Treatment-Resistant Mental Health Conditions
Mental health conditions are more common than we might think. Each year, 1 in 5 adults in America experiences a mood or anxiety disorder. At least 6.9% have one major depressive episode, while 18.1% live with an anxiety disorder such as OCD or PTSD, and 2.6% experience a bipolar episode.
Unfortunately, some of us don’t respond to first-line therapies. Over 40% of those who try antidepressants don’t respond to these medications. If you have been treated for a mental health condition and have tried multiple medications and forms of talk therapy, but your symptoms don’t improved or they return, you may have a treatment-resistant condition. Some suffer for years before finding the right treatment.
Is Ketamine Right for Me?
Ketamine can be incredibly effective for those with depression, anxiety, OCD, and PTSD who have not responded to first-line treatments. Very often, our patients have tried various forms of talk therapy and multiple antidepressants without sufficient response. Because Ketamine is so fast-acting, often within hours or as soon as minutes, it can also be particularly helpful for those with suicidal thoughts or ideation. If you have suffered with a treatment-resistant mental health condition, we encourage you to explore ketamine as a therapy option.
Before the course of treatment, our team will carefully interview you to determine if you are a good candidate. Our team will review your medical history and records, including current medications, and administer brief psychological tests. We will also discuss potential side effects, as well as the dissociative feelings that may occur during treatment.
Those ineligible for Ketamine treatments include pregnant or nursing mothers, as well those with dissociative or psychotic disorders or currently in a manic or mixed episode. Also ineligible are those with certain conditions including uncontrolled hypertension, currently taking anxiety medications, opiates, or marijuana.
What is Ketamine?
Ketamine therapy has been hailed in Science magazine as the “biggest breakthrough in depression research in a half century” and has provided much-needed, fast-acting relief to those with chronic, treatment-resistant mental health conditions and suicidal thoughts.
Developed in 1963 by researchers from Wayne State University as an anesthetic and analgesic agent, ketamine is one of the most widely used drugs in modern medicine. It was FDA approved in 1970 and has been used safely in surgical settings, including pediatric surgery. Ketamine is also been utilized in managing acute and chronic pain conditions.
In 2000, scientists from Yale University published a landmark study which found that ketamine can produce rapid, though short-lived, improvements in mood for those with treatment-resistant depression. In as soon as a few hours, some patients report feeling energized, more engaged with life, and better able to cope with everyday tasks and decisions. Although a course of ketamine typically produces effects that only for a few months, its efficacy is impressive. Repeated infusions have shown to have a cumulative effect, prolonging mood improvements from periods.
Ketamine therapy is now increasingly clinically applied as an off-label treatment for various chronic, treatment-resistant mental health conditions, including depression, alcoholism, substance dependencies, PTSD, OCD, and other psychiatric diagnoses. Leading medical centers including the Mayo Clinic, Yale University, and Kaiser Permanente in Northern California have launched ketamine clinics, and numerous private practices continue to spring up around the country.
Nearly 70% of patients respond positively to ketamine and more than 75 studies have been completed to demonstrate that it is safe and effective. Researchers continue to study ketamine’s mechanisms and long-term effects, and to refine formulation
How Ketamine Works
Ketamine regulates the flow of neurotransmitters in the brain to not only improve mood but stimulates neural growth within days, and sometimes hours.
Stress floods the brain with a neurotransmitter called glutamate. Glutamate is generally acknowledged as the most important transmitter for good brain functioning. However, an excess of glutamate can damage the networks of neurons that facilitate normal functioning and can lead to feelings of depression and anxiety. These neural networks begin to recede.
Over time, chronic stress can cause whole areas of the brain to be shrunken and underactive; including the hippocampus and the prefrontal cortex, which regulate mood and impulse control. Meanwhile, neural networks in the amygdala, which governs fear and anxiety, experience growth. Together these mechanisms reinforcing a cycle of depressive thinking.
Our present understanding of ketamine’s mode of action is that it blocks N-methyl-D-aspartate (NMDA), a receptor in the brain activated by glutamate. Ketamine thus reduces the flow of glutamate to a manageable level and helps “reboot” the brain. Neural connections that regulate mood and help us cope seem to grow back within days.
However, there is no current consensus on mode of action, and other mechanisms may be found central to ketamine’s effects. Scientists continue to research ketamine’s properties, and explore other formulations to improve delivery, efficacy, and durability.