Ketamine for Anxiety

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Medically reviewed: Paloma Lehfeldt, MD
a woman thinking about ketamine treatment to help her anxiety

How Ketamine is Changing the Way We Handle Anxiety

Ketamine is an anesthetic and dissociative medication with over 50 years of medical use. This long service life has given ketamine an exceptional safety profile, leading to ketamine being the preferred anesthetic for pediatric, elder care and surgical patients at risk of respiratory problems. This is due to its lack of negative impact on the respiratory system. 

Ketamine therapy has been an off-label (other than its FDA-approved usage) treatment for anxiety since the early 2000s. It may effectively treat certain chronic and treatment-resistant anxiety conditions that may not respond well to traditional treatment types. 

What is Anxiety?

For most people, minor anxiety, or feelings of unease, are a normal part of life.

For the 40 million Americans suffering from chronic or severe anxiety disorders, it can feel like a nightmare. Anxiety disorders are typically associated with prolonged feelings of fear, unease, an impending sense of doom, or a belief that something negative may occur at any time. These feelings are often out of proportion to any actual danger.(1)
a woman considering using ketamine for anxiety

What are Some Anxiety Symptoms?

Some common anxiety symptoms include:(1)

  • Nervousness
  • Tension
  • Rapid Heartbeat
  • Shallow or Fast Breathing
  • Insomnia
  • Feelings of Fear
  • Dread
  • Avoidance Behaviors
  • Intrusive Worrying

What Causes Anxiety?

Many factors can trigger anxiety. Experiences such as losing a loved one, past traumatic events, or abuse may cause someone to develop anxiety. Anxiety may also run in families.(2)

Other stressors like work, job change, a move, or chronic physical illness can also trigger the onset of anxiety symptoms. Experiencing some minor worry is a normal part of life, but anxiety can quickly get out of control for some. Medications such as ketamine may help.(2)

What is the Difference Between Anxiety and a Panic Disorder?

Experiencing anxiety is never pleasant. Although anxiety and panic disorders are often used interchangeably, key differences exist in how they are diagnosed. While anxiety is characterized by irrational feelings of fear and worry, a panic disorder occurs when these symptoms coincide with panic attacks.(3)

Some symptoms of a panic attack include:

  • Rapid Heartbeat
  • Chest Pain
  • Agitation
  • Loss of Emotional Control
  • Extreme Sense of Doom or Fear
Thankfully, medical providers have new tools to treat panic disorders. You may be able to manage chronic anxiety and panic attack symptoms with ketamine treatments.

Is Ketamine an Effective Treatment for Anxiety?

For most people experiencing anxiety, traditional treatments may suffice. For those with more severe and treatment-resistant (i.e., you have not responded to at least two treatment modalities) forms of anxiety, ketamine may be a better solution.

Some research has shown that part of the biological basis of anxiety may be due to a decrease in glutamate in certain areas of the brain.(4) Ketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist which blocks glutamate’s ability to bind to that receptor.(4)
is ketamine an effective treatment for anxiety

How Does Ketamine Work for Anxiety?

Ketamine can help treat anxiety by altering glutamate’s ability to bind to NMDA receptors. Researchers believe that mood can be improved by changing how glutamate interacts with this receptor, and some anxiety symptoms, such as increased fear, can be reduced.(5)

A recent double-blind, placebo-controlled clinical trial (a study where neither the administrators nor participants knew what medications were being given to which group) saw 18 adult participants with a social anxiety disorder (SAD) randomly given low-dose IV ketamine over 28 days or saline placebo in the case of the control group. The ketamine group exhibited a 50% VAS-A (Visual Analogue Scale for Anxiety) reduction vs. a 0% reduction for the placebo control group. The research team also observed an 89% response rate vs. the control groups’ 53% response to placebo. Effects in the ketamine group were evident for three hours after the treatment and were maintained for two weeks in some cases.(5)

Put simply, this means the group that received ketamine infusions experienced significant symptom relief compared to the participants who only received the placebo. The ketamine group also had a better response rate when compared to the placebo control group. The ketamine group continued to show positive effects for nearly a month after the end of the experiment.

How Fast Does Ketamine Work for Anxiety?Depending on the method of administration (i.e., IV drip, injection, nasal spray, or lozenge), ketamine’s effects can be felt within 12 to 30 minutes.(6) One study indicates that ketamine may relieve anxiety symptoms in as little as an hour, while other conditions may take up to 24hrs for similar results.(7)

While these results are promising, other patients with anxiety disorders may need to undergo additional treatments to experience similar results. Ketamine affects everyone differently, and you may not experience the same results as others.

ketamine assisted therapy IV bag used to treat symptoms of anxiety

What Are the Risks of Ketamine for Anxiety?Ketamine treatment has seen safe and effective use in hospitals and clinics for over 30 years. However, it does carry some risks and side effects. For example, individuals with schizophrenia and high blood pressure should consult a medical professional before trying ketamine therapy.(8)

Other short-term side effects of ketamine include:

  • Stomach Cramps
  • Nausea
  • Dizziness
  • Stomach cramps
  • Increased Body Load (feeling heavy)

Could Ketamine Help Manage Your Anxiety?Depending on your unique medical needs, ketamine therapy could be a good choice for helping you with your anxiety symptoms. Studies have shown that off-label ketamine for anxiety is both safe and can be highly effective. Schedule a consultation if you think ketamine treatments for anxiety are right for you. Like many psychiatric therapies, ketamine treatment requires a diagnosis from a medical professional. If you’re interested in moving forward, you can find a ketamine clinic near you

Where to Find
Ketamine TreatmentLocate outpatient ketamine clinics and at-home ketamine service providers in the U.S. that offer care for pain, depression, anxiety, PTSD, OCD, and addiction.