Overview
Ketamine is a popular club drug that got its start in the 1960s as an anesthesia medicine during the Vietnam War. Today, it is making strides as a popular drug for treating severe depression, but is it safe?
Ketamine and the Brain
It’s essential to understand how ketamine works in the brain. Once ingested, ketamine quickly takes over a receptor in the brain and acts rapidly. Under professional medical care, this could be beneficial, but outside of medical care, it is hazardous.
Studies from Yale research labs show that ketamine starts glutamate production in a complex, cascading series of events. Then it prompts the brain to form new neural connections. This allows the brain to be more adaptable and it enables the brain to create new pathways, thus allowing patients to develop more positive thoughts and behaviors. This is an effect that had not been seen before, even with traditional antidepressants.
Important for people to know, however, is that ketamine needs to be part of a more comprehensive treatment plan for depression. Ketamine may be most effective when combined with cognitive behavioral therapy (CBT). CBT is a type of psychotherapy that helps patients learn more productive attitudes and behaviors. Ongoing research, including clinical trials, addressing this idea is currently happening at Yale.
Ketamine for Depression
Doctors are most likely not giving ketamine to patients as an antidepressant. It is still being tested by scientists for its antidepressant effects, and it is not approved by the FDA. In current studies and clinical trials, patients with severe depression are administered ketamine through IV injection or nasal mist once a week under medical supervision and some have reported that depression symptoms ease in only a few hours after a ketamine dosage. Still, other results show that few were helped by ketamine. These studies continue in hopes that they will discover a dosage that is large enough to relieve depression but small enough to avoid the unfortunate side effects.
What sets ketamine apart from other antidepressants is its fast-acting properties. Most anti-depressants take a few weeks before people begin to feel them work, but ketamine’s effects on depression seem to happen as soon as it leaves your body.
While all the reports sound promising, ketamine is not ready for significant use on the clinic level. There are too many unknowns, it still can have many unfortunate side effects, and it has a reputation as a street drug with addictive properties.
What Ketamine Does
When ketamine is taken in a low dose, it can lower pain, but when abused, ketamine can change your senses of sight and sound. People have reported suffering from hallucinations and having difficulty speaking and moving.
A high dosage of ketamine can make you feel like you are in what users have termed a “k-hole.” This usually occurs right before one may fall unconscious.
Ketamine has several addictive properties, including tolerance, which makes users require a higher dose to achieve the same intoxicating effect that was previously experienced at a lower dose. This increases chances for an overdose, which may be deadly.
Other Ketamine side effects are:
• Bloody or cloudy urine
• Trouble urinating or needing to urinate often
• Pale or bluish lips, skin, or fingernails
• Blurred vision
• Chest pain, discomfort, or tightness
• Shortness of breath, difficulty breathing, or not breathing
• Confusion
• Convulsions
• Problems with swallowing
• Dizziness, faintness, lightheadedness, or fainting
• Fast, slow, or irregular heartbeat
• Hives, itching, rash
• Delusions
• Puffy or swollen eyelids, face, lips, or tongue
• Sweating
• Feeling too excited, nervous, or restless
• Unusual tiredness or weakness
Esketamine
Esketamine is a new FDA-approved drug created for one version of the ketamine molecule. It only accounts for half of what is found in the anesthetic form of the medicine. It works quickly and closely to ketamine, but due to its chemical makeup, it binds more tightly to the glutamate receptors making it two to five times more potent. Therefore, patients need a lower dosage of esketamine than they do of ketamine. This new drug needs to be given under the supervision of a medical doctor and can be delivered in a nasal spray option making it easier to administer in an outpatient setting that by an IV as most ketamine treatments are required.
Esketamine comes with side effects and cautions as any new drug, dizziness, rise in blood pressure, disconnection for reality, feelings of detachment, etc. Also, as of 2019, doctors have only followed patients using esketamine for a year, so its long-term effects are still unknown.
Esketamine is just a part of treatment for those with depression and its shown to only be effective when taken in combination with an oral antidepressant. It’s only prescribed for people with moderate to severe depression who have received no help from at least two other antidepressant medications.
If you or someone you love is battling depression or a mental health disorder our caring, licensed, and professional IMPACT Behavioral counselors are available to you at every Pathway Healthcare and Impact Healthcare location. Find a location near you.
