You are not alone. Depression is on course to become the world’s largest global burden of disease. Millions are struggling from clinical depression, and the sad truth is too many aren’t getting better with antidepressants. But, thanks to an innovative medical treatment there is another answer. This new treatment approach is called ketamine therapy.
Ketamine is a medication used as far back as 1970 for emergency medicine and minor surgical procedures. However, it wasn’t until more recently that ketamine treatment for clinical depression was discovered.
Ketamine is rapid-acting and one of the most effective medications for immediate relief from depression which has been shown in many ketamine for depression clinical trials. Additionally, this medication has a completely different mechanism from other antidepressant medications.
Unlike traditional antidepressant medications which work on the serotonin neurotransmitter system, ketamine blocks a type of glutamate receptors. It is believed that a significant part of ketamine’s effectiveness is due to the boost in brain-derived neurotrophic factor (BDNF) that has been observed in medical research. BDNF is an important brain hormone that promotes the creation of new connections between neurons, potentially reversing some of the long-term effects of chronic depression.
Antidepressant medications have saved many lives. Unfortunately, the STAR*D study demonstrated that most people who take antidepressants don’t receive significant benefits. Even more disturbing, the more antidepressants a person tries, the higher probability antidepressants won’t work effectively for that person.
Most ketamine clinical trials have focused on giving people with treatment-resistant depression ketamine infusions. These studies demonstrate that 70% of people that undergo ketamine infusions for depression reliably experience a significant reduction in symptoms of depression. No medication for clinical depression has ever had this level of efficacy.
In 2017, a meta-analysis of ketamine for depression stated: “Controlled clinical trials with IV ketamine have suggested that the antidepressant benefits of ketamine can be maintained by repeated dosing at 2-to-7-day intervals and that the benefits of ketamine can in this manner be extended for months to years.” [4</>]
A 2006 randomized trial of ketamine for depression conducted at the National Institute of Mental Health showed the fast-acting nature of ketamine for depression. Subsequent studies have also shown about a 70% response rate for IV ketamine for treatment-resistant depression.
In the following study, depressed people received one IV ketamine treatment and had seven days of follow-up assessments. Figure “A” demonstrates that seventy percent of study participants had at least a fifty percent reduction in depression peaking on day one. This graph also shows that by day seven (after only one infusion), about half of the benefit was gone. Further demonstrating the need for subsequent infusions.
Figure: Zarate 2006.
Between 2006 and the present, researchers have refined the treatment protocol with
subsequent sessions, frequency and dosing to prolong the benefits of ketamine.
“My current dose of meds weren’t cutting it anymore. I didn’t want to up my dose, but I needed a helping hand in calming my reactive body and mind. Within six hours of my first Ketamine session, I felt dramatically better, more grounded, less repetitive thoughts, and the darkness of depression significantly reduced. It was very reassuring to have the Ketamine-Assisted Psychotherapist “holding the space” when I was under the ketamine. In addition, having someone to help me process what I experienced during the treatment led to greater insights about my visions. I think people should embrace Ketamine-Assisted Psychotherapy as a great tool in the toolbox. I had fears about experiencing dark thoughts that would overwhelm me, but in all of my Ketamine sessions the opposite happened: I felt comforted and rejuvenated. And, knowing there was a therapist by my side at all times made it a very safe and nurturing environment.”
“I started at IPC with severe depression, low self-confidence, and didn’t know what I wanted to do with my life. After my ketamine treatments, I finally stopped having suicidal thoughts. I have a positive outlook and feel a connection in my relationships. I also see how my degree is useful, and I’m connecting the dots between school and career. It was really nice to have a therapist to talk with throughout the Ketamine sessions about how to be my best self.”
“I had treatment-resistant depression for my entire life. I know it sounds cliche but I was only seeing dark clouds. The ketamine sessions allowed me to start functioning again with the desire little by little to get off the couch and re-engage with life. I don’t think there would have been any effect without the therapist. The ability to discuss my experiences and to continue to work on these issues within the integrative sessions was invaluable.””
“I struggled with depression. The ketamine sessions helped me gain more perspective. I’m now able to see my life and my existence in a larger context and pick up on things I couldn’t previously do. During the sessions, it was really helpful to have a therapist to create a safe container, guide me through the rough spots, and explore the deeper areas.”
“Ketamine-Assisted Psychotherapy had a profound effect on my life. I struggled with chronic depression and was on meds for twenty years. I did the Ketamine series about a year ago and have not had any depression since the treatment. My baseline emotional affect has lifted. I gained tools along with new perspectives. My therapist was so supportive and understanding talking me through what I call the Ketamine world. We talked through how my new insights could be useful and help me with depression.”
“Last summer, my twenty year old daughter was struggling with a horrible depression. She was having a hard time functioning, and pharmaceuticals didn’t work for her. We decided to have her try ketamine therapy at the Integrative Psychiatry Center. After six sessions, I saw my daughter completely emerge from her depression and she remains so all these months later. Due to the therapeutic assistance that she received during these sessions, she also seemed resourced to meet her life in new ways. I’m so grateful that IPC offers Ketamine treatment, and I highly recommend this therapy to others suffering from depression.”
“Before Ketamine therapy I was struggling mostly with depression that had come on very suddenly and was very debilitating. After the Ketamine sessions, I noticed the depression I had been experiencing began to let up, I noticed I was able to make art again, and socialize with others much better than I had before. Having a therapist present made me feel safe and helped me negotiate some of the experiences I had while on the Ketamine, and also helped me negotiate my relationship with the traditional role of a therapist.”
“I had been struggling with severe treatment resistant depression for many years before the Ketamine treatments. I had tried a large number of medications but none of them seemed to work for any length of time. I had been struggling with intermittent severe depression and suicidal thoughts just prior to the ketamine sessions. My mood lifted substantially during and after the sessions. I stopped having frequent suicidal thoughts. I also became more able to make changes in my life. The ketamine treatment was very freeing in this regard. I am a longtime binge-eater and have trauma and was able to work on these issues during the Ketamine sessions which really helped me make changes during and after the ketamine treatment.”
“I decided to get treated at IPC specifically because they had a psychotherapist present during the ketamine administration. Following up with the therapist during and after the ketamine treatment was critical in reinforcing the changes that the ketamine was allowing me to make in my life. Having a therapist present was also important for helping me deal with traumatic memories that came up during the ketamine therapy. All of the staff at IPC were very caring and supportive. I had a wonderful transformative experience.”
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:
1. Huang YJ et al. New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity. Neural Plast. 2017; 2017:4605971.
2. Gaynes BN et al. What Did STAR*D Teach Us? Results From a Large-Scale, Practical, Clinical Trial for Patients With Depression. Published online 1 Nov 2009. https://doi.org/10.1176/ps.2009.60.11.1439.
3. Zarate CA, et al. A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression.Arch Gen Psychiatry. 2006 Aug;63(8):856-64.
4. Andrade, C. Ketamine for Depression, 1: Clinical Summary of Issues Related to Efficacy, Adverse Effects, and Mechanism of Action. J Clinical Psychiatry 2017 Apr;78(4):e415-e419.
4. Gaynes BN et al. What Did STAR*D Teach Us? Results From a Large-Scale, Practical, Clinical Trial for Patients With Depression. Published online 1 Nov 2009. https://doi.org/10.1176/ps.2009.60.11.1439.