How Does Ketamine Help with Depression?

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How Does Ketamine Help with Depression?

Depression is a widespread problem. In the United States each year, 16 million adults experience an episode of major depression and the prevalence has increased further during the COVD-19 pandemic. Unfortunately, on top of these high numbers, deaths from suicide have risen, making the search for effective depression treatments more crucial than ever. Fortunately, ketamine could provide a solution.

Dr. Karen Giles offers the latest treatments available for mood and anxiety disorders, particularly treatment-resistant depression, at Breakthru Psychiatric Solutions in Sandy Springs, Georgia (a suburb north of Atlanta). If you or someone you love has depression that has not responded to traditional therapies, here’s how ketamine could help.

A new tool for major depression

Ketamine may be a new medication for treating major depression, but has been around for decades. Its use in clinical settings dates back to the 1960s as an anesthetic. However, it’s become a game-changer for mood disorders, like depression, and anxiety disorders in more recent years.

Nearly half of people with major depression do not find relief with traditional antidepressant medications that act on the serotonin and norepinephrine neurotransmitter systems in the brain and take 6-8 weeks to fully work. Unlike traditional antidepressants, ketamine rapidly activates glutamate production — an excitatory neurotransmitter in the brain. This triggers a cascading chain of events that causes the brain to form new neural connections (referred to as neural plasticity). The result? The brain creates new pathways, becomes more adaptable, and may enable you to develop more positive moods, behaviors, cognition, and thoughts.

This unprecedented neural response makes ketamine highly effective for even the most severe cases of depression, especially those with suicidal ideations. In fact, studies show a single ketamine treatment can have a beneficial impact on suicidal thoughts within 72 hours.

How ketamine therapy works

All ketamine treatments are administered under medical supervision of a physician at Breakthru Psychiatric Solutions (this is not always the case elsewhere). Dr. Giles uses two different forms: ketamine infusions administered intravenously (IV) and Spravato® (esketamine) nasal spray.

Ketamine infusions

During a ketamine infusion, you receive a customized low dose of ketamine through an IV placed in your arm vein. This dose is intentionally much lower than when ketamine is used as an anesthetic, therefore you will remain awake, calm, and fully aware during the experience. The ketamine is slowly infused over 40-60 minutes. 

Spravato® (esketamine) nasal spray

Spravato® is the only FDA-approved form of ketamine available for treating severe depression. It must be prescribed by a Psychiatrist and administered in a clinic. You self-administer this form of ketamine by inhaling a spray through your nose, making it a slightly easier method than an infusion You will be awake following the nasal spray and then relax for 2 hours while the medication takes effect. By 1.5-2 hours, the noticeable effects will wear off and then you will be able to leave at 2 hours. 

Whether you have ketamine therapy by infusion or nasal spray, you should see a positive response within 1-3 sessions. If this occurs, Dr. Giles continues with your ketamine treatments. If it doesn’t, she can recommend other approaches instead, like transcranial magnetic stimulation (TMS).

What to expect during ketamine treatments

During IV or nasal ketamine treatment, Dr. Giles and a nurse will monitor your vitals and check in with you throughout the process to ensure you are comfortable. We will create a peaceful experience for you with a private room, dimmed lighting, and options of eye masks, blankets, and music. You are welcome to bring your own music and items for relaxing during the treatment. Once you are done with your treatment, someone you trust must pick you up from our clinic and bring you home. You are free to drive the next day after a good night of sleep.

Like all medications, ketamine can come with side effects. However, when compared with severe depression or suicidal ideations, the benefits typically outweigh the possible risks. Further, Dr. Giles monitors you closely throughout your treatment and administers fairly low dosages to avoid potential side effects.

If you do experience side effects during your treatment, they could include:

  • Changes in perception
  • Disssociation, floatiness, or out-of-body experiences
  • Nausea and vomiting
  • Increased blood pressure

If any of these symptoms arise, they typically pass quickly, and you remain under staff supervision the entire time. Dr. Giles can administer medication to help with side effects if needed.

In most cases, Dr. Giles recommends a series of ketamine treatments for lasting results, but she offers personalized strategies on a case-by-case basis.

Curious to learn more about ketamine therapy for depression? Contact Breakthru Psychiatric Solutions to schedule a consultation with Dr. Giles in Sandy Springs, Georgia, by calling 470-231-2235 today.