Ketamine has been safely used in the field of anesthesiology for many decades. It is a US Food and Drug Administration (FDA) approved sedative medicine and can be found on the World Health Organization’s List of Essential Medicines.
Ketamine is a glutamate N-methyl-D-aspartate receptor (NMDA-R) antagonist. In the 1990’s, several studies suggested that these antagonists had a significant impact on improving depressive symptoms within hours of treatment.1
In 2000, the first double-blinded, placebo-controlled study on the subject concluded that patients treated with ketamine showed a significant decline in depressive symptoms when compared to the placebo.2
The results of a larger randomized control trial, using an active placebo, showed a significant reduction in the patients’ depression severity.3
In traditional doses, ketamine is a reliable agent for the induction and maintenance of anesthesia as well as for procedural sedation in both children and adults.
More recently, a compelling amount of evidence shows that in sub-anesthetic doses, a ketamine infusion can produce a rapid, profound, and sustained improvement in many debilitating psychiatric and pain conditions.
Looking into the neurophysiology of ketamine’s effects, researchers have discovered sustained changes in frontoparietal lobe activity following a sub-anesthetic infusion, possibly explaining its efficacy in the treatment of other neuropsychiatric (OCD, PTSD, etc) and pain disorders beyond depression.5
Studies looking specifically into OCD, PTSD, GAD, Bipolar disorder, Fibromyalgia, Refractory Headache, Neuropathic Pain and CRPS have shown very convincing results for the use of ketamine therapy in these conditions.6, 7, 8, 9, 10, 11, 12
Currently, electroconvulsive therapy (ECT), also known as “electro-shock therapy”, is considered the gold standard for the treatment of resistant depression. In this therapy, electrodes are placed across the patient’s forehead, general anesthesia is induced, and a strong electrical current is applied to induce a clinical seizure leading to chemical changes in the brain.
Side effects of ECT include memory loss, muscle/jaw pain and even the possibility of cardiovascular collapse/death.
As a promising alternative, ketamine has been shown to have a significant benefit even in ECT treatment-resistant depression, without exposure to these potential side effects.4
Furthermore, if you feel you have exhausted your current treatment options including depression therapy, ketamine infusion therapy may be the next step for you.
ARTICLE REFERENCE LINKS
- Adaptation of N-methyl-D-aspartate (NMDA) receptors following antidepressant treatment: implications for the pharmacotherapy of depression.
- Antidepressant effects of ketamine in depressed patients.
- Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial.
- Rapid decrease in depressive symptoms with an N-methyl-d-aspartate antagonist in ECT-resistant major depression.
- Evidence that Subanesthetic Doses of Ketamine Cause Sustained Disruptions of NMDA and AMPA-Mediated Frontoparietal Connectivity in Humans.
- Randomized controlled crossover trial of ketamine in obsessive-compulsive disorder: proof-of-concept.
- Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial.
- Effect of baseline anxious depression on initial and sustained antidepressant response to ketamine.
- Ketamine as a novel treatment for major depressive disorder and bipolar depression: a systematic review and quantitative meta-analysis.
- Ketamine in chronic pain management: an evidence-based review.
- Intravenous Ketamine Infusions for Neuropathic Pain Mangement
- Ketamine Infusions for Treatment Refractory Headache