Every year, 8.1% of adults in the United States will suffer at least one major depressive episode. That’s about 21 million people. But only about two-thirds of those individuals will receive treatment for their depression.
Some individuals don’t seek treatment because they feel the available remedies don’t work. It’s not uncommon for patients to report constant, recurring depressive episodes. This can happen despite trying every available antidepressant.
Many will give up hope of finding an effective treatment.
For these individuals, ketamine therapy may present the solution they’ve been looking for. But how can ketamine help individuals that suffer from treatment-resistant depression?
To find out, let’s look at this medication and how it’s revolutionizing treatment.
What Is Ketamine?
Ketamine is a short-acting general anesthetic. It was first developed in Belgium in the 1960s for veterinary purposes. In the 1970s, it was approved for human medicine. It soon found use as a sedative and pain medication during the Vietnam War.
Ketamine is what’s called a dissociative sedative. Besides sedation, it can cause effects like euphoria, vivid dreams, and waking hallucinations.
Researchers believe this is because of how it interacts with receptors in the brain. Of particular note, it blocks the neurotransmitter glutamate.
Because of its sedative effects, emergency responders may give it to agitated patients in high-stress situations. Calming a patient after an attempted suicide is one such example.
This emergency application piqued doctors’ interest in the drug’s therapeutic potential. Patients who had been suicidal reported improvement after receiving ketamine. For some, this period of relief would last for months.
When one person reports improvement in their suicidal depression, it’s easy to dismiss. It could be a coincidence or an individual’s unique reaction to the drug.
But when multiple patients report a similar phenomenon, coincidence becomes less likely. Instead, doctors have to question if there’s something worth investigating. And through those inquiries that researchers developed a model for ketamine-assisted psychotherapy.
Background of Ketamine-Assisted Psychotherapy
In the year 2000, a Yale School of Medicine team carried out a controlled randomized trial to determine ketamine’s efficacy in treating depression. It was the first such study ever conducted.
The team found that a single dose could improve severe depression symptoms in as little as 24 hours. In some cases, subjects reported a complete recovery. And the dose administered was less than the amount used for anesthetic purposes.
This was the beginning of the modern movement toward using ketamine for therapy. In the almost two decades that followed, evidence would continue to mount. It became clear that ketamine could be a safe and effective remedy for treatment-resistant depression.
In 2019, the FDA would finally approve a ketamine-based antidepressant. Administered by a doctor, it’s authorized for treatment-resistant depression and suicidal ideation. At the time of this writing, it remains the only medication to get such approval.
But it’s a promising start. Its success continues to captivate researchers and medical professionals.
Although only one such medication is approved to treat depression, patients still have options. Under the law, doctors may prescribe medications outside of their approved purposes if they have the patient’s consent. This means that patients may still receive other forms of ketamine-based therapy.
Thanks to this caveat, we continue to learn more about ketamine’s capabilities.
The Ketamine Therapy Experience
Ketamine-assisted psychotherapy (KAP) emerged as a promising new treatment for depression and post-traumatic stress disorder in the last decade. And as we learn more about it, its potential for treating other conditions becomes clear.
But if it’s so effective, you might question why it’s only now finding wide therapeutic use. It’s a fair question. And part of the answer is due to certain stigmas around the drug.
Like other psychedelic or dissociative medicines, ketamine found popularity as a party drug. This caused many researchers to dismiss its purported benefits without proper examination.
And it’s also partly why ketamine therapy is administered in controlled environments. In a normal therapy session, ketamine will be given intravenously. The FDA-approved nasal spray-administered alternative may also be available.
Supervision for these sessions is only one reason why these are the preferred methods. Another important factor is time.
A survey of studies found that when given via IV, patients tend to report improvement within 24 hours. In some cases, it can take as little as two hours. By contrast, oral doses could take up to two weeks to provide relief.
That ketamine can ease symptoms in such a short time may be its greatest strength. For patients suffering severe distress, it can mean preventing a mental health emergency.
Ketamine Benefits for Depression Treatment
As a dissociative agent, ketamine use can cause a wide range of experiences. Patients may describe sensations unique to them.
Some will have altered perceptions of time. Others have temporary mood and behavior changes.
In general, patients should expect feelings of unreality. Visual or sensory distortions and distorted feelings about one’s body are common. Unusual thoughts and beliefs combined with euphoria are likewise normal.
It’s after this period that the therapeutic component of the treatment takes place. A healthcare provider sits down with the patient to discuss their experience. This part of the process is called integration.
Some clinics will do this talk therapy session immediately afterward. Others may have the patient do their integration with another mental health professional. It often depends on the needs of the individual.
Patients tend to have a great deal to say during this time. Taking ketamine can be a profound experience. And oftentimes, it can lead to the patient unpacking a lot of mental or emotional baggage that they’ve been carrying with them.
Some patients will not experience the “trip” other patients describe. All the same, though, they still tend to report relief from their depression symptoms.
Researchers are still trying to determine why patients report such varied responses. One theory concerns the state an individual’s brain is in when they start treatment.
When a person lives with depression for a long time, they lose some of the synapses in the brain. These are key parts of the nervous system that the brain uses to communicate. Controlled ketamine use may help some of those connections regrow.
Potential Side Effects
Like any medication or treatment, ketamine carries potential risks and side effects. Most of the effects are mitigated when ketamine is administered in a clinical setting. But some are still a factor even in small, controlled doses.
For example, while most individuals respond well to ketamine, adverse reactions can happen. These experiences may include feelings of paranoia and panic attacks. Short-term memory loss and unpleasant hallucinations are also possible.
That said, most risks associated with ketamine come from its misuse. And as a popular party drug, these risks are well-documented.
Individuals who use ketamine may struggle to move or speak. Used under medical supervision, there is little risk to the patient when this happens. But when used recreationally, a person may fall due to numbness and loss of coordination and cause injury.
Ketamine can also cause unpredictable emotional responses. Users may become agitated or aggressive.
Again, in a clinical setting, there’s little danger. Outside of a professional setting, ketamine-induced mood swings can lead to violent altercations.
And using the drug in high doses over long periods carries more risks.
Vomiting and memory problems are both signs of ketamine misuse. Prolonged abuse can lead to liver and renal failure. Slowed and stopped breathing can also occur and may lead to death.
Users who abuse ketamine may also develop a dependence on it. Becoming addicted to any drug increases the risk of misuse and long-term harm. These reasons are why it should only ever be administered by a healthcare professional.
Alternatives to Ketamine Therapy
Ketamine is only one of the emerging psychoactive treatments among many.
For a natural alternative, microdosing psilocybin in Arizona is one potential candidate. Psilocybin is the active ingredient in “magic mushrooms”. This naturally occurring psychedelic has been used by numerous cultures for thousands of years.
And there is a historical precedent to support their use as a therapeutic tool. Clinical research into psilocybin’s benefits was already underway by the 1960s. Those advances would come to an end when the Drug Enforcement Agency reclassified psilocybin as a Schedule I drug.
While it remains restricted under federal law, attitudes towards psilocybin have relaxed. It now finds use in psilocybin therapy in Arizona.
MDMA-assisted therapy that’s worth exploring. Clinical trials suggest that MDMA is effective at treating disorders like PTSD for up to four years. One found that after treatment, two-thirds of participants with PTSD no longer qualified for that diagnosis.
Using KAP to Take Your Life Back
Living with depression can make you feel like you don’t have full control over your own life. By using ketamine therapy as part of our approach, we can help you take your life back.
