“IS KETAMINE THERAPY JUST CHASING THE HIGH.”
Ketamine is a dissociative anesthetic and is used to induce a sleep-like state in humans and pets. It’s also a favorite party drug used by people seeking a psychedelic high, which varies on how much of the substance you take.
Ketamine is creating quite the buzz as a treatment for depression, with studies indicating that just two weeks of ketamine therapy can lead to a significant improvement in depression and anxiety.
Even though the treatment is getting growing attention from psychiatrists, people are confused about how the therapy works, and more importantly, can psychedelic drugs get you more than just a dissociating high.
Managing treatment-resistant depression: Patients whose depressive symptoms are not relieved after receiving adequate treatment have “harder-to-treat depression,” typically called treatment-resistant depression (TRD).
The effectiveness of ketamine: Studies have shown that a single dose of ketamine acts rapidly in reducing depressive symptoms, owing to its growing reputation as an effective therapy for treatment-resistant depression.
While ketamine’s potential as an antidepressant has enraptured researchers and patients alike, the subject still needs long-duration studies before its efficacy as a treatment for depression can be established.
How ketamine therapy treats depression: Ketamine was approved by the U.S. Food and Drug Administration (FDA) on March 5, 2019, as a medication for treating major depression. The drug is a nasal spray called esketamine.
What it treats: Major depression is defined as a period of at least two weeks where a person experienced a depressed mood, loss of interest, or pleasure in their daily activities.
The initial clinical use of ketamine: Ketamine has only gained a reputation as an antidepressant over the last two decades despite being used in clinical practice for over half a century.
Ketamine rapidly moves from a party drug to something that could be at the forefront of treating the symptoms of depression, but the subject is still not as well researched. People have reported both positive and adverse side effects to ketamine therapy, with some even reporting the experience as “terrifying.”
What to expect from your first ketamine infusion: Ketamine therapy is typically conducted through intravenous infusions, with doses lower than what is used for sedation.
What happens after you complete the treatment: After the administration of ketamine IV or esketamine, your healthcare provider monitors you anywhere from about half an hour to at least two hours in some cases.
What comes after: The treatment protocols for ketamine therapy vary from patient to patient and depend upon the mode of treatment you are receiving.
If you feel your current treatment for depression isn’t working for you, the first step should be to consult your psychiatrist about whether ketamine therapy is a viable option for you.
Dissociation and a happier existence: A 2021 study interviewed 13 patients aged between 30 and 60 years diagnosed with treatment-resistant depression about their experience of receiving ketamine treatment for depression.
“People on maintenance ketamine are in a cycle of reduced or no depression symptoms (a return to ‘normal’) and then a decline over a period of 5-7 days until their next ketamine infusion. Some participants were able to use ketamine to experience longer remission and return to a socially engaged, active and purposeful life,” stated the authors of the study.
Adverse events: The same study reported that a few participants described their experiences as unpleasant.
Another study involved 54 participants to study the safety and efficacy of ketamine for treatment-resistant depression. During the infusion, the most common side effects of ketamine reported were a feeling of being sick, decreased energy, increased blood pressure, nausea, vomiting, and anxiety.
The ethical dilemma: Many people who have received ketamine therapy recommend that others should try the treatment. However, people are still skeptical of the therapeutic effects of ketamine and other psychedelic drugs.
Despite how ketamine has come into play as a viable therapeutic drug for treating depression, psychiatrists are positive about the outcomes of this form of therapy.
A growing body of research is not studying how ketamine may benefit in treating a number of disorders besides depression, including:
Talking to your psychiatrist: The first step in deciding any form of treatment for depression, including ketamine therapy, requires you to have a thorough discussion with your psychiatrist. It might be the right form of treatment for you if:
Is ketamine therapy the right choice for you: If your depression isn’t the treatment-resistant kind, conventional forms of treatment might be the more comfortable choice. You should also consider how much you are willing to spend, and if you’re fairly risk intolerant to ketamine use.
The risks associated with ketamine therapy: Most healthcare practitioners considered the therapeutic use of ketamine to be safe when after proper screening and under medical supervision.
However, just like anything, there are certain risks associated with ketamine therapy.
Where experts stand: The American Journal of Psychiatry published a report on the available evidence for ketamine and esketamine in treatment-resistant depression.
The report notes that although the therapy is effective in “providing hope to affected persons,” there is still an “urgent need to clarify the long-term efficacy of these agents” along with answering significant questions such as dosage, frequency, and adverse events.
The nasal spray medication approved by the FDA for treating depression is esketamine, which is derived from ketamine.
The efficacy of the medication was evaluated in three short-term clinical trials and one longer-term maintenance-of-effect trial, according to the FDA press release.
The most common side effects experienced by patients using the drug were:
According to a 2021 review, the most common side effects of esketamine include:
Rarer but more severe side effects include:
According to a 2019 study, the most common side effect of ketamine therapy was a “strange or loopy” feeling. This is in conjunction with what various other trials report.
However, another recent study showed that ketamine infusions over a course of two weeks led to a significant worsening of depressive symptoms in several patients.
When it comes to ketamine therapy, you can receive it in several different forms, including:
Depending upon the approach you chose, a single session could cost you anywhere from $400 to $2,000, depending on your location, condition, ketamine dose, and other factors.
Since the Spravato nasal spray is the only FDA-approved treatment for depression right now, insurance companies won’t cover other forms of treatment in most cases.
However, the cost of Spravato is covered to a certain extent by some insurance companies, about which you can learn more here.
On the other hand, ketamine infusions can cost between $400 to $800 per treatment, with most patients requiring 6 treatments over a few weeks. Depending upon the cost of a single infusion, the entire IV treatment can cost up to $4,800.