Ketamine Therapy: New Hope and Innovation for Depression

About the Author Dr. Steve Levine is a board-certified psychiatrist internationally recognized for his contributions to advancements in mental health care. Though he is a psychiatrist who places great emphasis on the importance of psychotherapy, medication is often a necessary component of treatment, and he was dissatisfied with the relatively ineffective available options with burdensome side effects. Dr. Levine pioneered a protocol for the clinical use of ketamine infusions, has directly supervised many thousands of infusions and has helped establish similar programs across the country and around the world.

Ketamine For Depression: Using Ketamine Treatment For Depression

Ketamine has been used safely as an anesthetic in medical settings for decades. The use of ketamine for depression has gained notoriety as nasal esketamine – brand name Spravato – became FDA-approved in March of this year. At Actify Neurotherapies, we are proud to utilize a depression treatment protocol for intravenous ketamine that helped to inform the treatment Consensus Guidelines in the leading medical journal, JAMA Psychiatry. In the process of treating over 4,000 patients across nine treatment centers, we’ve been able to make remarkable progress when it comes to treating intractable depression and other mood disorders.

The term “Treatment-resistant depression” describes when two or more oral antidepressant medications (such as Prozac or Zoloft) do not sufficiently treat a patient’s symptoms. About one third of depressed patients in treatment for depression do not respond to traditional antidepressants, which focus on helping the brain produce and maintain serotonin levels. Ketamine therapy works differently, by repairing damaged connections and pathways that result from depression.

How Does Ketamine Work For Depression

When someone has depression, a number of things occur in the brain. Neurotransmitters such as serotonin and dopamine are dysregulated, causing changes in behavior, emotions and cognition. Neuropathways – the routes along which neurotransmitters move about the brain – also become damaged or shut down completely, making it difficult for the neurotransmitters to operate in areas of the brain. Think of these systems as roads (neuropathways) with cars (neurotransmitters) on them – when someone is depressed, certain roads are damaged or closed off and cars are breaking down. This can cause quite a bit of upset to normal functioning of the brain.

While traditional oral antidepressants are relatively competent at getting the “cars” (neurotransmitters) up and running again, if the “roads” (neuropathways) are still shut down, the cars can’t make it to their destinations. This is where ketamine therapy comes in. Ketamine operates on the brain’s N-methyl-d-aspartate (NDMA) receptors, which can help to rapidly restore neuropathways and bring neurotransmitters to areas of the brain that are impacted by severe depression. While ketamine is not a cure for depressive disorder, it is a treatment option that can help to accelerate the healing process while relieving symptoms of depression. Ketamine is a powerful treatment option as part of a comprehensive care plan for depression and other mood disorders.

Ketamine Dosage For Depression

Intravenous ketamine therapy and esketamine nasal spray are given in sub-anesthetic doses to treat mental health conditions. At Actify Neurotherapies, we calculate the dose based on the patient’s weight, starting at about 0.5 mg/kg. This low-dose treatment is generally safe for adults and produces limited side effects. Some patients report feelings of dissociation or dizziness, while others feel nothing. It is unclear if feelings of dissociation, or having an out-of-body experience, indicate whether or not the patient’s depressive symptoms will respond to ketamine therapy.

Why To Use Ketamine For Depression

Ketamine infusions have an approximately 70% response rate in patients, and ketamine can be rapid-acting: it can potentially be felt as early as 24 hours after the first treatment. Outside of the infusion experience, patients generally do not experience side effects and there is no daily dose of ketamine. If you are part of the 30% of patients who do not respond to ketamine therapy, you will know within a few treatments and can decide to use a different course of action, rather than the 6-8 weeks of treatment that is usually required before determining patient response to an oral antidepressant.

Who Should Use Ketamine For Depression

Actify’s board-certified psychiatrists determine patient eligibility for ketamine therapy through a comprehensive in-office consultation that follows a free 15-minute phone screening consultation – one of the cornerstones of these criteria is having tried two or more oral antidepressants without a sufficient reduction in symptoms. We are able to treat a range of mental health issues, including suicidal thinking, anxiety, post traumatic stress disorder, bipolar depression, obsessive-compulsive disorder, and some types of chronic pain.

About Depression

Depression is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities such as sleeping, eating, or working.

For the first time in 50 years, depression treatments are available that do not require taking daily medications that can cause side effects like sleepiness, weight gain, sexual side effects, upset stomach, and mental fogginess. Depression is a treatable condition. While there is currently no cure for depression, recent medical advances have produced new options that can have faster results, such as intravenous (IV) ketamine. Symptoms of clinical depression include:

There is hope now – ketamine infusions for depression.