Ketamine for Depression: What You Need to Know

“Depression for me, is like the ticker tape that runs at the bottom of your TV screen,” says Polly H.. “I’ve had negative thoughts about other people and about myself, mostly, that “I’m not good enough,” that “I’m unworthy to be happy,” “it’s my fault,” or that “everything that goes wrong is my fault.”

Polly tried antidepressants for about 35 years. “The hardest part was being on antidepressants and not feeling that they were working anymore,” she says. “After the third (ketamine) treatment, the part of my brain where all the negative feelings are, it wouldn’t let me in, and it’s been two months since my last treatment, and I still can’t get in! It’s fabulous! It’s freeing. It’s wonderful.”

“The impact that it’s had on me has been phenomenal. I kind of say like I’m “born again,” because I feel like I’ve never had this brain, a normal brain, because I’ve had depression since I was a child. After ketamine, I’m at a 10. I don’t feel that depression anymore.”

What is Ketamine?

In the 1960s, ketamine surfaced as an anesthesia medicine for animals. The FDA approved ketamine as an aesthetic for humans in 1970 and it was first used as a treatment for wounded soldiers during the Vietnam War. Over the decades, it was found to have a powerful effect on the brain that could reduce depression, anxiety, and suicidal ideation.

Emergency responders, for example, had tried giving ketamine to an agitated patient who had attempted suicide. Although the initial attempt was to calm the patient down, the result was the patient reporting not feeling suicidal for 9 months afterwards. Over the decades since ketamine was first used in humans, doctors like Ken Stewart, MD, began to find that ketamine could have powerful effects against depression, anxiety, and suicidal thoughts, as well as bipolar disorder, obsessive-compulsive disorder, and PTSD. “When enough stories like that started to pile up”, doctors said, “Maybe there’s something here,”” says Stewart.

Ketamine differs from other aesthetics in that it doesn’t slow breathing or heart rate. As a result, patients do not need to be on a ventilator to receive ketamine treatment. Currently, ketamine should be administered only by a certified medical professional by either one of two methods: 1.) by IV or 2.) by nasal spray.

The Effects of Ketamine

What are the effects of ketamine? The drug can cause feelings of unreality, visual and sensory distortions, unusual thoughts, and a sense of euphoria. The human brain may respond in a number of different ways to the treatment. Some patients who have experienced depression for much of their life lose some of their brain’s synapses (or connections) that allow nerve cells to communicate. Research is showing that a dose of medically supervised ketamine can actually encourage these connections to regrow.

Ketamine may help patients’ brains in other ways too. For example, some neurons which affect mood use a chemical known as glutamate to communicate with each other. The glutamate receptors in nerve cells are weakened in those who experience depression. Once a patient receives ketamine treatment, new glutamate receptors in the nerve cells appear to replace those that have weakened or have deactivated. The regrowing and reactivating of these receptors is what helps the brain to change and move out of a state of depression. It may also be the reason why antidepressants or psychotherapy that didn’t work for the patient prior to ketamine treatment may actually work afterward.

Ketamine Treatment

The IV infusion of ketamine lasts for approximately 40 minutes. The dissociative sensations begins quickly and subsides about 15 to 20 minutes after the drip ends. During the treatment, a doctor is always present should the patient become anxious or confused. During the process, the patient looks as if they are asleep. Most people during the IV infusion don’t move or say anything and feel calm during the process.

When a patient receives a single infusion, the effects of ketamine wear off in several hours, days, or a couple weeks. With several doses, the effect can last much longer. A few weeks, months, or even years, after the first series of six to eight infusions, people may come back for a booster. However, there is no standard recommendation for patients needing a followup infusion, as they may discuss possibilities of a booster with their doctor if their symptoms of depression or anxiety reappear.

According to Stewart, “For about 30% of people who complete the whole series, that’s it. They never come back.”

Cost & Insurance

At present, the only FDA-approved ketamine treatment for depression is nasal spray (esketamine or Spravato). This is also the only treatment that insurance will cover. Most insurance will not cover an IV ketamine infusion, so you can expect to pay around $450 for a single infusion and approximately $3,000-$4,000 for six infusions. (This doesn’t include booster doses).

Some patients may opt for the IV treatment over intranasal administration. Currently, research doesn’t show whether IV or intranasal treatment is more effective over the other. Learn more about the differences between Spravato vs ketamine infusions here.

Ketamine for Depression: In Conclusion

Although this anesthetic drug was originally developed over 60 years ago for anesthetic purposes in surgery, in recent years, it has been found to be highly effective for treating a number of mental health conditions. Ketamine can help to treat persistent cases of depression, anxiety, suicidal thoughts, bipolar disorder, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD) alike. The breakthrough of ketamine’s powerful effect against depression sufferers is still being researched. While the drug may not work for everyone, it’s profound impact has truly changed some people’s mental well-being.

“Before the ketamine treatments, my future was rather bleak-looking. I just, kind of, lived day-to-day. I am so thankful for the Ketamine Wellness Center, because it has truly changed my life, not on the outside so much, but on the inside. And to feel so good, is just a huge blessing.” – Polly H.

References

Collins, S. (n.d.). What is ketamine? how it works and helps severe depression. WebMD. Retrieved from https://www.webmd.com/depression/features/what-does-ketamine-do-your-brain