Ketamine is an FDA-approved anesthetic drug that has been used in anesthesia practice since 1970. It works on several areas in the brain, and has recently been shown to be an effective treatment in managing symptoms of depression, suicidal ideation, Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), Postpartum Depression (PPD), and several pain syndromes.
While any medication may cause side effects, the dosages of ketamine that we use at VMI are associated with minimal side effects. Should they occur they are often short lived, resolving in an average of 30 minutes. The side effects can include dizziness, blurred vision, and rarely, nausea. However, if the patient feels any discomfort from the side effects, we have medication and comfort care to allay these effects.
Ketamine—a depression “miracle drug”
Studies from Yale research labs showed that the drug ketamine, which was widely used as anesthesia during surgeries, triggers glutamate production, which, in a complex, cascading series of events, prompts the brain to form new neural connections. This makes the brain more adaptable and able to create new pathways, and gives patients the opportunity to develop more positive thoughts and behaviors. This was an effect that had not been seen before, even with traditional antidepressants.
Gerard Sanacora, MD, PhD, a psychiatrist at Yale Medicine was involved in many ketamine studies. Dr. Sanacora states, “It wasn’t just, ‘Let’s try this drug and see what happens.’ There was increasing evidence suggesting that there was some abnormality within the glutamatergic system in the brains of people suffering from depression, and this prompted the idea of using a drug that targets this system.”
For the last two decades, researchers at Yale have led ketamine research by experimenting with using subanesthetic doses of ketamine delivered intravenously in controlled clinic settings for patients with severe depression who have not improved with standard antidepressant treatments. The results have been dramatic: In several studies, more than half of participants show a significant decrease in depression symptoms after just 24 hours. These are patients who felt no meaningful improvement on other antidepressant medications.
Most important for people to know, however, is that ketamine needs to be part of a more comprehensive treatment plan for depression. “Patients will call me up and say they don’t want any other medication or psychotherapy, they just want ketamine, and I have to explain to them that it is very unlikely that a single dose, or even several doses of ketamine alone, will cure their depression,” says Dr. Sanacora. Instead, he explains, “I tell them it may provide rapid benefits that can be sustained with comprehensive treatment plans that could include ongoing treatments with ketamine. Additionally, it appears to help facilitate the creation new neural pathways that can help them develop resiliency and protect against the return of the depression.”