By Robert Amorde, MD

Living with persistent depression, suicidal ideation, chronic pain, or any mental health disorder takes a major toll on life. As time passes each new medication and treatment brings initial hope, but sometimes that hope goes unfulfilled and symptoms continue—you may feel there is no hope left.  If you or a loved one are suffering from persistent feelings of hopelessness, worthlessness, sadness, fatigue, anger or suicidal thoughts, do not give up hope.  Ketamine may be able to help. 

Ketamine is a treatment option for patients with persistent cases of major depressive disorder, suicidal ideation, bipolar disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and chronic pain. Ketamine is a highly effective alternative treatment and works differently than oral antidepressants. Studies have shown Ketamine can improve symptoms within hours, compared to oral antidepressants that often take weeks to demonstrate their effectiveness. Learn more about what ketamine can do for depression.

What is Ketamine?

Ketamine was developed over 50 years ago as an anesthetic agent with a long history of safe human administration.  Over the last 20 years Ketamine has been found to be effective in improving persistent symptoms of major depressive disorder in people who have not responded to, or not tolerated, conventional therapy.  Depression that does not improve with oral antidepressants is classified as Treatment Resistant Major Depressive Disorder. Ketamine’s ability to rapidly improve persistent feelings of sadness and suicidality provides a beacon of hope to those who may feel all options for improvement have been exhausted.

How Ketamine Treatments Work

Ketamine is not like standard oral therapy because it works on different biochemical pathways. Oral antidepressants work by increasing the concentration of monoamine neurotransmitters in the brain. Monoamine transmitters include serotonin, dopamine and norepinephrine.  Ketamine works in the glutamate system by altering the messages and responses communicated within the brain’s neural structure through interactions with NMDA glutamate receptors. 

Some patients have noticed symptom improvement 4 hours after their initial treatment. Depression, anxiety, pain and other forms of stress damage the communication system between areas of the brain that are responsible for memory, learning and higher-order thinking. Ketamine is able to stimulate the resources necessary to repair this damage.

How Is It Administered?

Ketamine is administered via a slow intravenous infusion. Treatments typically begin with a series of 6 infusions occurring over a three-week time period. After the initial infusions, maintenance infusions occur at individualized time intervals. The dose used for the treatment of mood and anxiety disorders is very low and safe.

About the Author

Robert Amorde, MD is a medical provider in the Fox Cities where he has practiced Anesthesiology for the past 10 years. He has been the medical director of the Ketamine Wellness Center since it opened in 2018.  Dr. Amorde holds a bachelor’s degree in chemistry and biochemistry from the College of St. Scholastica and a Medical Degree from Loyola University Chicago, Stritch School of Medicine.

References

Berman, R. M., Cappiello, A., Anand, A., Oren, D. A., Heninger, G. R., Charney, D. S., & Krystal, J, H. (2000). Antidepressant effects of ketamine in depressed patients. Biological Psychiatry, 47(4), 351-354.

Krystal, J. H., Abdallah, C. G., Sanacora, G., Charney, D. S., & Duman, R. S. (2019). Ketamine: A paradigm shift for depression research and treatment. Neuron, 101, 774-778.

Study answers why ketamine helps depression, offers target for safer therapy. (2018, January 2). UTSouthwestern Medical Center . https://www.utsouthwestern.edu/newsroom/articles/year-2017/ketamine-protein-monteggia.html