Can ketamine treat depression?

Ketamine is a medication that has mainly been used for anesthesia and pain management. In recent years, researchers have found that lower doses of ketamine can also be used to help with severe or treatment-resistant depression. While it has not yet been approved by the FDA, some doctors have begun to prescribe ketamine treatment to their patients.

How does ketamine treatment work?

Most antidepressants come in the form of a pill, which you take daily at home. Ketamine is a bit different—it’s given to you directly by a medical professional. There are two ways to receive ketamine:

• Through a series of injections (this is called the ketamine infusion model)
• At the beginning of a therapy session (the ketamine-assisted psychotherapy model)

The ketamine infusion model involves patients receiving a standard dose (typically 0.5mg/kg over 40 minutes) of ketamine through an IV. Usually, patients will undergo an “induction phase” and a “maintenance phase.” The induction phase is the first one to two weeks of treatment, where patients will receive two to three ketamine infusions each week. In the maintenance phase, patients return as needed for more infusions. Patient moods are tracked over time using validated depression scales to determine when is best to get another infusion. Osmind provides software for doctors to help monitor their patients.

The ketamine-assisted psychotherapy model involves both ketamine and psychotherapy. The patient receives ketamine as a needle injection, a lozenge, or a spray into their nose. After they take the ketamine, a mental health professional (psychiatrist, therapist, psychologist, etc.) will give them psychotherapy. Occasionally, patients may also be prescribed ketamine to administer at home as well. These appointments may last as long as three hours.

What is ketamine treatment like?

Ketamine treatment can differ across people. Most people will experience a gentle floating feeling with some mild hallucinations. Patients can experience different feelings or experiences during two separate infusions. For example, they may see colors during one infusion, and think about people in their lives during the next. Side effects of this treatment may include hallucinations, dizziness, or dissociation (feeling disconnected from your own mind or body)—but these usually only occur after the session and stop fairly quickly after.

Osmind provides an online community and care platform for patients with treatment-resistant mental health disorders, their mental health providers, and people interested in FDA-approved psychedelic medicine. They also have treatment guides and patient interviews that may help.

How can I decide what type of ketamine treatment is best?

There is no evidence to show that one model of ketamine treatment is better than another. It might be helpful for you to talk to your doctor and consider the following to decide which ketamine treatment will be best for you:

• Do you want to do psychotherapy?
• Is one treatment more convenient for you and your schedule?
• How much does each treatment cost? Are you willing and able to pay more for one treatment?

Ketamine is also available in another form, called esketamine.