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How did ketamine go from being “Special K” to being a medication for depression?

Ketamine was patented in Belgium in 1963 for use as a veterinary anesthetic; by 1965 it was found to be safe for anesthetic use in humans. It was not until 1970, however, that ketamine was approved by the FDA for this purpose. As an anesthetic, ketamine has the advantage of not depressing the heart rate or the respiration rate which makes it safer for use in children and for adults undergoing minor surgical procedures. Before long, ketamine became invaluable as a battlefield anesthetic during the Vietnam War.

Strangely, during the same period, a doctor, whose patients reported “out of body” experiences under the influence of ketamine, dubbed the drug a “dissociative anesthetic,” and it rather suddenly it became popular as the recreational drug soon to be known as “Special K.” Despite its increased usage as a hallucinogenic “party drug,” its psychedelic side effects led psychiatrists to discover its remarkable use as a psychiatric medicine. Currently, ketamine is being successfully used to combat severe depression in patients who have not otherwise been able to find relief. It should be noted that ketamine treatments should only be administered by a qualified and knowledgeable psychiatrist with experience in the this field of medicine.

Intractable Depression Responds to Ketamine

Depression has become a more and more common aspect of modern life. It is estimated that one in nine individuals in this country now takes an antidepressant. While there are several different categories of antidepressants and several types within each category, for an unfortunate percentage of people suffering from severe depression, none of these medications work. In the early 2000s, it was discovered that ketamine, administered in low doses intravenously, can be effective in such intractable cases of depression.

Ketamine’s Advantages Over Other Antidepressant Medications

By 2017, ketamine was being used as an “off label” psychiatric medication, since ketamine had been FDA-approved for anesthetic use only. At we write these words, that is still the case, meaning that insurance will still not cover the cost of ketamine treatments. For those who have suffered with severe depression and have had no relief from other medications, however, ketamine is worth its weight in gold. In addition to successfully treating depression that has been unresponsive to other antidepressants, ketamine has several advantages over these other medications, including:

  • Ketamine works much more quickly. Whereas most antidepressants, like Prozac and Zoloft, take a month or more to kick in, Ketamine can bring relief within hours. In suicidal patients, this feature can be live-saving.
  • Ketamine does not have the undesirable side effects that many other antidepressants do, such as weight gain and loss of libido
  • Ketamine can be used on an outpatient basis

One drawback of ketamine treatment, however, it that it doesn’t have a long-term effect on depression. The relief from overwhelming depression, not to mention from generalized anxiety, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), panic disorders, bipolar disorder, schizophrenia, adult ADD and addiction disorders involving alcohol and cocaine, may be dramatic. The problem is that ketamine’s positive effects have a short shelf life, typically lasting about a week. For the present, patients whose lives are rebooted with administration ketamine are satisfied to receive repeated administrations of the medication that keep them comfortable and functioning.

How Ketamine Works Differently in the Brain

Ketamine acts on the brain’s chemical system in a different way than other antidepressant medications. It alters neurotransmitter processes which appears to cause a rapid increase in glutamate. This in turn activates glutamate receptors, which are believed to strengthen synapses in the parts of the brain involved in motivation, memory, and mood — parts which in depressed individuals are underactive. Previous to the discovery of ketamine’s antidepressant properties, psychiatrists prescribed medications that increased the uptake of serotonin and the role of glutamate in psychiatric disorders was unknown.

Amazing Results

In 2006, the National Institutes of Health, did a study with 17 subjects who had already tried an average of six antidepressants each without success. Within a day, 70 percent reported full remission of symptoms — for up to a week. In hundreds of studies since, 60 to 70 percent of depressed patients have shown a significant improvement in mood after a single dose of ketamine.

Posted in: Depression