Can Ketamine Cure Depression and Anxiety?

If you’re familiar with ketamine, you may know it as a party drug — a mainstay at raves, nightclubs, and musical festivals in the ‘80s and ‘90s thanks to its euphoric and hallucinogenic effects. But these days, researchers are exploring how very small doses of this drug might help to treat depression and anxiety, among other mental health conditions. In fact, the FDA has already approved a nasal spray containing a certain form of ketamine for treatment-resistant depression. In order to understand how ketamine works, it’s important to note that this drug was originally developed as an anesthetic for medical procedures. “Ketamine blocks pain signals to the brain,” explains Jenna Jarrold, a licensed associate counselor at Drug Helpline. “It can also create a feeling of detachment from one's surroundings.” What sets ketamine apart is that it operates completely differently in the brain than traditional psychiatric medications. And as mounting research reveals promising results, and an increasing number of ketamine therapy clinics open up shop, it’s becoming more widely accessible to people suffering from depression and anxiety. RELATED: Researchers Say Ketamine Is Amazing Treatment for Severe Depression So, is ketamine right for you? Read on for the full scoop on the benefits and risks of this trending treatment. What Is Ketamine Used to Treat, and Is It Effective? The majority of the research that’s been done on using ketamine to treat mental health symptoms has focused on depression — specifically, treatment-resistant depression. This term is used to describe people who are having trouble finding relief from standard treatments. In other words, they may have tried a combination of psychotherapy and antidepressants, but their symptoms didn’t get better. A small 2019 study found that when men with severe depression were given six doses of ketamine injections over two weeks, they experienced a significant reduction in depression and anxiety as quickly as one hour after the first dose. These positive effects lasted up to one month after the last dose. Another small 2017 study yielded similar results: 83% of patients with general anxiety disorder (GAD) and social anxiety disorder (SAD) had less anxiety within just one hour of receiving ketamine treatments. As for ketamine helping with specific symptoms, a 2022 review found single-dose ketamine infusions reduced panic and irritability in people with GAD and SAD. In general, the higher the doses of ketamine, the more effective they were. Another relatively new and exciting new development is at-home ketamine treatments — which tend to be vastly more affordable than in-clinic or in-hospital treatments, and may be equally as effective. A 2022 study revealed that when subjects did four weekly at-home ketamine sessions with oral tablets, they experienced strong and rapid improvements in their depression and anxiety. “While there is less published research on treating anxiety with ketamine, it is being studied and the early results look quite promising — especially for patients with PTSD and those with end-of-life anxiety related to a terminal illness,” says Dr. Rachel Dalthorp, a psychiatrist at LifeStance Health. According to Lauren Swanson, a board-certified physician assistant and lead clinician at Wondermed, emerging studies are examining how ketamine might help people with other mental health issues including eating disorders and post-traumatic stress disorder (PTSD). How Does Ketamine Work? Traditional prescription drugs used to treat depression and anxiety work by increasing the level of certain “feel-good” neurotransmitters in your brain, like serotonin. But ketamine operates totally differently. Specifically, it triggers a reaction in your brain that boosts the activity of glutamate, a chemical messenger in the brain that helps to regulate mood. Glutamate also plays a role in your brain’s ability to shift away from negative thought patterns that stoke depression and anxiety, and form newer and healthier pathways. This is known as neuroplasticity “Ketamine provides an immediate relaxation effect that moves you from beta to theta brainwave state, similar to what is induced by meditation,” says Swanson. “The psychedelic component offers insights and perspective shifts that empower you to see and address the root cause of your anxiety, not just the symptoms.” Ketamine has the ability to enhance neuroplasticity, which makes the brain more adaptable, flexible, and open to change in the days that follow the treatment session. This window provides an optimal state for facilitating positive cognitive restructuring and behavioral change, which can improve all areas of life, including one’s mental health. This phenomenon of increased plasticity actually stimulates the growth of new neural pathways and disrupts thought loops that may contribute to anxiety. For that reason, patients are recommended to implement behaviors into their daily routines that spark new, healthy thought patterns such as journaling and meditation. So not only are you removing the unhealthy habits but they’re being replaced by new, healthy patterns. RELATED: Misconceptions About Mental Health Guys Have Dalthorp says ketamine may also help repair the brain from the effects of stress. Here’s a very scientific explanation of how it does this: When your brain circuitry is operating properly, your mood is regulated more easily and effectively. Stress and depression are associated with abnormal brain signalling, or unhealthy neurons that don’t connect or communicate well. Ketamine treatments trigger a dramatic increase in a particular molecule that supports neuron survival and growth. As a result, damaged connections between the neurons can be repaired, so they’re able to better communicate with each other and form new circuits and pathways connecting areas of the