You may have met someone who has benefited from ketamine for chronic pain or seen a video about how ketamine works to alleviate depression and anxiety. So you get all jazzed about trying ketamine infusions for yourself and you approach your doctor about it. Instead of getting helpful information and support to pursue infusions, you get a cold reception, a flat out “no”, or a simple shrug of the shoulders.
Ketamine is shedding it’s old reputation and gaining a new life as an effective and rapid treatment for depression, PTSD, and anxiety. Some researchers even state that ketamine is "the biggest breakthrough in depression research in a half century.” You may have read news articles, seen videos on YouTube, or perhaps have even heard of a ketamine infusion clinic near you. But should you consider trying it for your own depression?
The diversity of life on earth is extraordinary, therefore the perspectives and experiences we each carry as human beings can be vastly different from each other. In relation to medicine and mental health, researchers at the Affiliated Brain Hospital of Guangzhou Medical University in China recognized that we all have our own biological, environmental, and experiential complexities which prompted them to identify four different subgroups of depression: anxious, melancholic, anxious-melancholic, and no subtype. They then conducted a post-hoc study regarding the association between ketamine and the aforementioned subtypes.
The American Society of Ketamine Physicians (ASKP) formed in 2017 and had its second annual conference near Denver, Colorado in September 2019. The gathering included over 200 people including: anesthesiologists, emergency physicians, family physicians, internists, nurse anesthetists, patients, pharmacists, psychiatrists, psychotherapists, registered nurses, and support staff.
It was astounding to connect with others and learn a myriad of ways ketamine is being used therapeutically in outpatient clinics, homes, and hospitals. The learning not only came from the speakers’ presentations, who were experts in their fields, but also other ASKP members who are out in the trenches applying their unique perspective on ketamine.
When you break the word itself down, it comes in two parts: “neuro” as in neuron, and “genesis” as in creation. Neurogenesis broadly speaking is the process by which new neurons are created in the brain, thus allowing for increased plasticity of the brain and stronger synaptic connections. Adult neurogenesis is the process by which new neurons are created and integrated into existing brain circuitry when you are an adult. Adult neurogenesis can be seen in the olfactory bulb and the hippocampus.
Ketamine is alleviating symptoms of those suffering from Major Depressive Disorder (MDD). It works rapidly and effectively, especially compared to traditional treatment such as selective serotonin reuptake inhibitors (SSRIs).
So, how is ketamine making this happen? There is currently no definitive answer to “How Does Ketamine Exactly Work?”, and honestly we don’t believe there is only one single answer. We believe there are multiple mechanisms (scroll to the bottom to check out a couple videos where Dr. Ko explain the less “scientific” mechanisms, such as the spiritual mechanism)
Fibromyalgia is a leading cause of chronic pain affecting millions of Americans every day. Researchers hypothesize that central sensitization is the primary mechanism involved, but there are many other factors including genetics, immunological, psychological, and hormones that influence the development of fibromyalgia. Central sentization refers to a process called “wind-up” where the central nervous system gets regulated into a persistent state of high reactivity. This persistent or wound up state of reactivity lowers the threshold for what causes pain and can create extreme pain even with minimal stimulus. This phenomena is believed to be related to neuroplasticity which is mediated by the N-Methyl-D-aspartate (NMDA) receptors located in the spinal cord.
Ketamine’s most immediate mechanism of action is to block NMDA receptors. It is the most potent clinically available NMDA receptor antagonist today. By blocking the activity of the NMDA receptor, ketamine seems to reset the altered pain receptors that have become hypersensitized in patients with fibromyalgia.
Ketamine infusions are becoming increasingly popular due to the fact they are can potentially rapidly treat anxiety, pain disorders, and treatment-resistant depression. You may be curious about what the experience of ketamine infusion will be like, especially since there is a lot of confusing and misleading information out on the internet. Well, we got you covered!!
Multiple studies have shown the benefits of using ketamine for treatment-resistant depression. Typically, the spacing of the ketamine infusions have been either two or three times per week. However, one recent study published in 2019 in the American Journal of Psychiatry showed that the reduction in depression symptoms were maintained with once-weekly infusions.
Ketamine is made up of two enantiomers, one is called (R)-ketamine and the other is (S)-ketamine, also known as esketamine. All chemicals have two mirror images and when combined, it is called the racemic mixture. The generic version of ketamine contains both (R) and (S)-ketamine and has been approved by the FDA for use as a dissociative anesthetic agent since 1970.
There is a growing body of clinical evidence that has shown how ketamine works to produce antidepressant effects in those with treatment-resistant depression (TRD). These studies have used a common subanesthetic dose of 0.5 mg/kg over a period of 40 minutes when administered through an IV. An outpatient study from 2018, published in Molecular Psychiatry, recently added onto this body of research in order to find the optimal dose for antidepressant effects in those with TRD. They found that single IV doses of ketamine of 0.5 mg/kg and 1 mg/kg proved to be more effective than an active placebo in reducing depression over a 3-day period.
Dear Health Insurance Company Representative,
Thank you for being a part of the system that helps to reduce the cost of health care for me and my patients. I appreciate your commitment to collaborating and serving patients by covering the charges from unexpected healthcare fees. Because of your services it allows for greater coverage to a large group of people for disease prevention, improving health, and fully living life.
This piece was published first on BreastCancer-News.com. For more information about the author, Nancy Brier, click here.
“No fresh flowers,” my doctor said. “Avoid salad. No uncooked food. And don’t bring visitors home.”
Treatment for breast cancer took the better part of a year, and a lot of that time, I spent alone. No wonder cancer sometimes comes with depression.
Major depressive disorder affects nearly one in four teenagers. Some characteristics of this disorder include irritability, fatigue, and low self-esteem. A major concern for this group in particular is suicide, especially since suicide is the third leading cause of death amongst teenagers. With traditional antidepressants, SSRIs, taking weeks to months to be effective and with over 40% of teenagers being non-responsive to traditional treatments, ketamine therapy may be a fast-acting treatment alternative.
You don’t have the time nor money to get infusions, or perhaps you are not ready...whatever your reason is, we get it. As much as we love educating about ketamine and providing ketamine infusions, we’d love a world so healthy that we wouldn’t need to be in business.
However, the reality is there are a lot of people hurting, and we are honored to help them. But back to you all who aren’t ready or don’t ever want to find themselves in a ketamine clinic - here are 6 strategies to help you avoid getting a ketamine infusions:
![3 Reasons Why Your Doctor Isn’t Telling You About Ketamine [2020 Update]](https://images.squarespace-cdn.com/content/v1/5a8dfbc1cf81e0fb77ead442/1520489352243-F0H3L98Q4GQE6S5EA3GR/IMG_9684.jpg)
![Why You Should Consider Ketamine Infusions for Depression [2020 UPDATE]](https://images.squarespace-cdn.com/content/v1/5a8dfbc1cf81e0fb77ead442/1519943692485-0B3UWB5F75RGVGHOJK85/pexels-photo-847483.jpeg)
![The Four Types of Experiences You May Have With Ketamine [2020 Update]](https://images.squarespace-cdn.com/content/v1/5a8dfbc1cf81e0fb77ead442/1519853468092-YIIPMI8VWKZMGFE35QGV/pexels-photo-357891.jpeg)
