What is Ketamine?

Ketamine was first developed in the 1960s and approved by the FDA as an anesthetic in 1970. It has been used safely in surgical settings for decades and is on the World Health Organization's List of Essential Medicines.

In recent years, ketamine has gained recognition for its rapid and robust antidepressant effects when administered in sub-anesthetic doses. Unlike traditional antidepressants that may take weeks to show effects, ketamine can often provide relief within hours to days.

Ketamine therapy refers to the medical use of ketamine in controlled, therapeutic settings to treat various mental health conditions and chronic pain disorders. It's typically administered by healthcare professionals with specialized training in ketamine treatments.

While ketamine has been used recreationally and can be misused, therapeutic ketamine is administered in medical settings with careful dosing, monitoring, and integration support. The doses used for therapy are much lower than those used for anesthesia or recreation.

How Ketamine Works in the Brain

Ketamine works differently than traditional antidepressants like SSRIs (selective serotonin reuptake inhibitors). While conventional antidepressants primarily target serotonin, norepinephrine, or dopamine systems, ketamine's primary mechanism involves the glutamate neurotransmitter system.

NMDA Receptor Blockade

Ketamine is an NMDA (N-methyl-D-aspartate) receptor antagonist. It blocks these receptors, which play a key role in learning, memory, and neuroplasticity. This blockade triggers a cascade of events in the brain that ultimately leads to rapid antidepressant effects.

Increased Glutamate Activity

By blocking NMDA receptors, ketamine increases glutamate neurotransmission in certain brain regions. This surge in glutamate activates AMPA receptors, which are involved in fast excitatory transmission in the brain.

Neuroplasticity and Synaptogenesis

Perhaps most importantly, ketamine stimulates brain-derived neurotrophic factor (BDNF) production, which promotes the growth of new neural connections (synaptogenesis) and enhances neuroplasticity—the brain's ability to reorganize and form new neural connections.

Default Mode Network Effects

Research suggests ketamine may temporarily disrupt the default mode network (DMN)—a network of brain regions active when the mind is at rest and wandering. Overactivity in the DMN has been linked to rumination and depression. By disrupting this network, ketamine may help break patterns of negative thinking.

These mechanisms help explain why ketamine can provide rapid relief from depression and other conditions, often within hours or days, compared to traditional antidepressants that may take weeks to show effects.

Safety & Side Effects

When administered in a medical setting by qualified healthcare professionals, ketamine therapy has a strong safety profile. However, like any medical treatment, it comes with potential side effects and considerations.

Common Side Effects

Most side effects of ketamine therapy are mild and temporary, typically resolving within a few hours after treatment:

• Dissociation: A feeling of detachment from your surroundings or sense of self
• Dizziness or lightheadedness
• Nausea (anti-nausea medication can be provided if needed)
• Changes in blood pressure (typically a temporary increase)
• Blurred or double vision
• Drowsiness
• Perceptual changes (colors may seem brighter, sounds may seem louder)

Who Should Not Receive Ketamine Therapy

Ketamine therapy may not be appropriate for individuals with:

• Uncontrolled high blood pressure
• Unstable heart disease
• Active substance abuse
• History of psychosis or certain psychiatric conditions
• Pregnancy
• Severe liver disease

A comprehensive medical evaluation is essential to determine if ketamine therapy is safe and appropriate for you.