doctor and patient talking in waiting room

Ketamine Medical Uses for Specific Issues and Conditions

doctor and patient talking in waiting room

Sometimes, medications that are created for one reason prove to be beneficial for other purposes. Ketamine was originally produced as an anesthetic drug, but recent studies have found that it works well for treating psychological issues like anxiety or depression.

Ketamine may be a great option for people who struggle with psychological challenges as a relatively safe medication with a low risk for overdose and addiction because Ketamine provides sedation without lowering the respiratory rate;1 it is considered safer than other sedatives and pain medications.

Ketamine has been around for many years and was originally produced as a sedative drug to help numb humans and animals during painful procedures like surgery. More recently, Ketamine is gaining recognition for its other potential uses, such as treating psychological disorders like depression, anxiety, and PTSD .

What is Ketamine?

Ketamine is an anesthetic drug that causes a feeling of dissociation. The FDA-approved use of Ketamine is for anesthesia. The effects of Ketamine are often described as a feeling of detachment from one’s body. Ketamine may be used on its own or in combination with other medications to help sedate patients undergoing painful procedures such as surgery.

injecting a patient in the arm

In recent years, Ketamine has been studied for some of its “off-label” uses. Off-label use means using medication for something other than the purpose it was created for. Since Ketamine was originally produced to be used as an anesthetic drug, its use for psychiatric conditions and other health issues is considered off-label.

Ketamine is often used to sedate patients with mental health crises, such as someone attempting or preparing to attempt suicide. First responders administer Ketamine on sight to calm or sedate patients who are dangerous to themselves and others due to a mental health crisis.

After it was noticed that some patients treated with Ketamine during a mental health crisis remained free from depression for an extended period, scientists began studying some of the other potential uses for Ketamine, such as treating anxiety and depression. Studies have continued to show that Ketamine is an effective treatment for patients with psychiatric conditions, which we will discuss further below. Ketamine has a unique effect on the brain that other antidepressants do not offer.

man sitting on a bench holding his head

How is Ketamine used to treat depression?

Ketamine can be a fast-acting solution to depression, as it can relieve symptoms of depression in only hours . Ketamine can be administered intravenously or intranasally. The form of Ketamine, esKetamine that is inhaled, is commonly used to treat major depressive disorder (MDD).2

Ketamine for depression is usually given to individuals with treatment-resistant depression, meaning they’ve tried many different methods for treatment, and nothing has worked.3

Many studies have examined the effects of different Ketamine on patients with depression. Oral Ketamine may be an effective treatment but doesn’t work as quickly as IV Ketamine. Ketamine is generally considered a safe medication when administered by a trained healthcare professional, but the long-term effects of higher doses remain unknown.4

One thing that makes Ketamine unique from other medications that are used for depression is the way it affects the brain. Rather than only relieving depression when the drug is in a person’s system, Ketamine causes the brain to make new neural connections , leading to a lasting effect even after the medication has worn off.

Because Ketamine’s effects on depression are still being studied, it is important to only use Ketamine as instructed by your doctor. There is no set dosage for treating depression, meaning that dosages and treatment frequency will vary from patient to patient.5 Always use Ketamine in a controlled environment with a healthcare provider present.

How is Ketamine used to treat anxiety?

Ketamine is also being studied as a treatment for anxiety. One study used sublingual Ketamine to treat patients at home and significantly affected patients’ anxiety.6 It isn’t entirely clear how long the effects of Ketamine last for patients following treatment.

anxiety spelled out

This study found that patients significantly improved their anxiety after one month of the dosage. Still, the results of treatment beyond one month were not noted.

Treatment results will vary for each patient, and further studies are needed to assess the long-term safety of Ketamine therapy for anxiety.7 Because repeated doses may be required and the effects of ongoing Ketamine use aren’t entirely clear, continued research on Ketamine for anxiety is still needed.

man having a headache

How is Ketamine used in pain treatment?

