Esketamine Helps The Brain Form New Connections
Research suggests that untreated depression causes long-term brain damage and is a risk factor for dementia. Studies show that people with depression have up to 20% shrinkage of the hippocampus, a region of the brain critical for memory and learning. But esketamine may counteract the harmful effects of depression.
Animal studies indicate that connections between brain cells diminish under chronic stress, but esketamine reverses these stress-related changes. Esketamine is different than any other antidepressant in that it not only prevents the neurotoxic effects of depression on the brain, but it also seems to have a growth-promoting effect, explains Kaplin.
Ketamine As An Illegal Drug
Ketamine serves a purpose in medicine when prescribed correctly, but it is also a commonly abused drug. Commonly referred to as “Special K” and “Cat Valium,” Ketamine is sold illegally as a mind-altering drug that enhances or alters mood and perception.
The anesthetic properties can also cause the individual to feel numb, which may lead to accidents and severe injuries while under the influence of ketamine.
Usually, the high lasts for less than an hour and can cause a state of utter bliss, also known as euphoria. In addition to the typical out of body experience, higher doses that are typically injected can lead to an effect known as the K-hole.
K-hole refers to a near-death, out-of-body experience, where the user is incapable of interacting with others.
Potential Risks Of Ketamine Therapy
I asked Meisner about the risks of ketamine therapy, including whether ketamine can be addictive. All of us who specialize in this area remain concerned about the potential for physiologic and psychological dependence, he tells me. At his clinic, for example, a previous history of substance use usually means a patient will not be treated with ketamine .
Its important to understand that even though you may suffer from treatment-resistant depression, ketamine may not be the wisest choice, he says.
That said, Meisner and his colleagues have not seen a high volume of patients who show signs of ketamine addiction. To the best of my knowledge, we have received only one consultation request over the phone in which the caller was seeking treatment with ketamine for reasons consistent with addiction, he tells Allure. Moreover, to the best of my knowledge, not a single one of our patients has gone on to develop physiologic or psychologic dependence to ketamine after completing our protocol.
However, experts remain alert about any potential for abuse. Currently, there is an epidemic of oral ketamine abuse in parts of Asia. Ketamine as a street drug is quite a different experience from ketamine as a treatment for depression , but epidemics like this are always cause for concern.
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What Can You Expect When Starting Ketamine Therapy For Depression
When you come to Principium Psychiatry for ketamine therapy in NYC, well do everything we can to make you feel comfortable and relaxed at every appointment. In most cases, well provide six ketamine infusions, given 2-3 times per week over 2-3 weeks. Depending on your unique needs, you may receive additional infusions after this initial treatment period.
At a typical ketamine therapy appointment, youll have both a registered nurse and a psychiatrist or psychiatric nurse practitioner in your private room with you the whole time. Once the IV is inserted, treatment usually takes around an hour. Youll stay awake during treatment, and youll have the option to listen to music or chat with the supervising staff. Our unique ketamine protocol was developed by our medical director Dr. Cohen.
Some patients start to experience relief from symptoms soon after the first treatment, although you may have several treatments before you notice a substantial effect.
Insurance typically does not cover ketamine infusion therapy. However, we will provide a detailed invoice you can give to your insurance company to receive reimbursement for aspects of treatment that are covered, such as IV placement and saline solution.
Are Cell Phones And Other Electronics Allowed
Cell phones are allowed in the suite, but the cell signal is poor. There is a cordless phone in the recovery room, or staff can place a call. Additionally, we are just below the cafeteriawhich does get a better signaland family members who want to wait there can take a pager from the suite and will be paged when the treatment is complete.
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How Do Antidepressants Work
Research into ketamine as an antidepressant began in the 1990s with Dr. Krystal and his colleagues Dennis Charney, MD, and Ronald Duman, PhD, at the Yale School of Medicine. At the time depression was considered a black box disease, meaning that little was known about its cause.
One popular theory was the serotonin hypothesis, which asserted that people with depression had low levels of a neurotransmitter called serotonin. This hypothesis came about by accidentcertain drugs given to treat other diseases like high blood pressure and tuberculosis seemed to drastically affect peoples moods. Those that lowered serotonin levels caused depression-like symptoms others that raised serotonin levels created euphoric-like feelings in depressed patients. This discovery ushered in a new class of drugs meant to treat depression, known as selective serotonin reuptake inhibitors . The first one developed for the mass market was Prozac.
But eventually it became clear that the serotonin hypothesis didnt fully explain depression. Not only were SSRIs of limited help to more than one-third of people given them for depression, but growing research showed that the neurotransmitters these drugs target account for less than 20 percent of the neurotransmitters in a persons brain. The other 80 percent are neurotransmitters called GABA and glutamate.
The Need For An Alternative Treatment
Depression is an ever-growing epidemic in America and its one that requires outside-of-the box thinking, such as the introduction of ketamine therapy. An NBC article reports that since 2013, diagnoses of major depression have risen by 33%, including a 47% increase in those ages 18 to 34.
