Researchers don't know exactly how Ketamine works to treat depression, but they have some ideas. Unlike antidepressants, which work by shifting the balance of brain chemicals like serotonin and dopamine, Ketamine is thought to change the way brain cells communicate with each other. Ketamine blocks a type of receptor in the brain, known as NMDA, thought to play a role in depression. Recent studies find that Ketamine can have long-lasting effects on depression, even though the drug only stays in the body a short time. Ketamine also acts on other brain receptors -- like opioid receptors, which affect pain and depression.
Usually, Ketamine is given as an IV into a vein, which is the quickest route for the medicine to get to the brain. Most people start with about six doses over a period of one to two weeks, and then get booster IVs thereafter. Dr. Sambunaris will work with you to determine the best protocol for your situation. You may need to continue treatments for a year or more to see long-term results.
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Ketamine is FDA-approved as an anesthetic for surgery and diagnostic procedures. It's also used to treat depression, fibromyalgia, migraines, post-traumatic stress disorder (PTSD), OCD, ADHD, anxiety other mood disorders, and nerve-related pain.
Ketamine also shows promise in the treatment of addiction. Recent studies have linked Ketamine’s antagonism of NMDA receptors to destabilizing and even erasing memories that reinforce drinking. The drug has helped heroin addicts abstain following release from rehab.
There are no guidelines on treating depression with Ketamine. However, we have developed a specific treatment protocol based on experience and the American Psychiatric Association published a consensus statement that offered:
*At your initial appointment, we will ask about your symptoms, treatment history, other medical conditions, and whether you've had any problems with substance abuse before starting you on Ketamine. Knowing your health history will help ensure that the benefits of this treatment outweigh the risks.
*The team will also check your vital signs -- including blood pressure, heart rate, and oxygen levels -- before and after treatment, as well as monitoring you during the process.
Ketamine provides an option for people who have not found relief through other depression treatments. One of its most promising features, and one that sets it apart from traditional antidepressants, is an extremely rapid onset. Depressive symptoms tend to improve within just 24 to 72 hours—a huge improvement over the 6-12 week waiting period of other medications. While it doesn’t work for everyone, Ketamine’s success rate of 85% is almost double that of traditional antidepressants (45%). It’s also highly effective in patients with treatment-resistant depression, even if their symptoms have persisted for decades without relief.
Ketamine is an anesthetic drug that blocks pain. It was first developed in the 1960s and was used to operate on soldiers during the Vietnam War. In 2000, researchers started studying Ketamine as a treatment for depression. As an antidepressant, Ketamine’s S-enantiomer, or “esKetamine,” has twice been designated a “breakthrough therapy” by the FDA. In August 2016, it was fast-tracked for development as a viable medication.
Ketamine is a miracle drug. Although many patients experience a “lightening of mood” with the first treatment, this is not a quick fix. The initial effects of the drug on depression can fade quickly and most people need to get repeat treatments over many months or years to see long-term improvements.
Isn’t Ketamine addictive? Ketamine does not appear to be physically addictive, but recent research and anecdotal reports do point to Ketamine being habit-forming, especially for recreational users (those not being treated by a physician.) Ketamine has been used in medicine ways all over the world for over 20 years and its pharmacological, short term and long-term effects are well known.
Isn’t Ketamine a horse tranquilizer? A common misrepresentation by the media, Ketamine was originally created for and tested on humans. Today, it’s perhaps the most effective therapy for treatment-resistant depression, while remaining one of our most reliable anesthetics. In fact, it’s one of only two injected general anesthetics listed on the World Health Organization’s Model List of Essential Medicines.