Ketamine has taken center stage recently as a new therapy for hard-to-treat depression, PTSD, and other mental health disorders.
This drug once known as a veterinary anesthetic and “club drug” is now gaining mainstream acceptance for its potent antidepressant and anti-anxiety effects. The growing excitement around ketamine therapy has led to a surge in ketamine clinics across the country.
But is this seemingly miraculous mental health treatment really all its hyped up to be? Let’s take a closer look at the current ketamine therapy craze.
What is Ketamine?
First synthesized in the 1960s, ketamine is a dissociative anesthetic that can induce a trance-like state and memory loss. Because it is safer and more effective than similar anesthetics like phencyclidine (PCP), it was adopted for use as a battlefield anesthetic during the Vietnam War.
Since the 1970s, ketamine has been used recreationally as a club drug and hallucinogen. At low doses, it produces mild euphoria and dissociation. At higher doses it can cause psychedelic effects and “K-holes” – temporary states of complete dissociation from reality.
Ketamine for Treatment-Resistant Depression
In the 1990s and 2000s, research began to demonstrate ketamine’s effectiveness at rapidly reducing treatment-resistant depression (TRD) symptoms. While traditional antidepressants like SSRIs can take weeks to take effect, ketamine can quickly provide relief for some people, within as short as 40 minutes, research shows (Harvard Health Publishing).
There is also a growing body of research on ketamine for reducing suicidal ideation or thoughts. The potential short-term effects shown during use in acute-care settings needs more studies done, though, as this area is still fairly new. Also, comorbid mental disorders are important factors.
The Rise of Ketamine Clinics
As evidence for ketamine’s TRD effects mounts, there has been a boom in ketamine clinics across the U.S. These clinics provide intravenous ketamine infusions to patients with mood disorders. Prices range widely from $350 to over $1000 per infusion, with patients requiring 4-6 infusions on average.
Most of these clinics operate on a cash-pay basis since ketamine is generally not covered by insurance for mental health treatment. Critics argue ketamine clinics profit off vulnerable people by aggressively marketing an expensive treatment without enough research behind it.
But advocates view qualified clinics as lifesaving options for those not helped by other therapies. Guidelines have been developed to uphold safety and ethics at clinics. And an increasing number of academic medical centers are now offering ketamine.
Concerns about Ketamine
Despite promising research, there are valid concerns about the ketamine craze. Ketamine does provide rapid but generally short-lived relief of depression. Long-term impacts and optimal dosing are still unknown.
And misuse can be dangerous — Ketamine may cause dissociation, hallucinations, faster heart rate, and a rise in blood pressure. Dependence is also possible with long-term, frequent use.
More research is still needed on the safety and long-term outcomes of ketamine treatment. More studies must happen to determine who can safely benefit from ketamine therapy, as well as which method is best (intravenous, nasal spray, or taking a pill).
While the US Food and Drug Administration (FDA) has approved doctors to prescribe ketamine, it is not approved for treatment of any psychiatric disorder. While the FDA knows about compounded ketamine products have been marketed towards this, the FDA has not determined that ketamine is safe for these uses. Messages of concern about the risks associated with high doses recently skyrocketed on social media following the passing of actor Matthew Perry.
Alternative Types of Therapy than Ketamine Therapy
Here are some other therapy options than ketamine:
- Cognitive Behavioral Therapy (CBT) – This is one of the most researched and effective therapies for depression and anxiety. It focuses on modifying negative thought patterns and associated behaviors.
- Dialectical Behavior Therapy (DBT) – DBT teaches distress tolerance, emotion regulation, and interpersonal effectiveness skills. It is often used for borderline personality disorder.
- Interpersonal Therapy (IPT) – IPT aims to improve interpersonal functioning and relationships. It is useful for depression caused by life changes and events.
- Eye Movement Desensitization and Reprocessing (EMDR) – EMDR uses bilateral stimulation like eye movements while recalling traumatic memories to reprocess them. It is primarily used for PTSD.
- Acceptance and Commitment Therapy (ACT) – ACT increases psychological flexibility and values-based action. Some people find ACT helpful with depression, anxiety, addiction, and more.
- Exposure Therapy – This behavioral therapy gradually exposes you to a fear stimulus in a safe way to decrease fear and anxiety. It is highly effective for phobias and OCD.
- Transcranial Magnetic Stimulation (TMS) – TMS uses magnetic pulses to stimulate and rebalance brain activity. It has been cleared for treatment-resistant depression.
- Electroconvulsive Therapy (ECT) – ECT passes small electric currents through the brain to induce a brief seizure. It remains a last resort treatment for severe depression.
- Support Groups – Connecting with others facing similar mental health challenges can provide support. Groups focus on issues like depression, anxiety, addiction, and grief.
About Ketamine Therapy
Ketamine therapy does show immense promise for giving short-term relief to people with treatment-resistant depression and suicidal thoughts when other options have failed.
But providers must be cautious not to overstate benefits without sufficient data. Time and science will tell if ketamine lives up to its lofty expectations. For now, this intriguing new therapy provides fresh hope to those suffering from depression’s most debilitating effects when standard treatments have let them down.
This article is for information purposes only and is not medical advice. Always seek your doctor’s help for depression and other mental health conditions. See your doctor immediately if you are contemplating suicide. The FDA has not approved the use of ketamine for psychiatric disorders.
Top photo by Chainarong Prasertthai from Getty Images Pro (Canva Pro Content License).