With about 16 million adults affected yearly, depression is the number one cause of disability in America. Nearly 9 million adults have been prescribed medication for major depressive disorder, and an estimated 2.8 million are suffering from treatment-resistant depression.
Depression is a psychiatric mood disorder that causes feelings of worthlessness, hopelessness, and emptiness. Major depressive disorder and treatment-resistant depression are more severe forms of depression, which cause changes in mood and thought patterns and loss of interest in things once found pleasurable. When someone with major depressive disorder doesn’t respond to two or more types of medication or treatment, they’re considered to have treatment-resistant depression.
Ketamine for Depression Treatment
There are several treatment options for people who suffer from suicidal thoughts and depression, including antidepressant medications, talk therapies, electroconvulsive therapy (ECT), and transcranial magnetic stimulation (TMS). However, most of these options often take weeks or months to impact the person suffering from the disorder. Some people go through several courses of medications combined with various types of therapies in an attempt to find relief.
Researchers have found a breakthrough treatment option for treatment-resistant depression – ketamine. This FDA-approved anesthetic has been used in the medical industry for over 50 years. Its dissociative properties made it a popular drug for illicit recreational use, but researchers have been studying its fast-acting antidepressant properties for more than 20 years.
Since ketamine is only FDA-approved for use as an anesthetic, it is used off-label to treat severe and treatment-resistant depression, anxiety, chronic pain, and PTSD that haven’t responded to two or more traditional therapies or medications. Not only has ketamine been found to be effective for treating depression and anxiety combined, but it has also been proven to rapidly relieve severe depression symptoms and rapidly reduce suicidality.
Another point well worth mentioning is the necessity of integrative coaching and group therapy. In conjunction with ketamine infusions, an exploration of a person’s intent as well as the treatment of underlying behaviors that could be leading to their current condition are necessary to truly reap the benefits of ketamine treatment.
How Ketamine Works in the Brain
Ketamine infusions for depression treatment are administered through a slow and continuous IV drip. While researchers and medical professionals are still figuring out exactly how it works, they’re sure that it has positive, calming effects on the parts of the brain that control behavior and mood.
It’s theorized that ketamine targets and binds to the brain’s NMDA receptors, which increases the amount of glutamate that fills the gaps between neurons. This neurotransmitter activates other connections in the AMPA receptor. Then, other molecules assist neurons in communicating with one another as they form new pathways in the brain. This process is known as synaptogenesis or neuroplasticity.
Furthermore, it is imperative that during ketamine treatments, the second brain, otherwise known as the microbiome, is also tended to. This is due to the fact that 75 to 90% of both dopamine and serotonin are created there. Thus, if anything is amiss in one’s microbiome the production of these chemicals could be affected, leading to depression and anxiety.
Potential Side Effects
All drugs come with a list of potential side effects. However, when someone suffers from major depressive disorder or is suicidal, the possible benefits usually outweigh the possible risks.
There are two types of ketamine used to treat treatment-resistant depression:
Racemic ketamine – this type of ketamine is used as an off-label depression treatment and is typically administered as an IV infusion into the bloodstream.
- Esketamine (Spravato) – this type of ketamine was FDA-approved in March 2019 to be administered as a nasal spray.
- While esketamine is FDA-approved, most of the research on ketamine and depression treatment has been conducted on IV infusions.
Each form of ketamine interacts with receptors in the brain differently. The type of ketamine used and the method of administration given affects the side effects of the drug and its effectiveness. While this much is known, further research is required to learn which is more effective and how the side effects differ between the two.
Potential Side Effects of Ketamine IV Infusion Treatment
- Dissociation (when the mind separates from the physical body)
- Perceptual disturbances (stimulating noises, colors, textures, movement of time)
- High blood pressure
- Nausea and vomiting
Esketamine Spravato nasal spray may cause the same general side effects, but their intensity and duration would differ.
In most cases, any noticeable changes in dissociation or perception are most prominent during the first treatment and end soon after that.
Frequent, long-term use of ketamine will have additional physical and cognitive side effects.
What to Expect During Your First Depression Treatment
When you arrive for your first ketamine infusion for depression treatment, you’ll be taken to a private room where you can get comfortable. A medical professional will attach monitors to your body to assess your vital signs throughout treatment. An IV will be inserted into your arm, where the ketamine will be administered. Shortly after the ketamine drip starts, you will enter a state of deep relaxation. For the next 30 minutes or so, the ketamine drip will continue, and you may have out-of-body-type experience. Once the treatment is over, you will relax for some time before having someone you know drive you home. The infusion treatment lasts about 45 minutes to an hour with the office visit lasting one and a half to 2 hours. If you or a loved one suffers from treatment-resistant depression, major depressive disorder, anxiety, PTSD, or other mood disorders, ketamine depression treatment can help provide relief. Contact us today to book a consultation and learn more.