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Ketamine: A Game-Changing Treatment for Treatment-Resistant Depression
Ketamine: A Game-Changing Treatment for Treatment-Resistant Depression

Ketamine: A Game-Changing Treatment for Treatment-Resistant Depression

Ketamine: A Game-Changing Treatment for Treatment-Resistant Depression

Ketamine improves depression quickly and effectively

Until recently, electroconvulsive therapy (ECT) was the only option for treatment-resistant depression (TRD), or clinical depression that doesn’t respond to treatment. ECT intentionally triggers a brief seizure and carries risks and serious possible side effects, such as memory loss and difficulty learning. Now, research shows that ketamine may improve treatment-resistant depression as effectively as ECT with fewer negative side effects. This revolutionary treatment brings hope to many people suffering from severe depression.

Illustration of woman parting heavy, dark curtains to let in some light
Illustration by Joseph Moore
The History Behind Ketamine

Developed in the 1960s, surgeons and veterinarians have long used ketamine for its potent painkilling and sedative properties. Ketamine can also produce feelings of unreality, hallucinations and euphoria. It’s these effects that led to its abuse as a club drug and classification as a controlled substance. More recent research shows that ketamine at lower doses has great potential for use in psychiatric medicine, and it is currently approved for treating patients with severe depression that doesn’t respond to other treatments.

What Makes Ketamine Different from Typical Antidepressants?

Ketamine works in an entirely different way than most currently prescribed antidepressants. Unlike traditional antidepressants, ketamine operates on glutamate – a chemical messenger that regulates your nervous system and performs a significant role in your brain’s response to experiences.

Neuroimaging shows that ketamine spurs a release of glutamate in the prefrontal cortex. Researchers suspect that this surge activates downstream receptors, which then trigger new synapses to grow. According to pioneer ketamine-researcher John Krystal, MD, of Yale Medicine, “With most medications, like Valium, the anti-anxiety effect you get only lasts when it is in your system. When the Valium goes away, you can get rebound anxiety. When you take ketamine, it triggers reactions in your cortex that enable brain connections to regrow. It’s the reaction to ketamine, not the presence of ketamine in the body that constitutes its effects.”

Another important difference is that ketamine works almost instantly. Traditional antidepressants may take several weeks or longer to improve symptoms. Ketamine’s fast-acting effects make it especially useful for treating people in crisis.

Spravato® (Esketamine) – A More Patient-Friendly Version

In 2019, the FDA approved Spravato® (esketamine) nasal spray for treating treatment-resistant depression and depression with suicidal thoughts. Derived from the ketamine molecule, it binds more tightly to certain glutamate receptors than ketamine, increasing its potency. This means that you can receive a lower dose of Spravato®, potentially causing fewer side effects. While ketamine treatments must be delivered intravenously, Spravato® is delivered by nasal spray. This gives you better access to treatment because your doctor can administer it more easily in an outpatient setting.

Side Effects of Ketamine

Both ketamine and Spravato® can sometimes cause side effects, such as:

  • Dysphoria
  • Increased blood pressure
  • Drowsiness
  • Nausea
  • Headaches

While most people don’t experience severe side effects, it’s still important to talk to your doctor about any potential issues that may arise during treatment. Your doctor will be able to help you decide whether this treatment is right for you.

Next Steps

If you or someone you love suffers from severe depression, you may benefit from professional help. Talk to your primary care doctor about options or contact the caring professionals at Athena Care today.

Photo of Rachel Swan
Rachel Swan, MS

Rachel has a Masters of Science in Clinical Psychology from Vanderbilt University, where she spent 16 years as a Research Analyst in the Psychology and Human Development Department.