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Ketamine for Bipolar

A rapid-acting medication intervention for Bipolar Depression



Is Ketamine Treatment for Bipolar Disorder for You?

  • Were you diagnosed with bipolar depression and medications don’t help enough?
  • Do you often feel sad, lost, lethargic, and suicidal, and don’t know what to do?
  • Has bipolar depression stopped you from having meaningful relationships and a productive work life?

Bipolar depression is obviously a very challenging condition when it impacts your way of life. Bipolar depression–unlike unipolar depression–does not respond favorably to antidepressants, and medications used for bipolar disorder often come with many side effects. However, there is hope with a novel approach to treatment. In recent years, clinical research shows promise that ketamine therapy for bipolar depression helps people suffering from severe symptoms such as suicidal thinking, low motivation and a loss of interest in daily activities.

How Does Ketamine Work for Bipolar Depression?

Ketamine was discovered in the 1970’s as an anesthetic used in emergency care. It’s anesthetic properties produce sedation and pain relief and is very safe because it does not cause respiratory depression like many anesthetics. But, it wasn’t until the last decade that ketamine treatment for bipolar disorder was researched.

Here’s why this is relevant to you…

Ketamine can have an immediate effect on certain depression symptoms, such as suicidal thinking, sadness and loss of interest in daily activities. Clinical trials have repeatedly shown that suicidal thinking can go away within just one treatment of ketamine [1], which many individuals with bipolar disorder suffer from. In addition, ketamine does not have long-term side effects that come hand-in-hand with many bipolar medications.

Ketamine boosts Brain-Derived Neurotrophic Factor (BDNF)[2] which is an important brain hormone that appears to help reverse the loss of connectivity between neurons caused by chronic mental illness. Ketamine also blocks receptors for glutamate[2], a neurotransmitter associated with mania and brain excitotoxicity. All of these mechanisms are theorized to play a significant role in the rapid mood benefits of ketamine.

How Effective are Ketamine Infusions for Bipolar Depression?

Medications used judicially can be of great benefit to individuals with bipolar disorder. However, many medications that are available for depression can make bipolar disorder much worse and the ones that are safer in bipolar depression can come with long-term side effects.

A New Type of Therapy For Bipolar Depression: IV Ketamine

Most ketamine clinical trials for bipolar depression gave people with treatment-resistant bipolar depression ketamine infusions. These studies demonstrate a rapid and significant reduction in bipolar depression symptoms.[3]

Ketamine for Bipolar Depression Clinical Trials

In 2010, NIMH published a controlled trial of IV ketamine for bipolar depression.[3] This study showed a significant decrease in depression in people suffering from bipolar depression. Notably, ketamine was well-tolerated in this trial.

Figure: Diazgranados et al 2010b

Ketamine for Bipolar Disorder

  • Personal Outcomes

    Imagine waking up and feeling inspired to greet the day after a good night’s sleep. When it’s time to chat with friends and family, picture yourself laughing and feeling grateful for these people in your life. See yourself going to work and looking forward to feeling focused and a renewed sense of purpose. IPC patients with bipolar depression often report this type of transformation after completing our ketamine therapy program.

How We Are Different

Choosing a medical provider can be a stressful experience. We want to help you find the right ketamine provider for your needs. Although there are an increasing number of places offering ketamine, there are several key things that make our clinic different which are important to consider when determining if IPC is the right place for your care:

  • Medical Team:
    Our medical team is one of the most experienced groups of ketamine providers in the country.
  • Investment:
    At IPC we understand that patients who choose to pursue Ketamine Assisted Psychotherapy are making a significant financial investment in their long term health and we take that seriously. We are committed to keeping our costs as affordable as possible without compromising any aspect of the quality of care. We do not take medicaid, medicare or insurance, however, we can provide out-of-network claim forms if you want to seek reimbursement.
  • Integrative Psychiatry:
    Our clinic believes in assessing and treating root causes of mental health conditions. Unlike most ketamine clinics, you will be evaluated for your ketamine consult by an Integrative Psychiatrist. Rest assured, if we believe ketamine is not the right or only course of action, you will be recommended other treatments that go after the root of the problem.
  • Ketamine-Assisted Psychotherapy:
    Ketamine’s dissociative effects offer a unique opportunity to uncover new ways of understanding your depression. Most ketamine centers place multiple patients in one room without any psychotherapist. We have treated a number of people who felt very disturbed by the experience of being left alone on ketamine. Each patient in our clinic has a private room and a highly skilled therapist throughout the ketamine treatment. 

  • Physician On Site:
    Some ketamine centers do not provide a physician on site. Additionally, there are therapists who will provide psychotherapy for clients in their office who have received sublingual ketamine without medical staff present, even though the FDA recently mandated that a newly approved version of ketamine cannot be administered outside of a medical office. Although medical emergencies are an extremely rare outcome of ketamine, we stand firmly for safety first by having a physician and nurse on-site, and we do not condone the use of ketamine outside a medical office setting.
  • IV Ketamine:
    There are several different ways of administering ketamine and at IPC we prefer IV infusion because it is the most studied route of administration. If for some reason IV is not best for a specific individual we also have other routes of administration which can be discussed between a patient and their individual provider. Unfortunately, sublingual ketamine research is not compelling and scant, therefore, we do not generally recommend this route of administration.

Powered by the Integrative Psychiatry Institute

We’re not only on the forefront of integrative care for patients, but we are also backed by the educational power of the Integrative Psychiatry Institute. Our expert practitioners are learning directly from the premier educational community for integrative psychiatry. Rest assured, our practitioners are constantly implementing new practices from the latest research in innovative mental health care.

References:

1. DiazGranados N et al. Rapid resolution of suicidal ideation after a single infusion of an N-methyl-D-aspartate antagonist in patients with treatment-resistant major depressive disorder. J. Clin. Psychiatry. 2010 Dec;71(12):1605-11.
2. Huang YJ et al. New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity. Neural Plast. 2017; 2017:4605971.
3. Diazgranados N, Ibrahim L, Brutsche NE, et al. A Randomized Add-on Trial of an
N-methyl-D-aspartate Antagonist in Treatment-Resistant Bipolar Depression. Arch
Gen Psychiatry. 2010;67(8):793–802. doi:10.1001/archgenpsychiatry.2010.90.