Ketamine is considered a “dissociative” anesthetic, often used in children because of its safety. It has been used for sedation and pain relief as well, but more recently has received considerable attention for its off-label successful treatment of “treatment resistant” depression.
In addition to treating severe symptoms of depression, ketamine is being used to successfully treat PTSD (post-traumatic stress disorder) and chronic anxiety disorders. Besides its relatively newfound efficacy in treating formerly treatment resistant aforementioned disorders safely and cheaply, much of the excitement surrounding ketamine use includes the ability to do so rapidly – usually within the first course of treatment, but most often within days or even hours. A typical course of treatment includes six 40-50 minute infusions of ketamine over 2-3 weeks. Maintenance treatment, if necessary, usually involves additional 40-50 minute infusions once every 3-4 weeks thereafter.
How does ketamine work? Scientists are still working to understand ketamine’s mechanisms of action, but the current research shows that it appears to work by not only nudging (NDMA antagonism) our consciousness out of its rut (“DMN” or Default Mode Network), but also by quickly restructuring the brain by enhancing the ability to create a new outlook through creation of new pathways of thought (increased neuronal plasticity and new synapses created in part via agonism of mTOR and BDNF). The research and results are a relief for a very large cross-section of the world’s population who suffer from intractable depression, anxiety and PTSD, and exciting because the mechanism by which ketamine appears to work is safe, simple and jibes with other research showing the partial or complete efficacy of other treatments that work via the same mechanism of action though often in all too slow a manner or without sufficient strength.