The FDA first approved ketamine in 1970 as a dissociative anesthetic mainly used in veterinary practices. It quickly became a popular anesthetic in operating rooms and on battlefields. After that, it appeared in the club scene, with partygoers seeking it for its hallucinogenic effects. Today, researchers have uncovered qualities that make ketamine an effective, fast-acting treatment for chronic pain and major depression. 

Before ketamine was discovered as a fast-acting treatment method for reducing suicidality and relieving other major depression symptoms, the most effective treatments in such cases were antidepressant medications, talk therapy, electroconvulsive therapy, and transcranial magnetic stimulation. Each of these methods takes weeks to months to have an effect, by which time it can be too late. 

Please keep reading to find out more about ketamine treatment and how it works to decrease pain and depression.   

Types of Ketamine

There are two types of ketamine that health professionals use to treat treatment-resistant depression. 

Racemic ketamine is the classic type of ketamine that the FDA approved in 1970 for use as an anesthetic. Today it’s used as an off-label treatment for chronic pain and depression. It’s typically administered through an IV into the bloodstream. 

Esketamine, also known as Spravato, was approved by the FDA in March 2019 for use as a nasal spray. This type of ketamine does not have the dissociative properties of racemic ketamine. 

How Does Ketamine Work?

Researchers have only begun to understand how ketamine works in the brain, treating chronic pain and depression so rapidly. So far, it has helped thousands of people manage severe depression successfully when other treatment options have failed.

Ketamine targets NMDA receptors in the brain and binds to them. When ketamine is bound to the NMDA receptors, a neurotransmitter called glutamate increases in the spaces between neurons. Then, it activates connections in the AMPA receptor. When these connections are activated, other molecules that assist in the communication between neurons along new pathways in the brain are released. This process, known as synaptogenesis, is thought to affect cognition, thought patterns, and mood.  

Ketamine is also suspected to facilitate communication in specific areas of the brain. Additionally, it’s thought to reduce signals that support inflammation linked to mood disorders. Although researchers aren’t yet sure precisely how ketamine works, it likely works in several ways simultaneously.