The exponential growth of this affliction, despite the large number of chemical antidepressants currently available, indicates that there is an enormous need and opportunity for alternative treatments like using ketamine for depression.
Approximately 5 million people in the U.S. with depression dont respond to commonly prescribed treatments.
One of the major issues with todays well known and more socially-accepted forms of antidepressants is their ineffectiveness on a growing number of individuals. Around five million people in the U.S. with depression dont respond to commonly prescribed or recommended treatments.
This condition is known as Treatment-Resistant Depression. The hopeless feeling that these individuals experience is compounded by the bombardment of prescribed but ineffective treatments. The crushing weight of doom they carry is further impacted by the feeling that nothing is going to be able to help them unload this burden.
Its no wonder then that, as Bloomberg Businessweek reports, the rate of suicides in our country rose by 30% between 1999 to 2016 alone. Additionally, suicide is now the second-leading cause of death for Americans ages 10 to 34.
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The High Cost Of Ketamine
Unfortunately, ketamine is not usually covered by insuranceat Dr. Levines office, it costs $300 to $450 per treatment. Molly Shea doesnt know how long she will be able to stay on ketamine as her treatments arent covered by her insurance. But Dr. Levine says the insurance issue may be improving soon. Im really starting to see encouraging changes. Insurance companies are reaching out and covering treatment or considering covering it, he says.
In the meantime, some patients are willing to bear the cost. Nicole Bayman, who is getting ready to go back to work, has no plans to stop taking ketamine. It has been so incredible, she says. I feel like I have my life back.
Ketamine Is A Groundbreaking Treatment For Severe Depression And It Works Quickly
Ketamine is a well-known and widely used anesthetic. Its been used safely for decades as a sedation for operative procedures. In the last 10 years, it has been discovered that it can treat severe depression and chronic pain. While the exact reason as to why Ketamine works so well is not yet known, it is thought to work as a reset to the brain restoring neurotransmitter function and improve mood and energy.
As the only service provider in the greater Charlotte area to provide personal IV hydration, were very excited to be one of the very few offices in North Carolina who now offer Ketamine treatments in the comfort of our Hydrate Medical® clinic and spa. We do require a referral or approval from your PCP or psychiatrist. You can find our brochure on ketamine here.
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Hope For The Future At Last
Each infusion lasted 45 minutes. After my first one, I had a nurse play the cast album of my favorite musical as the drip began. Instead of running wild, my mind became immersed in the music, albeit in a deeply dreamlike state. Each time, it took about 15 to 20 minutes after the effects of the treatment wore off for me to be able to open my eyes and start walking. Afterward, I was exhausted. The half-hour Uber ride home felt like hours as I longed for the warm embrace of a nap.
Immediately after each treatment, I felt down. But by the time I woke up the next day, I was in less psychic pain and had more purpose. I would start the day on my long-neglected spin bike, feeling motivation that Id lacked for months. Lunches with friends no longer felt like they existed just to show them I was still alive and making an effort to get out of the house. I was beginning to connect with the world outside my head again. I noticed myself smiling more. According to Shah, feeling the effects of ketamine within 24 hours of treatment is typical. It is the most rapid-acting treatment for depression, he said.
In technical terms, as Ive said, taking ketamine had caused my brain to release glutamate, the neurotransmitter responsible for excitatory responses. But despite all his years of research into the drugs chemistry, Shah admits, No one knows the exact mechanism of any medicine.
What Do Patients Think Of Iv Ketamine Treatment For Depression
Ive heard every possible review from patients on their experience with IV ketamine for depression. These range from I loved it to I hated it and everything in between. I can say that the vast majority of people tolerate it, but some dont. Some enjoy it, some find it weird, interesting, bizarre, intense, and calming. The only way to really know what it will be like for an individual is to do it.
One drawback to ketamine is that when treatment is stopped, the benefits of the treatment diminishes. At Pacific Psychiatric we typically recommend either a second series of infusions over a much longer period of time, or a transition to what we refer to as maintenance infusions. Maintenance infusions involve single ketamine treatments that are typically done every 2-6 weeks. We have found that these infusions are very effective to maintain the benefits achieved during the initial series of treatments.
Although it can be a very effective, fast-acting antidepressant, ketamine is a challenging medication to use, especially for such a complex disorder as depression. Unfortunately, there is no magic bullet when it comes to psychiatric illnesses and there are some patients that this treatment is not effective, or appropriate for.
The good news is that there are alternatives to ketamine when and if it fails. At Pacific Psych we developed a protocol that has proven to be effective for a large percentage of patients that otherwise have limited options left.
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Esketamine Decreases Suicidal Thoughts
Conventional antidepressants may actually increase suicidal thoughts at the beginning of treatment, especially in children and young adults. Esketamine is the only drug besides lithium, a drug commonly prescribed for bipolar disorder, thats proven to decrease suicidal thoughts, says Kaplin. Although esketamine isnt currently approved for this purpose, the FDA is considering it.
