine and the potential psychedelic effects ⁴ (such as hallucinations and detachment from reality) increase the likelihood that this drug can be misused in dangerous ways that can lead to severe complications.

If you do not take ketamine as it has been prescribed for you, you may become dependent on it. It is also possible to overdose on ketamine. For these reasons, it is best to receive ketamine only under medical supervision so that your doctor can monitor your reactions to the drug and prevent and/or treat any complications that may arise.

Because ketamine infusions require medical supervision, they are most often given in the hospital or doctor’s office.

However, you can ask your doctor to give you a referral for a house-call doctor to administer your ketamine infusions for depression in the privacy and comfort of your own home instead. Receiving ketamine for depression at home can make it easier to stick to the treatment plan because you will be more comfortable at home than in a doctor’s office or hospital. House calls are also more convenient and do not require as much effort on your part, which can be very helpful on particularly difficult days that are already overwhelming or exhausting due to your depression. For example, if you are having a hard day due to your depression, you can receive treatment without having to fight the uphill battle of forcing yourself to perform better than you are presently able to. Feeling less overwhelmed and tired can also help reduce depression symptoms.

Another advantage of house calls for ketamine treatment is that you will have a friendly companion during your treatments. Although it can be difficult or off-putting to socialize while you are feeling depressed, connecting with others can help you feel better by fighting off feelings of loneliness or unworthiness.

Conclusion

Ketamine is only FDA-approved to be used as an anesthetic. Still, a nasal spray of a stronger form of ketamine called esketamine is FDA-approved to treat depression that has not improved after taking at least two antidepressant medications. Esketamine can also be used as an emergency treatment to reduce or stop suicide attempts and suicidal thoughts.

There is a potential to abuse ketamine by taking it in higher doses than prescribed. It is sometimes used recreationally (therefore illegally) for its ability to cause unconsciousness, reduce pain, and bring about hallucinations and a disconnect from reality. Abusing ketamine can lead to dependence or overdose.

You cannot be given ketamine if you are under the influence of alcohol or have an alcohol use disorder, as mixing these two substances can be fatal. Adverse drug reactions can occur when you combine ketamine with asthma and chronic obstructive pulmonary disease (COPD) medications such as theophylline or aminophylline, low blood pressure medications like Vasopressin, or central nervous system (CNS) depressants such as benzodiazepines or opioid pain relievers.

However, with the help and supervision of a trained medical professional, ketamine or esketamine can be used to safely and effectively treat suicidality, suicidal ideation, and other symptoms of depression.

Talk to your doctor today to find out if ketamine for depression may work for you.