Ketamine: Uses, Dosage, Side Effects, Warnings
It is also a drug of abuse that is used illegally recreationally for its hallucinogenic properties and is known to be a “date rape” drug as it causes short-term memory loss. Despite the fact that antidepressants can be immensely helpful for people, they don’t work for everyone. Ketamine and esketamine were approved for forms of depression that haven’t responded to traditional oral antidepresants (such as fluoxetine/Prozac, sertraline/Zoloft, etc.). In circumstances where insurance pays for treatment (more common with esketamine than ketamine), patients are often required to have tried at least two oral antidepressants before starting treatment with ketamine/esketmaine. (The exception would be when a patient is imminently suicidal, in which case the treatment would often be started while the patient is hospitalized.) What counts as “trying” an oral antidepressant?
Beginning in the mid-2010s (see figure 1 in this paper), more doctors started offering ketamine as a treatment for depression. In 2019, the Food and Drug Administration (FDA) approved esketamine as a treatment for forms of depression that haven’t improved with standard antidepressants (like citalopram/Celexa or bupropion/Wellbutrin). Given over 10 years of experience with ketamine as a researcher and physician, in this article I try to answer some basic questions prospective patients often have about ketamine/esketamine. Keep in mind that casual use isn’t a treatment for depression, and the FDA has warned that ketamine and compounded ketamine products aren’t approved to treat any psychiatric disorders. One recent systematic review and meta-analysis that looked at 36 studies on ketamine and esketamine concluded that both drug forms are effective and safe for people with depression. More research, however, needs to be done on the long-term safety of ketamine, the authors noted, and more research should be done on the efficacy of at-home versus in-clinic treatments.
Ketamine should not be used in patients for whom a significant elevation of blood pressure would constitute a serious hazard or in patients with known hypersensitivity to ketamine or to any excipient. Ketamine use can be fatal in people who are alcoholics or acutely intoxicated with alcohol. There are animal reports of an increased risk of toxicity when ketamine is combined with caffeine. Theoretically, this may be a concern in people who have consumed energy drinks, often done at nightclubs where this medicine may be abused. Because the FDA hasn’t approved IV ketamine for depression, most insurance doesn’t cover it.
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The dissociative effects are one reason ketamine is popular as a “club drug” for recreational use. They may offer you an eye mask and headphones, or you may want to bring your own. Some people find it more pleasant to have an eye mask on and listen to calming music. You may begin to feel some of the effects of the ketamine within a few minutes. You might feel a “floaty” sensation or you may feel like you are not quite in your body.
How Ketamine Succeeds Where Other Treatments Fall Short
But the settings in which ketamine was developed and historically used were highly regulated and supervised inpatient health care facilities. First, it’s important to remember that ketamine isn’t a first-option treatment for depression. It’s generally used only when other, more longstanding treatments haven’t been effective. Ketamine doesn’t offer a cure; rather, it improves symptoms of depression for a certain amount of time. The initial effects of ketamine on mouse behavior occurred independently of its effects on spine formation.
Should you go to a ketamine clinic for treatment?
- Currently, this means that ketamine, outside of esketamine FDA-approved use, is being used off-label.
- Weeks, months, or years after their first series of six to eight doses, patients may return for a booster.
- Someone who is suicidal does not have the luxury of waiting several weeks for a medicine to kick in.
- Typically, drug companies are restricted to marketing and promoting their products only for FDA-approved indications.
- Depression is a serious mood disorder with symptoms that include prolonged periods of sadness, hopelessness, and irritability.
Talk to your primary care doctor, your mental health provider, and any other health care professionals who care for you to help make a decision. Based on your goals, your experiences with depression, and the possible side effects of the drug, it’s often easier to say who isn’t appropriate for ketamine treatment. Earlier this year, the FDA approved a form of the drug ketamine to treat depression. Ketamine is a fast-acting antidepressant that relieves depressive symptoms in hours instead of the weeks or longer that previous drugs required. In addition to being a major advance in treatment, ketamine provides an opportunity for researchers to investigate the short- and long-term biological changes underlying its effects on depression.
Serious ketamine side effects
For information on mood disorders, support tools for mental wellness, and how to stay mentally healthy, this organization is an accurate and thorough go-to resource. (Insurance may cover the cost of the psychotherapy sessions, however. Ask about your specific benefits.) “The cost of treatment is not an insignificant amount of money,” says De La Hoz. One issue is that because of the cost, it may only be available to those with higher incomes. What Is Salvia for Parents “We have hope that this will become more accessible to all who need it, not just specific populations,” he says. Because ketamine distribution for treatment is not widely regulated, each clinic or company has their own protocol for how many ketamine sessions are recommended and how follow-up sessions and maintenance doses are handled. Avoid driving or operating machinery for at least 24 hours after you receive ketamine.