Some studies have also looked at Ketamine as a potential treatment for patients suffering from chronic pain.8 Because Ketamine blocks certain pain receptors in the brain, it is an effective treatment method . Ketamine can be used to treat postoperative pain or chronic pain in replacement of opioids.

Ketamine carries less risk for overdose than other pain medications like opioids, which makes it a desirable option for patients with chronic pain . Treating chronic pain is challenging for providers, and Ketamine may offer a potential new solution. However, Ketamine carries the risk for tolerance and addiction, so it may not be ideal for patients with chronic pain since the safety implications for ongoing usage are still unclear.

Since Ketamine for postoperative or acute pain does not require ongoing use, this would be an ideal way of using Ketamine for pain. Individuals with chronic pain would have to use Ketamine continuously to have results, so it may not be as safe for these individuals.

How is Ketamine used to treat PTSD?

Another condition that may be treatable with Ketamine is PTSD, or post-traumatic stress disorder. PTSD occurs in patients who have had a life-altering or severely traumatic experience. PTSD can be debilitating and majorly affect a person’s day-to-day life.

soldier holding his head

There are currently few studies that have looked at the effect of Ketamine on patients with PTSD, but it could be a promising treatment since other methods are sometimes ineffective. Psychotherapy and medications are the standard treatment for PTSD currently, but they are not effective for everyone. Psychotherapy for PTSD typically requires exposure therapy, in which the patient discusses in detail the traumatic event. Not everyone responds to this type of treatment, which makes treating PTSD challenging.

It’s not entirely clear how Ketamine works for PTSD, but studies have found that it may be an effective treatment . PTSD is often associated with substance use disorders, so Ketamine may not be a great option for individuals at risk for addictive behaviors. The studies on Ketamine and PTSD show promising results but warrant further research to fully understand how Ketamine works for PTSD, as well as whether it is safe for widespread usage.9

bi polar

How is Ketamine used to treat bipolar disorder?

Bipolar disorder is a psychiatric condition that is particularly difficult to treat. Bipolar disorder involves stages of depression and stages of mania. Ketamine would be particularly useful to patients with bipolar disorder experiencing depressive episodes.

Because of Ketamine’s high anti-depressive and anti-suicidal effects , it may be a beneficial medication for patients who struggle with bipolar disorder. This study found that Ketamine was an effective treatment for bipolar disorder, but the effects were not long-lasting.10 To fully understand the effects of Ketamine on patients with bipolar disorder and determine safety implications, further research is needed.

a woman adjusting her medical face mask for Covid with both hands and looking into the distance

How is Ketamine used to treat post-Covid syndrome?

Many patients who recover from COVID-19 end up with long-lasting symptoms such as fatigue, brain fog, and changes in taste and smell. Long COVID isn’t entirely understood, but this condition may result from inflammation caused by the COVID virus.

Ketamine has been tested as a potential treatment for long COVID symptoms, as well as for patients currently infected with COVID-19. Ketamine may help with some neurological symptoms of long COVID, such as anxiety and depression. It is also a useful medication to give to patients with severe cases of COVID since it can help with certain symptoms and does not cause any type of respiratory depression (like other medications do). COVID patients are at an increased risk of respiratory distress, but Ketamine is a safe medication option even for these patients. Ketamine may also be given in combination with Naltrexone to help minimize the effects of inflammation when patients have severe cases of COVID.

Side effects of Ketamine

As with any medication, Ketamine may cause some side effects. The most common side effects of Ketamine include the following:

  • Nausea
  • Vomiting
  • Dizziness
  • Double vision
  • Drowsiness
  • Dysphoria
  • Confusion

Sometimes, patients may experience hallucinations as a side effect of Ketamine. Some rare adverse effects may occur due to using Ketamine which is why it is so important to only use Ketamine in the presence of a healthcare provider. Severe side effects of Ketamine include:

  • Blood in the urine
  • Blue skin or lips
  • Burning while urinating
  • Chest pain or discomfort
  • Cough
  • Difficulty breathing
  • Difficulty swallowing
  • Lightheadedness and dizziness

If any of the above side effects occur while using Ketamine, seek emergency medical care immediately.