brain that impact mood. What Does a Ketamine Session Entail? Much of your experience will depend on how the ketamine is administered, as well as the dosage. Ketamine can be taken in the following forms: Intravenous infusions Intramuscular shots Lozenges or tablets Nasal spray Ketamine via an IV, shots, or nasal spray must be done in a hospital or clinic setting under the supervision of a doctor. Oral ketamine, such as through lozenges and tablets, can be prescribed for at-home use. Once a patient has been screened by their primary care provider or psychiatrist to ensure they are a good candidate for ketamine, Dalthorp says she typically advises doing 90-minute in-office sessions of six infusions over the course of two to three months, followed by less frequent sessions as needed for maintenance. “Treatment should be provided under medical supervision by a licensed mental health professional with proper training and the ability to handle urgent or intense side effects,” she says. She also notes that your environment is a key element that can impact your experience with ketamine treatments. Ideally, you’ll want to be in a quiet, safe, and comforting environment with staff trained to support you should any fear or other negative emotions come up. Another option is taking ketamine at home. For instance, Wondermed is a platform that prescribes low-dose oral ketamine. This approach is obviously a little more convenient and less invasive, but your body may not absorb the ketamine as well as it does with injections, which go directly into the bloodstream. With oral ketamine, Swanson recommends a weekly hour-long session. She also advises lining up an ally — either a therapist or a trusted friend or partner — to accompany you during your sessions to ensure a positive and safe experience. Patients may spend time meditating or journaling before a ketamine session to set an intention and relax. Wondermed also offers one-hour guided audio soundscapes that may help guide and enhance your journey. “The beauty of going through the protocol at-home is it allows patients to have full control over their setting and truly customize their healing journey,” says Swanson. How Will Ketamine Make Me Feel? Each person’s ketamine-assisted journey will look different — ranging from subtle feelings of serene relaxation to a deep meditative state, says Swanson. Ketamine is known as a dissociative drug. Dissociation is the feeling of being detached from yourself — in other words, having an “out of body” experience. This isn’t necessarily always a negative or scary feeling, says Dalthorp, and not everyone who takes ketamine will feel that effect. For some, it may just feel like you’re dreaming while you’re still awake. “This altered state may enable the patient to explore and process parts of the unconscious mind and participate in intense introspective work that may lead to transformative change,” explains Dalthorp. “Patients may be able to see themselves as separated from their depression, to reassess their place in the world and have a greater understanding of and appreciation of their role in it.” “Some patients report feeling drowsy or tired right after the treatment, but the effects are mild,” says Dr. Nima Fahimian, a double-board certified psychiatrist practicing and Medical Director for TMS & Brain Health. “Most patients report feeling relaxed or neutral after the treatment.” No matter where your ketamine sessions take place or how the drug is administered, it’s strongly advisable to avoid driving or operating heavy machinery for at least six hours after your treatment — even if you feel oriented and back to normal. Who Shouldn’t Try Ketamine? Are There Any Risks to Know About? Ketamine treatments aren’t right for everyone. That’s why Dalthorp recommends consulting your primary care doctor about how it might impact you specifically based on your current health, medications, and other factors. Fahimian says ketamine isn’t suitable for people with ongoing or previous addiction issues, or who are pregnant or nursing. It’s also not generally recommended for anyone with: Uncontrolled hypertension (high blood pressure) Cardiovascular disease Arrhythmia, or irregular heartbeat History of stroke Epilepsy Hyperthyroidism Severe liver disease Psychosis “Ketamine is a very safe and effective medicine with minimal side effects for those that are a good candidate, but it should always be prescribed through proper, legal channels,” says Swanson. “Typically, patients who are experiencing extreme mental health symptoms are not a good fit for ketamine treatments.” All anesthetics come with potential effects, and ketamine is no different, says Jarrold. The most common side effects include: Nausea Dizziness Drowsiness Confusion or dissociation Temporary increase in blood pressure Fortunately, these effects tend to be mild and short-lived, says Dalthorp. You’re Interested in Trying Ketamine Therapy – What Now? Accessing ketamine is getting easier and easier by the day. If you’re interested in giving it a go, the first step is discussing this option with your primary care provider or psychiatrist. Keep in mind that ketamine is usually a last resort — something that clinicians will try when other more well-studied approaches have failed. And even though the FDA approved the use of a ketamine-derived nasal spray, it’s intended to be used in conjunction with a traditional antidepressant. It’s also worth noting that as with any drugs, the positive effects of ketamine may be more powerful when it’s used alongside therapy. “Whether consistently journaling to integrate insights, or scheduling regular meetings with a licensed therapist, reiki healer, life coach, or even a friend, creating a plan to integrate your journey into your daily life will increase the benefits of the ketamine treatment,” says Swanson. 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