Ketamine Therapy: A Proven Medication with a New Purpose

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Ketamine was developed in the 1960s and initial widespread use was in the Vietnam war as an anesthetic. It continues to be used throughout the world in operating rooms. Previously, it also became a popular club drug for its mind-altering properties with a brief hallucinogenic and euphoric effect that can last one to two hours.

However, the past several decades research has found that ketamine has anti-depressive properties and incorporating it into the treatment of psychiatric disorders is highly effective. Although most psychiatric treatments with ketamine remain as an off-label use, there continues to be significant growth in this field and the future is very promising.

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Important Safety Information

Off-label Use of Ketamine

How Does Ketamine Work

Ketamine is an N-methyl-D-aspartate (NMDA)-receptor antagonist and FDA-approved anesthetic. Existing literature suggests that glutamate levels and NMDA receptor mRNA expression are abnormal in patients with major depressive disorder and bipolar affective disorder, and long-term antidepressant treatment reduces NMDA receptor mRNA transcription.

These findings led to the experimental use of ketamine for treatment of depression. Results of early studies of ketamine’s use as an antidepressant in humans are affirming.

Watch the video below to learn more about ketamine and neuroplasticity.

Depression and Ketamine Therapy

Depression is one of the most common and most debilitating mental health disorders. It affects approximately 17 million adults in the United States. affecting some 17 million adults in the US. Depression continues to be a misunderstood illness, and often hard to treat.

Neuroplasticity: Ketamine, the Brain, and Depression

For decades, researchers have been striving to unravel the neurobiology underlying depression. For patients with severe, treatment-resistant depression, the lengthy quest for effective treatments can be profoundly disabling. Historically, the dominant theory was that depression was controlled by the neurotransmitters serotonin and norepinephrine. However, emerging data suggested that a more extensive and global mechanism in the brain is in play. Thus prompting researchers to explore glutamate and GABA, the brain’s most abundant neurotransmitters. These chemicals play a crucial role in neuroplasticity—the brain’s ability to adapt and protect itself against stress. Neuroplasticity is a physical phenomenon, evident in the way synapses, or connections between neurons, form and function. “In depression, the number and strength of these interconnections decreases,” notes Rachel Katz, MD, a professor of Clinical Psychiatry at Yale. Gerard Sanacora, PhD, MD, Director of the Yale Depression Research Program, echoes this sentiment.

Ketamine Efficacy for Depression

Ketamine, initially developed in the 1960s as an anesthetic and still used as an anesthetic, impacts these two neurotransmitters and has been found to have rapid antidepressant effects. In some cases, ketamine treatment has shown to alleviate symptoms in less than 24 hours. “Ketamine appears to help the brain regrow synapses, the connections between nerve cells,” explains John Krystal, MD, Chair of the Department of Psychiatry at Yale. This novel mechanism might explain why ketamine is effective for patients who have not been responsive to traditional antidepressants.

Last year, ketamine has FDA approval as a treatment for depression with the introduction of Spravato (esketamine) for patients unresponsive to at least two other antidepressant treatments. Dr. Sanacora emphasizes the importance of combining ketamine with other therapies, such as cognitive behavioral therapy, to develop new coping strategies and prevent relapse. Innovative treatments like ketamine are transforming our understanding of depression and could pave the way for future research into the brain’s complexities.

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