Important Information to Know About Ketamine Therapy for Depression

An increasing number of people are turning to help from a psychiatrist for relief from depression. According to the National Institute of Mental Health, more than 21 million U.S. adults have had at least one major depressive episode. Major depression is categorized as a period of at least two weeks of depression that causes problems with sleep, energy, self-worth, and more. While talk therapy and prescription antidepressants have long been used for treatment, another approach is also on the rise.

Ketamine as a treatment for depression

In the past, ketamine was widely used as anesthesia for surgical procedures. However, research from Yale shows that it triggers glutamate production. Glutamate can help the brain create new neural connections, which may make it easier for patients to develop more positive thoughts. More than 20 years of research show dramatic results. In some studies, about half of the patients saw a significant decrease in depression-related symptoms in a single day.

There are different types of ketamine

There are two main types of ketamine that a psychiatrist may use to treat major depression. The first is racemic ketamine. Typically, the patient receives it as an IV infusion into the bloodstream. The mixture includes two mirror-image molecules. R-ketamine and  S-ketamine are FDA-approved as an anesthetic but are now also used off-label to treat depression. The other type of ketamine, esketamine, is also known as Spravato. More recently approved by the FDA, this form only uses the S molecule. Patients receive it as a nasal spray.  

Ketamine has possible side effects

As with any other prescription drug, ketamine does have side effects. Ketamine received via IV infusion most often causes high blood pressure and may cause nausea and vomiting. Some people who take ketamine for depression may experience perceptual disturbances, such as blurry vision, overly stimulating noises or textures, or time feeling as if it is speeding up or slowing down. Although rare, some people do have out-of-body experiences that cause them to feel as if they are looking down on themselves. For many people, the benefits of treating major depression outweigh the possible side effects of taking ketamine. 

Important information to consider

There is some important information to consider before asking about ketamine to treat major depression. First, ketamine is meant as a last-resort option for those who have often undergone several years of talk therapy and other types of medication. Typically, it is only for those with the most severe forms of depression.

It is also important to understand what insurance may or may not cover. Since the nasal spray version of ketamine is FDA-approved, it is most often what insurance providers will cover. Because the FDA has yet to approve IV ketamine, insurance providers typically will not pay for it. It is important to note that failing to keep up with treatments due to lack of funds may cause the treatment not to work as well if at all.