Are There Mental Health Benefits to Ketamine Treatments?

What’s your first association when you hear the word “ketamine”? Chances are, you’ve only known this drug through its reputation as a “club drug,” sought after by partiers who wanted the dissociative experience of a trip. Or, you may be familiar with its use in surgical suites as an anesthetic medication.

Well, forget everything you thought you knew about ketamine. A flurry of clinical research has prompted physicians to repurpose ketamine as a treatment for patients suffering from depression and trauma symptoms. Here’s what to know about ketamine and the potential benefits of ketamine treatments for chronic mental health conditions.

What is ketamine?

Ketamine got its start as an anesthetic in the 1970s, when it was used extensively as a surgical anesthetic during the Vietnam War. Compared to other anesthetics, ketamine suppresses breathing much less, and it stimulates the circulatory system (contrary to depressing it).

Until recently, ketamine was most well-known as a club drug, thanks to its hallucinogenic properties. Used recreationally, ketamine can “produce feelings of unreality; visual and sensory distortions; a distorted feeling about one’s body; temporary unusual thoughts and beliefs; and a euphoria or buzz,” according to John Krystal, MD and leader in the field of ketamine study.

Currently, the FDA has only approved ketamine for general anesthetic use and the nasal spray esketamine (Spravato) for use in physician offices for treatment-resistant depression. Interestingly, a recent review of 24 studies compared the relative effectiveness of ketamine versus the FDA-approved esketamine treatment and concluded that the IV ketamine treatment was more effective in treating depression. Ketamine infusion treatment is being utilized as an off-label treatment for depression, trauma, anxiety and pain conditions that have not responded to other treatments.  

How Does Ketamine Work?

Ketamine exerts a number of different effects on the brain and research is ongoing to understand exactly how it rapidly reduces mental health symptoms. It is well-established that ketamine blocks NMDA receptors in the brain and increases levels of the neurotransmitter glutamate. Ketamine also increases brain derived neurotrophic factor (BDNF) and stimulates synaptogenesis. This results in improved communication between neurons and brain connectivity.

Ketamine treatments and mental health

Ketamine infusion treatments at subanesthetic doses have been studied in treatment-resistant depression. A meta-analysis from the University of Exeter found that ketamine therapies provided “robust, rapid and transient antidepressant and anti-suicidal effects.” Specifically, a single ketamine infusion showed a reduction in unipolar depression severity as soon as an hour after treatment and lasted for up to two weeks. In bipolar depression, symptoms improved as soon as four hours after a single treatment, and the effects lasted up to three days. Repeated ketamine infusions are often used in clinical practice in order to extend the treatment response.

A recent study reviewed five randomized clinical trials of ketamine infusion for the treatment of PTSD. The study concluded that ketamine rapidly improved core trauma symptoms including intrusive memories, avoidance of trauma triggers as well as negative mood and thoughts.

There are few clinical studies investigating ketamine infusion treatment for anxiety disorders. A small study found ketamine may be effective in reducing social anxiety disorder. A 2013 randomized controlled trial investigated ketamine infusion treatment for adults with obsessive compulsive disorder (OCD). The study found a rapid reduction in obsessions following a single ketamine infusion that lasted up to a week. More clinical research is needed for these conditions.

So, should you try ketamine therapy?

First, the necessary caution: ketamine infusion treatment is not appropriate for every mental health condition and the FDA has not approved its use for depression, anxiety or PTSD. There is also a lack of oversight in the dissemination of ketamine treatments. You should not try ketamine recreationally or without the supervision of a licensed practitioner in a clinical setting.

A clinician should ensure that ketamine does not interact with any prescribed medications you are taking. There are certain medical conditions, including pregnancy and uncontrolled high blood pressure, that would be contraindications for the treatment.

What’s the best way to determine if ketamine treatment is right for you? Schedule a brief call with our Wild Health Ketamine Clinical Team or talk to your physician. And, if you are interested in being a part of our upcoming ketamine research study please check out our ketamine website.