Could Ketamine Revolutionize The Way We Treat Mental Health?

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Medically reviewed: Paloma Lehfeldt, MD
a woman participating in ketamine therapy to help treat mental health

Ketamine May be Set to Radically Change Mental Healthcare

Living with mental health concerns can be a daily struggle. The symptoms may feel overwhelming, especially for those who have failed to respond to traditional treatments. However, research into new uses for the drug ketamine has shown some promising early results for mental health conditions such as depression, anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), substance abuse, and even pain management. 

Ketamine has been used in the medical field since the 1970s, initially as a veterinary anesthetic and later for human use. Favored as an anesthetic by pediatricians, elder care specialists, and surgeons working with patients with respiratory problems, ketamine has a low risk of dependency and does not suppress breathing in surgical patients. 

Beginning with the first clinical trial on February 15, 2000, mental health and psychiatric professionals quickly began adopting ketamine as a treatment for mental health conditions.(1) Research suggests patients with depression, anxiety, PTSD, OCD, and other conditions have shown significant benefits from using ketamine in a clinical setting.

How Does Ketamine Treat Mental Health Conditions?

Ketamine impacts the brain’s glutamate system. Specifically, ketamine is an N-methyl-d-Aspartate (NMDA) receptor antagonist, meaning ketamine interferes with how glutamate interacts with the NMDA receptor. NMDA receptors in the brain are activated by glutamate, glycine, and other neurotransmitters.(2)

Medical professionals believe that an imbalance of glutamate may contribute to mental health conditions such as anxiety and depression. While the exact mechanisms are not fully understood, glutamate appears to have a role in regulating mood. By acting as an antagonist at the NMDA receptor, ketamine interferes with glutamate’s ability to bind to one of its receptors. Due to this interaction, ketamine may contribute to changes in mood, including producing antidepressant and anti-anxiety effects.(2)
a ketamine assisted therapy session to treat mental health conditions

How Ketamine for Depression Works

Medical professionals administer ketamine for mental health conditions like depression in various ways. Some of these ketamine treatments include an intramuscular (IM) injection and lozenges. Another delivery method is a nasal spray using esketamine (marketed as Spravato), which is FDA-approved for treatment-resistant depression (TRD), meaning you have not responded to at least two treatment modalities. FDA approval also applies to major depressive disorder (MDD) with suicidality. 

One of the most common administration methods is intravenous (IV) infusion of low-dose ketamine. IV ketamine infusions are usually given over only 40 minutes. In outpatient settings, clinicians might administer IV ketamine with different devices that ensure a 40-minute infusion time (e.g., syringe pump, digital IV pump, or elastomeric ball).(3)

Some research suggests that this subanesthetic (meaning too low to cause one to be rendered unconscious) intravenous dose of ketamine may trigger positive changes in a patient’s mood and mental health within as little as a day. Ketamine is currently being studied as a potential tool to manage the symptoms of several forms of depression, including treatment-resistant depression () and major depressive disorders. Several open-label studies (a study where both the providers and patients know what medication is being used) have shown that single-dose IV ketamine can lead to rapid symptom relief for patients with TR depression.(4)

How Ketamine Can Help With Anxiety

a woman thinking about ketamine therapy for her anxiety
40 million U.S. adults struggle with mild to severe anxiety. This can be a life-disrupting or even debilitating condition. Some chronic anxiety patients may not experience meaningful relief from traditional treatments. However, some studies indicate that ketamine may be a good option for anxiety if you’ve failed to respond to other treatment types.(5)

A recent review article looked at two randomized control trials in social anxiety disorder (SAD), three in PTSD, and one in OCD to determine the safety of ketamine in different disorders on the anxiety spectrum. The analysis showed improvement in anxiety scores for those with SAD who were treated with ketamine, as compared to the control groups. Some participants had carry-over effects (improvements that persist after the medication is administered) lasting up to 28 days after their ketamine infusion.(6)

How Ketamine Helps With PTSD

Roughly 8.7% of Americans and up to 20% of U.S. military veterans report experiencing PTSD. Clinical trials using multiple IV ketamine infusions demonstrate an 80% response rate.(7) This is significant as individuals treated with selective serotonin reuptake inhibitors (SSRIs) rarely exceed a 60% response rate, and less than 20-30% achieve full remission.(8) Ketamine appears to cause a reversal in trauma-related brain abnormalities and increases glutamate as well as a protein called brain-derived neurotrophic factor (BDNF). BDNF is related to fear extinction, learning, and brain plasticity. This may be partially responsible for ketamine’s ability to treat some underlying factors that contribute to PTSD.(9)

Is Ketamine Therapy for Mental Health Right for Me?Ketamine is an innovative potential treatment for individuals experiencing various mental health conditions. If you struggle with depression, anxiety, PTSD, OCD, or pain, ketamine could be a good option for you. Ketamine may be particularly effective for people with treatment-resistant and chronic mental health conditions. 

Like any psychiatric therapy, ketamine treatments and ketamine assisted-psychotherapy (KAP) require a diagnosis and often a provider referral. You should always consult with a licensed medical professional before beginning any ketamine treatments. If you’re interested in ketamine therapy, talk to your doctor and find a ketamine treatment 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.