Ketamine continues to gain recognition, by both lay public and medical professionals, as a remarkably effective antidepressant, with minimal side effects and a much faster onset time compared to traditional antidepressants. These differences are explained by Ketamine’s mechanisms of action, which are multiple. The most important is by correcting the glutaminergic dysregulation seen in major depressive disorder. In other words, Ketamine acts on glutamate, the most predominant neurotransmitter in the brain, by blocking NMDA and AMPA receptors. (Conventional antidepressants act on the brain’s monoamines, such as dopamine, serotonin, and norepinephrine.) Additionally, Ketamine promotes neuroplasticity, ie it repairs parts of the brain which have been damaged by depression, anxiety, and stress. It does so by increasing BDNF, or Brain-Derived Neurotrophic Factor, which is effectively ‘brain fertilizer’. Other mechanisms include its effect on sleep, central nervous system inflammation, and more.
Due to Ketamine’s minimal side effect profile, rapid onset, and superior therapeutic efficacy, it is more and more being considered not only as an advanced alternative for treatment-resistant depression like Electroconvulsive Therapy (ECT) and Transcranial Magnetic Stimulation (TMS), but as a first or second-line option.
We often refer to Ketamine as “the most powerful antidepressant yet invented”. In addition, our patients tell us that it relieves many of their other mood disturbances as well, such as anxiety, PTSD, and even their OCD symptoms. Furthermore, most chronic pain sufferers have issues with depression and anxiety, and ours are no exception. When they receive an infusion to relieve their chronic pain, they tell us that they come away feeling improved in both pain and mood.
The unprecedented relief that Ketamine confers has sparked a entire new area of psychopharmaceutical research to find a drug that Big Pharma can patent and profit from (this is ironic because Ketamine itself is quite inexpensive, having been on the market as an anesthetic drug since the Vietnam war). Indeed, Johnson & Johnson’s Spravato (esketamine), is one example of this – even though it is nowhere near as effective an antidepressant as regular Ketamine (as detailed in our post).