Identifiable by names like “special K” and “magic mushrooms,” psychedelics are surging ahead as one of the most significant breakthroughs in mental health treatment. Psychedelics refer to substances that can change perception and mood and were declared illegal in the late 1960s.
However, in the early 1990s, researchers began taking a more serious look at using psychedelics like ketamine and psilocybin (mushrooms) as possible solutions for major depressive disorder (MDD) and post-traumatic stress disorder (PTSD).
Much faster acting than traditional antidepressants, psychedelics can help those for whom other medications are ineffective or need more rapid, life-saving interventions. And as rates of mental health disorders rise and the definition of depression widens, so does the need for new, innovative treatments.
Today we’re taking a close look at ketamine, an anesthetic that can produce psychedelic effects, now touted as a possible solution to treatment-resistant depression.
What is ketamine?
Ketamine allows people to disconnect from their bodies and surroundings at a lower, sub-anesthetic dose. It can promote calm and relaxation and cause hallucinations and altered consciousness. It differs from more traditional psychedelics like MDMA (ecstasy) and psilocybin by working on different brain receptors.
Though you can take ketamine via a lozenge, IV, or nasal spray, only the nasal spray, Spravato, is FDA-approved for treatment-resistant depression. Its approval in 2019 was the first significant milestone in novel depression treatments in over six decades, highlighting both the need for and skepticism of new solutions.
What makes psychedelics like ketamine so remarkable?
Chronic stress can decrease the number of connections between neurons (message-sending nerve cells) in your brain. Researchers surmise ketamine can promote new connections and jump-start neural pathways, also known as neuroplasticity. In essence, ketamine can help “rewire” your brain, improve your brain’s resilience to stress, and reverse symptoms of depression.
And unlike other medications that need to build up in your system over weeks, ketamine provides relief within a few hours. As many as 70 percent of people find symptom relief from ketamine for whom SSRIs alone offer little to no benefit. In this regard, we cannot understate ketamine’s life-saving potential.
However, the effects of ketamine do not last long-term (often just a week or two), and it requires continuous use. Though, if paired with talk therapy, ketamine may provide more continued benefits than alone. One cannot deny ketamine’s potential, yet it is not without drawbacks.
What are the side effects of ketamine?
Some experts caution against ketamine’s use as it must bind the same brain receptors as opioids for people to feel its full antidepressant benefits, which could lead to addiction. For this reason, it’s not recommended for people who struggle with substance use. Ketamine may also not be appropriate for people with certain mental health conditions, like schizophrenia, as it can worsen symptoms.
Common side effects of ketamine, whether taken via IV, lozenge, or nasal spray, include:
- High blood pressure
- Headaches
- Anxiety
- Nausea
- Dizziness
Like other antidepressants, ketamine does not work for everyone. We also need more information about ketamine’s long-term use to fully understand its impact on the brain and its effectiveness as an antidepressant.
How does ketamine affect women?
Women report higher rates of depression than men—almost twice as much. Why? Though we need more research on the matter, studies hypothesize the difference lies in our reproductive hormones. Researchers propose that a decline in estrogen during our menstrual cycles and perimenopause may contribute to depressive symptoms, as can fluctuating hormones during postpartum. Still, other studies point to external factors “such as increased exposure to early life adversity and gender inequities” as reasons for increased depression among women.
It follows that ketamine, and other medications that treat depression, may affect women differently. The latest data shows women can be more sensitive to ketamine, and its effectiveness may vary based on the menstrual cycle. For instance, ketamine may be most effective closest to the beginning of a woman’s “follicular phase, when estrogen levels are at their lowest.”
However, other early studies found ketamine least effective during the follicular phase. The conclusion? Again, we need more research to fully understand why women have such varying responses to ketamine and whether it relates to our changing reproductive hormones or a yet unknown factor.
Even so, ketamine may prove vital for women’s health and wellness. For instance, research suggests ketamine may alleviate or prevent symptoms of postpartum depression (PPD) when used as an anesthetic during a C-section. A clinical trial is underway to investigate further ketamine’s effects on PPD in patients with prenatal depression.
Is ketamine truly a novel treatment for depression?
Today healthcare providers only prescribe ketamine for those with treatment-resistant depression or suicidal ideation. As one of only two drugs proven to decrease suicidal thoughts, its life-saving potential cannot be understated.
People who want to try ketamine for depressive symptoms must do so under the guidance of a qualified healthcare provider. Ketamine infusion centers and ‘ketamine-assisted therapy’ are becoming popular, though many lack appropriate medical oversight. A provider will likely recommend trying different antidepressants first before prescribing ketamine if those prove ineffective or symptoms worsen.
Ketamine may be an effective solution for depression, but studies, especially those that include women, remain inconclusive and raise more questions than answers. At the same time, we’re encouraged to watch its rise, particularly at a time when rates of depression are at an all-time high.
FemmePharma does not advocate or endorse the use of illegal substances of any kind.
The information contained in this article above is not meant to provide or replace medical advice. Please consult your healthcare provider.