How Ketamine is Being Used as a Cutting-Edge Treatment for Depression and PTSD

According to Mental Health America, one in five adults – 40 million Americans – have a mental health condition.

Within that number, nearly 16 million people suffer from depression and more than 7 million are affected by PTSD.  The two conditions tend to go hand-in-hand, as those who suffer from PTSD often experience depression in their lives.

Nearly twice as many women suffer from depression than men, and even though PTSD is mostly associated with male soldiers coming back from war, any traumatic event such as a car accident or sexual assault can cause the condition. PTSD is something that men and women must deal with, and it occurs twice as much in women according to the U.S. Department of Veteran Affairs.

While there are dozens of medications to treat depression and PTSD, some of which overlap, most merely cover up the problem.

“Many medications work on the assumption that you don’t have enough serotonin in your brain,” says Dr. Steven Levine (www.ktcpartnership.com). “And if you replace enough of these feel-good hormones, you will feel better.”

Levine is making an effort to treat patients who suffer from depression and PTSD by helping them repair damaged connections in the brain through the use of periodic Ketamine infusions in small doses.

Developed in 1962, Ketamine was originally used as an anesthetic, but quickly found its way onto the streets as a recreational drug, taking on the name Special K. It has also been used as a tranquilizer for animals such as horses and cats.

As an anesthetic, it’s still considered one of the safest around. But that usually happens in one dose. The unknown is what happens to the brain over time with repeated infusions of Ketamine.

“Those who may be at risk of cognitive damage are people who abuse it daily or multiple times a week in high doses,” says Levine.

Most of Levine’s patients receive an infusion once a month, and also go through traditional talk therapy.

“The results have been amazing,” says Levine who is internationally recognized as an expert in the clinical use of Ketamine for mood and anxiety disorders. “In some cases Ketamine has started to alleviate patients’ symptoms after one infusion. Most antidepressants can take weeks or months to start working.”

Extensive research conducted on Ketamine at multiple universities in the US and abroad, reveal a 75 percent success rate for the treatment.

A recent study at Columbia University has found that Ketamine infusions given in a vaccine-like fashion to those embarking upon an environment likely to cause significant stressors – such as soldiers entering a battle or aid workers going to a disaster area – prevented or reduced PTSD symptoms.

“Depression and PTSD can cause a lot of pain in people’s lives,” says Levine. “I don’t think of Ketamine as a magic bullet, it’s a tool. I want patients to eventually feel like they are sailing on their own and Ketamine is merely there as a backup.”

Now, given our family history of depression and the issues that my eldest son is dealing with, the thought of possibly implementing Ketamine infusions into his treatment intrigued me. So I reached out to Dr. Levine and asked him a few questions about how they work.

What is Ketamine?

Ketamine is best known for its misuses (e.g. “Special K”), but prior to this phenomenon, Ketamine was, and still remains, a life-saving medication developed for starting and maintaining anesthesia during surgery, severe injury, or acute pain. Outside of its original use, we’ve discovered Ketamine’s extraordinary effectiveness in treating depression and other mental illnesses, especially in the most stubborn cases.

How does it work to treat depression and suicidal ideation?

At present, we’re mostly treating patients who have failed on standard treatments for depression, including SSRIs and ECT. These patients are in the throes of severe depression. With a response rate of 70% in this treatment-resistant patient base, we’re seeing Ketamine literally lift depression from them, in sometimes as soon as a single treatment. To see this happen to a person is astonishing. Most psychiatrists spend months or years with patients who are not responding to standard treatments. And if their patients do respond, rarely does the moment of relief occur at their office. 

In regards to how Ketamine specifically alleviates depression and suicidal ideation, we believe it’s partially due to the glutamate system. Ketamine primarily acts on glutamate, which is the most abundant neurotransmitter in the brain, as opposed to SSRIs that selectively target the neurotransmitter serotonin. Once the glutamate system is engaged, we see repair in damaged neural connections and the formation of new synaptic connections in the brains of depressed people. This does not mean that Ketamine is a cure for depression. There is still no magic bullet out there, but with Ketamine infusion therapy, we’ve taken the biggest leap in the treatment of mental illness of our lifetime.

What are the benefits and drawbacks of Ketamine therapy?

Since Ketamine is saving lives, especially in the cases of people considering suicide, we believe the positives of treatment outweigh the negatives. Every patient, however, should be aware of the drawbacks that come with a treatment they’re considering.

Drawbacks

  • Little to no insurance coverage at the time of this post
  • Further treatments required to maintain response
  • Possibility of a dissociative effect during treatment
  • Effects of long-term use are still not fully established

Benefits

  • Response rate of 70% in patients who have not benefited from other treatments
  • Fast acting—responders often see benefits in days instead of months
  • Treats depression, bipolar depression, and suicidal ideation
  • Potential effectiveness in anxiety disorders, including OCD and PTSD
  • Little to no side effects between treatments

Is it safe for teenagers, young adults?

There has recently been a study of Ketamine for adolescents with depression at Yale that was quite positive. Research in this population is still early, and we must be careful with the unknown possible harms to the still-developing brain. There may be a case to be made for cautious use in life-threatening situations, weighing these unknown risks against the threat of suicide.

How often would you need the treatments?

The dosage of Ketamine is individually based, relying on factors such as a patient’s weight. Just as the optimal dose is different between patients, so is the number of treatments. We’ve developed a protocol at Ketamine Treatment Centers to account for the varying responses. Some patients require only a treatment to respond; others can take up to 7 or 8 infusions. Once we’ve reached response or remission, the maintenance protocol for Ketamine infusion is also different for every patient, but our goal is the same: swiftly get to wellness and stay there as long as possible between infusions.

What is the general consensus of other psychiatrists in the profession regarding Ketamine therapy?

You’ll find psychiatrists on both sides of the fence. This does not mean that psychiatrists in opposition to this use of Ketamine are trying to stop a breakthrough treatment from helping millions of people. Many psychiatrists are still in the dark about Ketamine for depression. Others know very little and are going off instinct in light of Ketamine’s dark past. Then there are psychiatrists who are aware, but do not feel there’s enough data. The opposing viewpoints only serve to bring Ketamine further into the spotlight, in turn helping more people get access to this life-saving treatment.

There is, however, a general consensus in the research and academic community around Ketamine’s remarkable effectiveness.

Have any studies been done over the past 20-50 years regarding this therapy and what were the outcomes?

There have been many studies done on treating depression with Ketamine, including several large meta-analyses. Interested readers can click here for study outcomes.

Is it covered by most insurance companies, Medicaid and/or Medicare?

At the time of this post, insurance companies in general do not cover Ketamine infusion therapy for depression and other off-label uses. At the Ketamine Treatments Centers, however, the psychiatry portion of the service is typically covered by insurance, which offsets the total cost of treatment. 

These questions were answered by Steven Levine, MD: Founder of Ketamine Treatment Centers. Steven has been treating patients around the world with Ketamine infusion therapy since 2010. His centers are currently located throughout the United States. For more information on Ketamine infusion therapy, visit Ketamine Treatment Centers by clicking here.

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