What is Ketamine?

Ketamine is on the “World Health Organization’s List of Essential Medicines” primarily because it can produce general anesthesia without interfering with a person’s ability to breathe and its overall high level of safety.  It is commonly used in emergencies, providing patients with sedation and anesthesia undergoing painful procedures. Ketamine is frequently used on the battlefield for sever unstable injuries prior to reaching the field hospital.  It is the most common anesthetic used in veterinarian medicine. Ketamine can be used in the adult population as well as pediatrics. Ketamine gained some unwanted popularity as a street party drug due to its hallucinogenic effects at higher doses.

In 1974, Argentina began using Ketamine as an adjunct to antidepressants.  In the 1990s studies began in the USA on the psychological uses of Ketamine. Many studies have shown positive results using low-dose Ketamine infusions to treat depression/ anxiety disorders, OCD, Bipolar disorder, PTSD, and many pain syndromes. There remains much research to be done regarding this newer use for Ketamine. In October of 2014, former NIMH Director Thomas Insel made the following statement regarding Ketamine: Recent data suggest that ketamine, given intravenously, might be the most important breakthrough in antidepressant treatment in decades.

 

How does Ketamine work?

Studies have supported the idea that Ketamine plays a role in the NMDA receptor blocking pattern, thus increasing a level of glutamate between neuronal synapses. This increase, in turn, affects other neurotransmitters including GABA and dopamine, which can lead to a re-setting of normal mood. Ketamine works on the theory that depression is the result of disrupted, disconnected nervous system rhythms. Ketamine appears to “re-boot” the system through a type of neurogenesis restoring connection and fostering a return to normal, healthy functioning.  While ketamine is not fully understood yet, continuing research is adding to our knowledge every day!

Ketamine is given as an IV infusion because all studies indicate it provides the best bioavailability to the brain. When given by mouth or nasal spray the breakdown of the drug before it reaches the brain is significant and renders it far less effective. Pharmacutical companies are researching other options but IV infusion remains superior.

 

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