Ketamine is a drug commonly used for anesthesia, but in recent years it has gained in popularity as a treatment for drug-resistant depression.
"Finally, a new way of treating severe depression, that works when many other treatments have failed and relieves the suffering caused by depression," said Robert Ostroff, MD, co-medical director of the Interventional Psychiatry Service at Yale New Haven Psychiatric Hospital and clinical professor of Psychiatry at Yale School of Medicine.
Ketamine increases neuroplasticity, which “re-wires” the brain and helps it to learn new things and adapt.
“It changes how we perceive things, how we interpret them and then how we behave,” said Greenwich Hospital psychiatrist Hande Omur, MD.
However, ketamine is not for everyone. Learn more about ketamine, how treatment works and who is a good candidate.
What is ketamine used for?
Ketamine currently has FDA approval for general anesthesia and for the treatment of drug-resistant depression. There is increasing interest in ketamine for pain management and post traumatic stress disorder.
How does ketamine therapy work?
Potential patients for treatment at Greenwich Hospital and Yale New Haven Psychiatric Hospital require an evaluation to see if they are an appropriate candidate. For example, those with high cardiac risk may need additional medical clearance.
Appropriate patients can receive treatment either through an IV or through an intranasal spray called esketamine, which is approved for treatment resistant depression and depression with suicidal ideation under the brand name Spravato. Patients receive their treatment in an outpatient setting and are then monitored for a period before they can go home. Then an adult will need to drive the patient home.
What are the potential side effects of ketamine treatment for depression?
Side effects can include:
- Increased blood pressure or heart rate
- Dizziness
- Drowsiness
- Blurry vision
- Nausea
- Vomiting
These side effects are usually mild and quickly resolved. Other potential side effects include psychiatric experiences. For example, some patients may report an out of body feeling that they describe as mystical or spiritual. Others may experience hallucinations. These are rare and quickly resolve.
Side effects happen during the monitoring period and are not expected once patients are cleared to go home.
How fast does ketamine work for depression?
Patients typically start with eight sessions, two sessions per week. It’s expected for people to start feeling some benefit by the fourth treatment. For patients who are significantly depressed, they might need to go up one dose after one or two treatments. If patients see no benefit, then treatment is discontinued.
Can ketamine cure depression?
Research finds ketamine therapy can be helpful for 50 to 70% of patients but it is not considered a “cure” for depression. Patients will still need to be seen by a psychiatrist outside of ketamine therapy, and many continue to take anti-depressants. Unlike other treatments for depression, ketamine is a temporary measure designed to help with future treatment.
Who is an appropriate candidate for ketamine therapy?
Ketamine therapy is helpful for patients with severe depression who have not responded to various anti-depressant classes. It can also be helpful for patients who are suicidal and can’t wait to try a new medication to see if it helps.
How can I receive ketamine therapy?
A referral from a psychiatrist or psychiatric APRN is required, and the patient must undergo an evaluation by an interventional psychiatrist. IPS staff work collaboratively with the referring provider.
For more information, please complete the Request for Information form. A patient navigator from Interventional Psychiatry Services will contact you to review the referral and intake process.