Although rare, it is possible to overdose on Ketamine when taking too much at once or taking the drug more frequently than directed.

How does in-home Ketamine treatment work?

At-home Ketamine therapy is a safe and convenient way to try Ketamine. A few different companies offer this type of therapy throughout the United States. You will need a referral or prescription from a doctor to qualify for Ketamine therapy.

You may be able to receive a Ketamine prescription from your primary care physician or your psychiatrist (if you actively see one). If not, you may be able to meet with a psychiatrist through a telehealth platform . This can be an accessible and convenient method to get a referral for Ketamine therapy at home .

Once you have determined that you qualify for at-home Ketamine therapy, you can schedule your visit. The cost of Ketamine therapy varies depending on where you live, the company you go through, and the form of Ketamine that you use. For example, IV Ketamine can cost anywhere from $400 to $2,000 for a single dosage. Sublingual Ketamine , meanwhile, typically runs around $200 to $250 per dose.

In-home Ketamine therapy may follow a unique dosing schedule. One protocol involved four weekly dosing sessions. Participants would take their sublingual Ketamine dosage, wear an eye mask, and listen to music for one hour. Following this process, they would write in a journal about their experience to reflect on what they felt. Speak with your potential ketamine provider to learn more about their treatment protocols and what to expect.

Is Ketamine the right choice for you?

Studies on Ketamine show promising results for people struggling with many different health conditions. Ketamine can work well when used properly as a safe and effective treatment. Of course, there is always the risk of addiction and abuse, so it is important to only use Ketamine as directed by your healthcare provider.

Because treating psychological issues like depression and anxiety is considered an off-label use of Ketamine, insurance will not cover Ketamine therapy and costs can be quite steep. You may be able to see results from only one dose of Ketamine, but it is important to follow your doctor’s recommendations on dosing and frequency of use.

Studies on Ketamine are ongoing and more research will be needed to confirm the safety of long-term Ketamine use. Continued dosing does present the risk of tolerance and addiction. It’s important to speak with your healthcare provider about treatment options , potential risks and side effects , and costs of therapy so you can make the most informed decision about your health.

References

[1] Eikermann M, Grosse-Sundrup M, Zaremba S. et al. - Ketamine activates breathing and abolishes the coupling between loss of consciousness and upper airway dilator muscle dysfunction. Anesthesiology.;

[2] Yavi M, Lee H, Henter ID, et al. - Ketamine treatment for depression: a review. Discov Ment Health.;

[3] Mandal S, Sinha VK, Goyal N. - Efficacy of ketamine therapy in the treatment of depression. Indian J Psychiatry.;

[4] Corriger A, Pickering G. - Ketamine and depression: a narrative review. Drug Des Devel Ther.;

[5] Andrade C. - Ketamine for Depression, 4: In What Dose, at What Rate, by What Route, for How Long, and at What Frequency? J Clin Psychiatry.;

[6] Thomas D. H., Matteo M., Adam G., et al. - At-home, sublingual ketamine telehealth is a safe and effective treatment for moderate to severe anxiety and depression: Findings from a large, prospective, open-label effectiveness trial. Journal of Affective Disorders.;

[7] Banov MD, Young JR, Dunn T. - Efficacy and safety of ketamine in the management of anxiety and anxiety spectrum disorders: a review of the literature. CNS Spectr.;

[8] Bell RF, Kalso EA. - Ketamine for pain management. Pain Rep;

[9] Liriano F, Hatten C, Schwartz TL. - Ketamine as treatment for post-traumatic stress disorder: a review. Drugs Context.;

[10] Alberich S, Martínez-Cengotitabengoa M, López P, Zorrilla I. et al. - Efficacy and safety of ketamine in bipolar depression: A systematic review. Rev Psiquiatr Salud Ment.;