"Recent data suggest that ketamine, given intravenously, might be the most important breakthrough in antidepressanttreatment in decades."
Ketamine treatment has shown an "ability to produce rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant to treatment".
"...studies have found that ketamine can do something no other drug can: it often relieves even suicidal depression in a matter of hours in patients who have not responded to other treatments."
Kay Jennings BSN, MHSA, MSN, PMHNP-BC and William D. Stratford MD, FAPA represent more than six combined decades of psychiatric experience providing exceptional personalized and compassionate care throughout the Rocky Mountain West. Recognizing that suicide and suicide attempts have reached epidemic levels in our region, Jennings and Stratford formed Psychiatric Ketamine Specialists, LLC to provide sufferers of severe depression access to new and lifechanging avenues for relief.
Ketamine is an anesthetic developed in the early 1960s. It is one of the most widely used drugs in modern medicine, and is on the World Health Organization's List of Essential Medicines. It has a variety of medical uses, and is FDA-approved as an anesthetic. Ketamine has a remarkably safe track record in surgical settings, and is frequently used in pediatric surgery. It is also commonly used to treat the extreme physical pain of a condition called CRPS/RSD.
About 70% of patients with treatment-resistant depression (including bipolar patients) experience rapid relief after a low-dose ketamine infusion. Similar success rates have been seen in returning combat veterans suffering from PTSD.
These patients' cases are the worst of the worst, lasting years or even decades, and which have not responded to any other treatments. Many have hovered on the verge of suicide for years, many have actually attempted suicide, and all have endured a very poor quality of life.
Before ketamine therapy, there was virtually no way to substantially improve the condition of patients like these.
The fact that ketamine works rapidly on 70% of them is astonishing, and its discovery has profoundly changed depression research, and our understanding of the very nature of depression.
It's important to keep in mind, however, that the degree of relief can vary among patients. Some sufferers get only partial relief, some do not get relief until a second or third infusion, and some do not respond to ketamine at all. And some patients have additional medical conditions in addition to depression that can reduce its effectiveness.
Ketamine is completely different from SSRIs, tricyclics, MOAI inhibitors, benzos, or any other antidepressant or anti-anxiety medication. The exact mechanism that causes ketamine to relieve depression is still under study, and is quite complex.
In short, when ketamine is administered in a very precise way it triggers a cascading sequence of events in the brain, which ultimately results in the re-growth of neurons that previously died off. It is thought by some researchers that prolonged exposure to stress causes these neurons die off in the first place, resulting in depression, but ketamine causes them to rapidly re-grow within hours, relieving the depressive symptoms.
This is an oversimplification of a very complex topic, and the latest research hints there may be several other mechanisms involved that also play important roles.
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