Ketamine for Depression and PTSD
Ketamine, a dissociative anesthetic and analgesic agent was developed in the 1960’s. It saw extensive use during the Vietnam War for pain control and even surgery. It is remarkably safe and can be used without a patient being on a ventilator or cardiac monitor. In many third world countries it is the only agent available to perform surgery due to the fact that advanced monitoring equipment is not necessary. More recently it was discovered that in small doses, typically one-tenth of the dose used for surgery, it had a positive effect on people’s mood. Studies have shown that 72% of depressed people treated with Ketamine have an improvement in their symptoms of depression, some in as little as four hours.
How does this seeming miracle drug work? There are several mechanisms that produce an improvement in mood. Ketamine binds to NMDA receptors in the brain. These receptors are present an estimated 10,000 times more frequently than the receptors that traditional antidepressants target. They also release a substance called “G peptide” from nerve cells that boost mood. While traditional antidepressant medications also release these proteins, it takes 6 to 8 weeks for that to happen. With Ketamine this happens in as little as 15 minutes. It is also suspected that the Ketamine therapy causes new connections in the brain that also help elevate mood. Ketamine does not carry a warning that depression or suicidal thoughts may actually increase before the antidepressant effects take place like so many traditional antidepressants carry.
We also offer Ketamine Assisted Psychotherapy. During this process a licensed Psychologist will help you examine the life stresses that have contributed to your condition while you are experiencing the mild dissociative effects of Ketamine. Most people I have treated or spoken with report that they recognize the stressor but it seems distant and does not cause the same emotional trauma as they deal with it.
Who is a candidate for Ketamine infusions? Anyone with depression or PTSD. It does not matter if you are already on medications or not. In fact you may be able to taper off those medications after treatment with Ketamine.
Who should not be administered Ketamine? Anyone with a history of psychosis or hallucinations. Anyone with uncontrolled high blood pressure or irregular or fast heart rates.
Are there side effects? Yes. If the infusion is too fast a patient may experience dysphoria, a condition of feeling unpleasant or detached from one’s body. This can easily be managed if needed by giving a sedating agent. The risk of this is very low especially at the low doses we use. It may also increase the heart rate and blood pressure but again by slowing the infusion rate this can be avoided.
Before beginning treatment you will have an office visit where you will be screened to make sure you are a candidate for this treatment.
If this sounds like something you would like to try or you know someone who you think might benefit from this treatment, please call 615-649-WELL (9355) to schedule an evaluation.