Ketamine Therapy For Depression: How Does It Work?

Besides their impressive wealth, what do several of the richest people in the world have in common? They promote the use of ketamine for depression and anxiety. Elon Musk is one such billionaire who uses ketamine. One might think someone like him wouldn’t be depressed, but it’s proof anyone can be. Let’s look at ketamine therapy for depression: how does it work?

Once Upon a Time a Party Drug

Ketamine was first used as an anesthetic for animals in the 1960s. Then it was approved by the FDA for humans in the 1970s, and was used extensively to treat injuries during the Vietnam War.

It became a party drug and was known as “special K,” put into drinks, injected, snorted, or added to joints. It projected a feeling of euphoria, but could be fatal if taken with alcohol. The side effects included high blood pressure, slowed breathing, kidney problems, ulcers, stomach pain, and poor memory.

Remedy for Treatment Resistant Depression

Today there are many clinics opening throughout the United States where ketamine can be given in a controlled clinical setting with a protocol for medically supervised use.

It has been found to be a help for those people who have taken antidepressants sometimes for years without getting any benefit, or for those considered having treatment resistant depression.

It is now being used two ways:

In 2019 it was FDA approved as a nasal spray taken along with other other oral antidepressants. It is dispensed in a controlled setting, and the patient is supervised by a doctor for approximately two hours after the spray.
As another form, it is an IV infusion or a shot given only in a doctor’s office. Patients must remain for several hours after the infusion and most receive counseling to determine the effectiveness before being released. It can have dissociative properties or out of body sensations like a hallucinative.

How Does Ketamine Work?

Neurons in our brain involve mood. A chemical neurotransmitter called glutamate allows communication between these cells, but they need glutamate receptors to work properly. These receptors become weakened during depression. With Ketamine the neuron glutamate receptors are reactivated to allow antidepressant effects.

In low doses ketamine alters levels of glutamate which results in new neural connections creating new pathways. This helps patients become more positive. This effect is almost instantaneous whereas antidepressants can take weeks to begin to work.

The downside is the way the brain responds can have addictive risks. It’s too early to determine if the risk of addiction or tolerance outweighs the benefits. This treatment may not be suitable for people who have a history of substance abuse.

There is no standard recommendation for when or if boosters are needed. Approximately 30% of patients never return after one treatment. Less treatments and a slow weaning process seems best.