Is Ketamine Really the New Magic Bullet for Depression?
By Dr Becky Spelman
Ketamine has a chequered reputation having been used originally as a horse tranquillizer before gaining notoriety in the late 2000s as the latest party drug of choice. So could it really be the key to providing much-needed relief to those suffering from depression where none had previously been available? Could it really be the magic bullet it’s being touted as?
In recent years there’s been a push in both the US and UK to setup ketamine clinics that provide ‘off-label’ treatment for its use in the treatment of depression. Although it’s not officially available on the NHS, it can be obtained by a referral from your doctor with the cost covered by yourself. The scepticism surrounding the effectiveness of the drug is understandable, given its previous applications. However, many people in the medical profession have cited the use of ketamine as one of the most significant developments to surface in years in the treatment of depression.
Much of the excitement surrounding the drug is that unlike anti-depressant medications, which can take anywhere from 2-6 weeks to take effect, the relief provided by ketamine can be measured in hours. This is an enormous benefit, as in cases where suicidal thoughts and/or tendencies have been cited by an individual, it allows for an immediate intervention, significantly reducing the chance of fatality.
However, there is still a lot that remains unknown about the exact workings of ketamine on the mind and body as it relates to depression. What researchers have found is that unlike most anti-depressant drugs that require time to build up in the system, ketamine’s mood-altering effects take place as it leaves the body. Instead of working on neurotransmitters such as serotonin, norepinephrine and dopamine, it works by blocking glutamate while increasing synaptic – or neuro – plasticity, which causes the brain to change, grow and adapt to new circumstances.
Despite its relatively recent availability as a treatment for depression, there has in fact been clinical studies exploring its effectiveness as a viable treatment for the past fifteen years. Infusion therapies offered in the US were shown to have a 60-70% effectiveness in helping people with treatment-resistant depression as well as those suffering from major depression accompanied by the risk of suicide. One study even had reported an 85% success rate in the treatment of those who’d exhausted all other avenues!
But what are the risks, if any? As with all drugs, there is always the nagging possibility of addiction, which you might find especially worrying given ketamine’s past reputation of creating long-term ‘users’ during its peak as a ‘party drug.’ However, these instances were the result of a high intake over a prolonged period. In a medical setting, ketamine is administered in controlled doses with treatments generally occurring in a tapering sequence with the individual receiving three doses during the first week, two in the second, and once weekly for the next three before settling on a maintenance dose of once per month going forward. In all of the studies conducted so far, ketamine has not created any kind of addictive tendencies among recipients of the treatment.
As of yet, it remains to be seen whether ketamine becomes accepted into the mainstream as a legitimate treatment for depression, but given the initial studies, trial runs and overwhelming success rates, it would be a shame not to see more people offered the treatment as a first option rather than a last resort.
About the author:
Dr Becky Spelman is a leading UK Psychologist who’s had great success helping her clients manage and overcome the effects of depression.
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