What Is Ketamine & How Does it Work?
You may have noticed a shift in the wellness community. Psychedelics have exploded onto the scene with many encouraging research studies coming out that indicate the psychedelic renaissance may offer powerful treatment modalities for individuals who have found that traditional medications and treatments aren’t effective for them or cause negative side effects. Specifically, due to its legal status and the psychedelic renaissance underway, ketamine-assisted therapy has reached the mainstream.
What is Ketamine?
Ketamine is a dissociative anesthetic also classified as a psychedelic. In the last decade, it has become a treatment option for depression and mood disorders. Ketamine is a prescription dissociative anesthetic that was created in 1962 and has since been used for anesthesia during surgical procedures. In 1970, the FDA approved ketamine as a general anesthetic and is now on the World Health Organization’s Model List of Essential Medicines. Although ketamine has been used safely for years, research on ketamine’s antidepressant effects has only taken off recently. Much of the growing interest in ketamine is due to the FDA approving a ketamine nasal spray in 2019. The FDA has found that ketamine is an effective, safe option for the treatment of treatment-resistant depression and depressive symptoms in adults with major depressive disorder with suicidal thoughts or behavior.
It should be noted, ketamine, like any prescription drug, is dangerous if abused. Taken consistently at high levels, it can be a dangerous and addictive medication. The U.S. Drug Enforcement Administration classifies ketamine as a Schedule III drug, which means it has a moderate to low potential for physical and psychological dependence (less than Schedule II drugs such as oxycodone, but more than Schedule IV drugs such as Klonopin). Ketamine can also cause other side effects, such as a short state of altered consciousness immediately following treatment known as a dissociative episode and colloquially as the “K-hole” if the dose is high enough.
How does Ketamine work?
As previously stated, ketamine is now being used as an effective treatment option for treatment-resistant depression. Additionally, it is also being used to treat other mental health conditions, including but not limited to Post Traumatic Stress Disorder, Bipolar Disorder, and drug and alcohol addiction.
In 2000, Yale School of Medicine published the first randomized controlled trial to explore ketamine’s antidepressant effects. Researchers found that a single subanesthetic dose (less than what would be given for anesthesia) of ketamine improved depression and in some cases led to a near complete recovery in less than 24 hours. Ketamine works very differently than traditional depression medications. While traditional antidepressants may take weeks to work, ketamine has shown to take effect as early as a few hours after administration. In addition to being faster, ketamine also affects the brain differently than other popular antidepressant medications that increase levels of serotonin, dopamine, and norepinephrine to improve mood. Interestingly, ketamine seems to primarily impact a different brain chemical called glutamate, which helps stimulate brain cells to communicate and may be able to reverse the damage to the connections between brain cells caused by chronic stress. Thus, ketamine can be used to aid in increasing brain plasticity. Researchers speculate that this may be why ketamine’s antidepressant effects seem to last longer over consecutive doses and prevents depression relapse. Further research is needed to explore the specific mechanisms by which ketamine exerts its effects.
On average, individuals only need 6-8 ketamine sessions to produce prolonged remission of symptoms, although some individuals may need occasional maintenance booster sessions to maintain gains. While the antidepressant effects tend to be temporary after a single ketamine treatment, multiple treatments have shown to have a cumulative impact, successfully alleviating symptoms with 70% of people experience moderate to significant relief from their symptoms after 6-8 ketamine sessions, while 30% do not respond.
According to the Wholeness Center in Colorado, ketamine offers hope for the future:
“Depression causes your whole self (mind, body, spirit) to shut down in an attempt to protect itself from perceived internal and external threats. Ketamine treatment is one of the most effective ways to reverse this self-protective process by reconnecting a person with their inner healing intelligence. When this occurs, someone suffering from depression, trauma, or addiction is able to reconnect with their inner wisdom and sanity, which illuminates the path out of stuckness, debilitating fear, and suffering.”
