Nobody can deny that our life today has significantly become much easier compared to 50 years ago, yet, mental health issues drastically continue to rise. You must be wondering why?
One of the primary reasons mental health problems are on the rise is because the stigma surrounding mental health is gradually reducing. Although mental health-related concerns were present a few years ago, there’s more awareness now.
While genetic factors are deemed as one of the primary causes, several other reasons have led to an alarming rise in mental health illnesses that include the use of social media, peer pressure, lack of sleep, and increased use of recreational drugs.
Additionally, the shortage of mental health resources has also contributed to the growing number of mental health problems. Among several, depression is a common mental disorder worldwide. Depression has many possible causes ranging from stressful life events to family history.
Several treatment options— psychotherapy, medication, support groups, and alternative medicine—can help treat mental health issues like depression and anxiety.
However, a new addition to the list of treatment options has also shown promising results. That new addition is ketamine. Once administered as anesthesia in operating rooms, results from scientific research indicate that ketamine therapy for depression reduces the severity of symptoms.
So how exactly does ketamine work in relieving symptoms of depression?
Let’s dive in!
Mechanism of Action
Ketamine works by binding to an NMDA receptor in the brain that increases the amount of a neurotransmitter called glutamate, releasing molecules that restore the neural connections damaged due to depression.
Glutamate, the brain’s common excitatory chemical messenger, is the prime target of ketamine. One of the glutamate’s roles is balancing the gamma-aminobutyric acid, the calming neurotransmitter.
During the rapid phase, ketamine activates the opiate receptors that impact the symptoms of depression, making the user feel relaxed. The sustained phase is where glutamate receptors activate to restore the levels of glutamate and GABA. After the levels are restored, the brain’s response to ketamine causes new neural receptors to grow that help reset the brain to normal functioning.
Ketamine’s effect on glutamate improves mood, thinking, and cognition.
Ketamine is usually administered when other antidepressants do not work. Patients who don’t respond to antidepressant medications are given ketamine either through an IV infusion or via nasal spray.
Ketamine administered intravenously goes directly into the patient’s bloodstream, becoming immediately effective, lasting from days to weeks. A patient receives a series of six infusions for two to three weeks, as part of the induction phase. The maintenance period begins right after the induction phase, where the patient returns for an infusion every two to six weeks.
Ketamine treatment with nasal spray usually takes place twice weekly, followed by a weekly session. The treatment team will discuss the symptoms and overall well-being with the patient to determine whether the treatment should be continued ahead or not.
Compared to other antidepressants that take four to six weeks to improve symptoms, ketamine nasal spray takes a few hours to show significantly improved results.
Pros and Cons
No treatment is perfect and similar to other medications used for treating depression, ketamine also has benefits and a few drawbacks.
Immediate symptom relief
Whether used in the form of nasal spray or an IV infusion, ketamine works immediately, usually within a few hours of treatment, to relieve symptoms of depression. A study concluded that the G protein responsible for signaling messages between brain cells was inactive in people suffering from depression.
When ketamine was administered in depressed patients, the outcome was the activation of G proteins within 15 minutes that re-established the neural connection, thus alleviating the symptoms of depression.
Compared to SSRIs that take a few days to activate the G proteins, ketamine produces better outcomes.
Little to No Side Effects
Unlike other antidepressants with several side effects ranging from diarrhea, dizziness, loss of appetite or weight gain, ketamine has little to no side effects.
People who often feel apprehensive towards using ketamine for treating depression are those who consider opting for psychedelic-assisted therapy. As most of them are classified as hallucinogens, these individuals will likely consider vomiting, diarrhea, or euphoria the side effects of ketamine use which is not true.
Ketamine itself shows mild side effects that either resolve on their own or can be easily managed. The common side effect is drowsiness or dissociation which patients happen to experience due to the anesthetic properties ketamine has.
Quick and Easy to Use
As mentioned earlier, ketamine is administered in two ways as an IV treatment or as a nasal spray. Unlike other medications that require days or specific administration protocols, ketamine is relatively easy and quick to use. Ketamine nasal spray is self-administered under the supervision of a healthcare provider to ensure patients’ safety.
Similarly, with IV therapy, the session usually lasts between 45 minutes to an hour, and the only downside is finding someone to drive the patient home.
Compared to other psychedelics, ketamine has addictive potential. Due to the dissociative effect, drug addicts tend to take ketamine in high doses to trigger escapism. As per these individuals, it is the tool to escape the harsh realities of life rather than confronting them.
Withdrawal symptoms such as anxiety and cravings usually occur when people recover from ketamine addiction. The likelihood of addiction is substantially low when ketamine is taken in low doses. Ketamine should always be taken within the appropriate dosage and under the supervision of a medical professional.
Lack of Regulation
While ketamine is highly applauded for its potential to relieve symptoms of depression, unfortunately, ketamine therapy clinics aren’t much regulated as they should. Therefore, a significant risk exists with untrained staff administering ketamine dosages.
Such practices can endanger the life of a patient. Patients must receive treatment in a ketamine-certified clinical setting to prevent any consequences.
Life has become easier in terms of survival and work; however, social norms have gradually impacted us psychologically and emotionally. It has led to the rise in mental health issues affecting every aspect of our life. In the light of rising mental health problems, several treatment options have also been introduced to help combat the outcomes of these issues.
Science is making progress towards introducing better and more effective treatments to overcome mental disorders. Ketamine therapy is amongst the widely known option available today that has shown promising results in alleviating symptoms of depression.
While further research is required, previous studies have concluded that ketamine is far more efficient in treating mental illnesses than other medications.