By Tessa Eskin
One of the most challenging side effects of modernity – only magnified during these troubled times – is the alarming growth of depression cases. As of January 2020, over 264 million people worldwide were affected by symptoms of depression or depressive episodes. In the US, the numbers have tripled since then. The mental health crisis greatly intensified an already difficult year of social isolation and economic woes. Antidepressants help in some cases, but these treatments can take weeks to kick in. Besides, they generally come with a handful of problematic side effects. So, when antidepressants prove ineffective, where can we turn for treatment? The answer may be found in ketamine.
Though research is still new, studies show that ketamine can successfully reduce symptoms of severe depression in a matter of hours. This is incredibly rare in treatments for mood disorders, and should not be taken lightly, especially when it comes to patients suffering suicidal thoughts. In these cases, time is of the essence.
What is Ketamine?
Ketamine is a dissociative anesthetic first synthesized and tested in the 1960s. Combat medics used it to sedate injured soldiers on the battlefields of the Vietnam War. It became a common anesthetic for medical emergencies and war zone surgeries.
Ketamine is still used for exceptionally painful procedures and to target certain chronic pain syndromes. Veterinarians commonly use it as an anesthetic on animals. But aside from pain relief and emergency use, the psychologically therapeutic potential of ketamine is only just being discovered.
A Rapid Antidepressant
In many cases of depression, there is a serious urgency for quick relief, which conventional treatment has been unable to provide. The speed with which ketamine works is a godsend. Clinical trials on treatment-resistant patients show rapid mood improvement shortly after a ketamine infusion. Antidepressants can take weeks or months to be effective, and they sometimes stop working altogether. The downtime can be excruciating for patients with major depressive disorders.
Though the initial effects are short-lived, ketamine can serve to bridge the gap for patients beginning new antidepressants. And, as a short term aid, it would make all the difference to those navigating different forms of long term treatment. A fast-acting drug, ketamine is particularly helpful for patients dealing with suicidal thoughts. Sometimes what is most needed is that initial push to help depressed patients on the long road to recovery.
How Does it Work?
Most drugs are only effective while they remain in the system. But ketamine actually enables the regrowth of brain connections. A recent study on “depressed” mice confirmed ketamine’s effect on synapse growth. The drug initially prompted changes in brain circuit function, improving the behavior of the mice within three hours of exposure. Researchers later observed the regrowth of synapses. Ketamine not only has an immediate effect on mood while still in the system, but also promotes neuroplasticity after treatment.
The drug works quickly with glutamate, a neurotransmitter that acts as a common chemical messenger in the brain. The body responds by releasing various molecules to achieve synaptogenesis. This process strengthens synaptic connections, supports neuroplasticity, and affects mood, cognition, and mental patterns.
Glutamate also balances the release of Gamma Aminobutyric Acid (GABA), a calming neurotransmitter. Depleted glutamate and GABA levels can cause depressive symptoms. Ketamine initially works by activating opiate receptors, quickly relieving acute symptoms of depression. Patients feel relaxed and sedated straight away, followed by an increase in the glutamine receptors. After these two initial phases, the brain reacts with the growth of neural receptors, which might also be called a kind of mental reset.
Ketamine also reduces inflammation, positively affecting mood and communication between different parts of the brain. By counterbalancing cortisol levels, ketamine can effectively lessen depressive symptoms linked to a build-up of long term stress hormones.
Current Forms of Treatment
Several doctors already prescribe off-label ketamine to treatment-resistant patients with depression. Ketamine clinics and wellness centers are popping up across the US and Canada. These clinics cater to patients who in many cases have grown desperate from years of failed treatment.
One such patient, Rory Basurto, suffered from severe depression. He found little relief as he made his way down a long list of conventional treatments. Finally, after a devastating breakdown and a suicide attempt, Basurto found relief at the Kalypso Wellness Center in San Antonio, Texas. The clinic opened its doors four years ago, answering the growing demand for ketamine therapy and treatment by providing the medicine in a safe and professional setting.
Basurto has undergone nearly two dozen ketamine infusions. The treatments began as a last resort in times of crisis but became the stabilizing factor in his recovery. Basurto still faces challenges, but there has been a huge shift in how he confronts them. He is now able to cope in the day-to-day with a stronger mindset. He is no longer treading water, and that has made all the difference.
Ketamine may not be a cure-all, but the physiological changes give patients the chance to keep fighting the good fight. Recent studies show that over 50% of patients showed a decrease in depressive symptoms after one day of treatment. Other studies show a response rate of up to 70% amongst patients who have been resistant to common antidepressants.
We are still in the early days of ketamine treatment, but the potential is undeniable, and in synch with the spirit of the greater medicinal psychedelic family.