Ketamine Education
“There is nothing in a caterpillar that tells you it’s going to be a butterfly.” ~ Fuller
Ketamine has been used safely since the 1960s and has been on the World Health Organization’s Essential Medicines list since 1985. It has been employed for mental health symptom relief for well over a decade, and Esketamine was recently approved by the FDA for treatment-resistant depression. At Awaken, we offer both Esketamine (nasal spray) and Ketamine administered via intramuscular (IM) or intravenous (IV) injection. Ketamine administered intramuscularly and intravenously is currently approved by the FDA for “off-label” use in treatment-resistant depression. Research indicates that Ketamine reduces symptoms in approximately 70 to 80% of clients. Ketamine therapy is intended to be used in conjunction with traditional therapy and integration, and the mindset and setting of the client are also important components.
Ketamine’s efficacy in treating resistant mental health conditions stems from its unique action on the brain’s neurotransmitter systems. Unlike conventional antidepressants that target monoamine neurotransmitters such as serotonin, dopamine, and norepinephrine, Ketamine primarily affects the N-methyl-D-aspartate (NMDA) receptor, leading to increased levels of Glutamate. Glutamate is the brain’s most abundant neurotransmitter and plays a crucial role in synaptic plasticity, which is vital for learning and memory.
Ketamine’s modulation of NMDA receptors triggers a cascade of effects that enhance neuroplasticity. This process involves the activation of brain-derived neurotrophic factor (BDNF) and other neurotrophic factors, which support the growth and strengthening of neural connections. In individuals suffering from chronic stress and depression, imaging studies have revealed neuronal shrinkage and atrophy. Ketamine treatment has been shown to reverse some of these structural changes, promoting the regrowth of dendritic spines and synaptic connections. This restoration of neural architecture allows for improved brain function and adaptability.
In addition to these neuroplasticity benefits, Ketamine has a significant impact on the hypothalamic-pituitary-adrenal (HPA) axis, which is crucial in the body’s stress response. The HPA axis regulates the release of cortisol, a hormone involved in the fight-or-flight response. In individuals with trauma or chronic stress, the HPA axis can become dysregulated, leading to persistent high levels of cortisol and heightened stress responses. This dysregulation contributes to symptoms of anxiety, depression, and PTSD.
Ketamine helps modulate the HPA axis by reducing the excessive release of stress hormones and normalizing cortisol levels. This effect can alleviate the persistent feelings of fear and hyperarousal associated with trauma, leading to a reduction in anxiety and improved emotional regulation. By dampening the overactive stress response, Ketamine facilitates a calmer state of mind and promotes emotional stability.
Moreover, Ketamine’s effects extend to reducing excessive activity in brain regions associated with negative emotions, such as the amygdala and prefrontal cortex. Elevated activity in these areas is linked with intensified depressive symptoms. By decreasing this hyperactivity, Ketamine can foster a sense of calm and improve overall functioning. Remarkably, Ketamine has demonstrated rapid effects in alleviating suicidal ideation. Research shows that within hours of administration, Ketamine can lead to significant reductions in suicidal thoughts, offering a critical lifeline for individuals in acute distress.
Research Findings:
In light of the growing interest in ketamine’s psychotherapeutic potential, this systematic review aimed to evaluate the existing evidence on ketamine’s effects in treating mental health disorders. The inclusion criteria focused on human studies investigating ketamine’s therapeutic effects for mental health conditions. Please review origin article for full findings. Below is a summary of specific conditions.
Source:
Walsh, Z., Mollaahmetoglu, O. M., Rootman, J., Golsof, S., Keeler, J., Marsh, B., Nutt, D. J., & Morgan, C. J. A. (2022). Ketamine for the treatment of mental health and substance use disorders: Comprehensive systematic review. BJPsych Open, 8(1), e19. 10.1192/bjo.2021.1061
Treatment-Resistant Depression
Effectiveness: Ketamine is highly effective for patients with treatment-resistant depression, providing rapid relief of depressive symptoms where other treatments have failed.
Mechanism: Its antidepressant effects are linked to NMDA receptor antagonism and increased synaptogenesis.
Suicidal Ideation
Effectiveness: Ketamine shows short-term efficacy in reducing suicidal thoughts, often independent of its effects on depressive symptoms.
Mechanism: This reduction is related to ketamine’s rapid onset of action and its impact on mood and suicidal thought-associated brain regions.
Post-Traumatic Stress Disorder (PTSD)
Effectiveness: Evidence for ketamine’s efficacy in PTSD is promising but limited.
Mechanism: Ketamine’s effects on neuroplasticity and stress response may contribute to its therapeutic potential in PTSD.
Obsessive-Compulsive Disorder (OCD)
Effectiveness: Limited evidence indicates potential benefits for OCD, though further research is needed.
Mechanism: The review suggests that ketamine’s effects on neuroplasticity and brain circuit modulation might be relevant for OCD treatment.
Anxiety Disorders
Effectiveness: Ketamine shows efficacy in treating generalized anxiety disorder and social anxiety disorder, though symptom can reoccur.
Mechanism: Its anxiolytic effects are attributed to rapid modulation of neural circuits involved in anxiety.
Substance Use Disorders
Effectiveness: Ketamine has potential in reducing substance use, cravings, and withdrawal symptoms, with particular promise for opioid use disorders.
Mechanism: Its effects on motivation and neuroplasticity contribute to its impact on substance use behaviors.
An additional study by Lullau, A. P. M., Haga, E. M. W., Ronold, E. H., & Dwyer, G. E. (2023). Antidepressant mechanisms of ketamine: A review of actions with relevance to treatment-resistance and neuroprogression. Frontiers in Neuroscience, 17, 1223145. 10.3389/fnins.2023.1223145
- Neuroplasticity and Synaptic Growth: Study Support The review by Lullau et al. (2023) highlights ketamine’s significant role in enhancing neuroplasticity. Ketamine’s NMDA receptor antagonism stimulates the release of neurotrophic factors like BDNF, leading to increased synaptogenesis and improved dendritic spine density.
- Impact on the Hypothalamic-Pituitary-Adrenal (HPA) Axis: Study Support The review also confirms ketamine’s impact on the HPA axis, noting that it can normalize cortisol levels and correct dysregulation associated with chronic stress and depression. This supports previous findings that ketamine helps mitigate excessive stress hormone release, enhancing emotional stability and stress response.
- Effects on Brain Regions Associated with Negative Emotions: Study Support Ketamine’s ability to reduce hyperactivity in brain regions such as the amygdala and prefrontal cortex is supported by the review. This aligns with findings on ketamine’s efficacy in alleviating symptoms of depression and anxiety by moderating activity in these critical brain regions, contributing to a more balanced emotional state and reduced negative emotional responses.
REDUCE SYMPTOMS OF PTSD
We Invite You to Watch This Video
Ketamine shows positive results in research for patients with PTSD, resistant depression and anxiety.
Hours: Monday – Friday and Some Saturdays (by appointment only).
75 Gilcreast Rd. Suite 303 • Londonderry, NH 03053
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