Ketamine Vs Ssri Medications
Ketamine treatment for depression works very differently from Selective Serotonin Reuptake Inhibitors medications like Zoloft and Lexapro. SSRIs work by increasing the amount of serotonin in the brain. Ketamine, on the other hand, is believed to repair damage to the brain. Such damage is caused by cortisol and other long-term stress hormones, which build up proteins in the brain over time.
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Ketamine Treatments For Depression: How It Works
We administer ketamine treatments for depression through an intravenous infusion of ketamine, which is the most effective route of administration and only one that has been scientifically proven to work. A full course of therapy consists of a series of 6 infusions provided over 2-3 weeks with each treatment session lasting 50-55 minutes.
When you undergo ketamine therapy for depression, youre closely monitored by our highly experienced medical team, led by Dr. Steven L. Mandel. Dr. Mandel is a board-certified anesthesiologist with a masters degree in psychology and over 35 years of experience administering ketamine. He is a world-renowned pioneer in the administration of ketamine for mood disorders and pain conditions and you can learn more about his credentials here and see media coverage on him here. At Ketamine Clinics LA, we use hospital-grade equipment to monitor your pulse, oxygen saturation, blood pressure, respiratory rate, and electrocardiogram. Even though ketamine is incredibly safe, especially in low doses, we take extra precautions to ensure your safety. Youll be made comfortable in our spa-like environment where the patient experience is our top priority.
Get Help For Your Depression
Have you heard of TMS therapy?
If youre not a fan of medication and are looking for a new way to treat your depression, TMS might be the solution.
TMS is covered by insurance and medicare, non-drug, non-invasive. Watch TMS reviews here.
63% of people treated with TMS achieve a complete recovery. 82% experience significant improvement in their depression.
We, Success TMS, are among the largest providers of TMS in the country. Find a TMS clinic near you.
Need help today? Call us at .
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Helping Individuals Who Struggle With Depression
The Ketamine Service at McLean Hospital offers specialized treatment for adults struggling with depression, especially major depressive disorder and bipolar disorder.
Our data-driven, evidence-based service applies cutting-edge research to clinical practice. We create personalized treatments based on thorough, scientific evaluation of each patient.
Although it has been used for years as an anesthetic, ketamine has been shown to be a highly effective treatment for many individuals who struggle with severe depression. In addition, those who are experiencing symptoms that are threatening their health or safety may be good candidates for ketamine, which can often work more quickly than other treatments.
For more information or to make a referral, please call 617.855.2364.
Our dedicated treatment team includes psychiatrists, anesthesiologists, and nursing staff who have both medical and psychiatric training. Staff are uniquely equipped to assist our patient population and ensure that treatments are administered in the safest manner possible.
We offer two types of ketamine therapy: IV ketamine infusion and intranasal esketamine administration. Our services are available as outpatient treatments or as a component of inpatient care.
McLeans Ketamine Service is located within the ECT/TMS suite in the de Marneffe Building on McLeans Belmont campus.
Ketamine Therapy Swiftly Reduces Depression And Suicidal Thoughts
The rave drug ketamine can quickly ease depression and soothe suicidal thoughts in the short term, research has revealed.
Analysis of 83 research papers showed that patients symptoms were reduced in just one to four hours.
Some patients were relieved of suicidal thoughts for up to a week though the average was three days.
The University of Exeters review found that the strongest evidence emerged around the use of ketamine to treat both major depression and bipolar depression.
Lead author Merve Mollaahmetoglu said: Our research is the most comprehensive review of the growing body of evidence on the therapeutic effects of ketamine to date.
Our findings suggest that ketamine may be useful in providing rapid relief from depression and suicidal thoughts, creating a window of opportunity for further therapeutic interventions to be effective.
Its important to note that this review examined ketamine administration in carefully controlled clinical settings where any risks of ketamine can be safely managed.
For other psychiatric disorders, including anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder, there is early evidence to suggest the potential benefit of ketamine treatment.
For individuals with substance use disorders, ketamine treatment led to short-term reductions in craving, consumption and withdrawal symptoms.
We now need bigger and better-designed trials to test these benefits.
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New Promise For Ketamine And Depression
The recent growth of research has also expanded the scope of ketamines potential for those dealing with PTSD, severe anxiety, chronic pain, OCD, and bipolar disorder, offering new hope for individuals who have felt hopeless for too long.
Like with any drug, ketamines effects can be dangerous and abused if its used improperly and for non-medical purposes. Its equally important though to weigh the exponential impact that ketamine could have for those who suffer from mental illness, and it would be negligent to not continue the expansion of research of this drug.
Time is rarely on the side of those suffering with a severe mental illness, but the fast-acting potential of ketamine might just be able to reverse the clock on depression rates and erase the drugs negative stigma.
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