AUTHOR

Stefan Filippo

Bachelor in Health Sciences

You may have seen mention of ketamine in the news recently, and in biohacking circles for a little while longer. This is because the FDA recently approved a new drug derived from ketamine, under the brand name Ketanest S, as a treatment for depression. Ketamine centers have been popping up throughout the country as of late to help provide this service for patients.

Let’s get into the science of this drug to see the reasons for its popularity.

What is Ketamine?

In the medical setting, ketamine has been used in humans as anesthesia for surgery and has been a registered medication since 1985 [R]. ketamine is different from other anesthetics and pain relievers, as it doesn’t depress breathing or lower blood pressure [R].

More recently, ketamine is being heralded for its use in treating depression, PTSD, chronic pain and other beneficial effects. In the US, it is listed as a Schedule III medication by the DEA, meaning a prescription is needed to purchase this drug.

How does Ketamine work?

Selective Serotonin Reuptake Inhibitors (SSRIs) are among the most commonly prescribed anti-depressant drugs. SSRIs work on altering reuptake of serotonin in the brain. This leads to more serotonin interacting with post-synaptic receptors, resulting in increased effects of serotonin, including mood control.

Ketamine exerts its antidepressive effects via a different pathway. It has mainly been studied in depression models for its ability to decrease NMDA receptor activity [R].

What does the NMDA receptor do?

Activation of the NMDA receptor is excitatory and causes stimulation of the brain. Too much excitation of the brain can lead to damage and even death of the brain cell. Excitotoxicity has been associated with diseases such as depression, Alzheimer’s and Parkinson’s Disease [R, R, R].

How does it help in depression?

Numerous studies suggest ketamine is effective in treating depression, via its downregulation of NMDA receptor activity [R, R].

When compared to most SSRI drugs, ketamine has a key advantage: speed. SSRIs can take 4-8 weeks to start taking effect while ketamine begins to take effect within 5 minutes to an hour of administration [R]. The reason for the speed difference is that SSRIs work on changing the levels of neurotransmitters while ketamine works directly on the receptor sites of these neurotransmitters.

What else is it used for?

On top of depression, ketamine has also proven effective in the treatment of chronic pain, insomnia, PTSD, OCD, and seizures [R].

Finally, a systematic review found ketamine to be an effective treatment for alcohol, opioids, and cocaine addiction [R]. Ketamine therapy decreased self-reported cocaine cravings and administration, increasing motivation to abstain. Regarding opioids, ketamine reduced cravings and improved abstinence. More frequent use of ketamine and a higher dose led to more effective treatment. When used for alcohol addiction, ketamine combined with psychotherapy led to a 68.5% abstinence rate after a year while psychotherapy alone had just 24% success.

Dangers

It’s important to realize that there are some dangers to ketamine use. The reason for its Schedule III listing by the DEA is due to its potential for abuse, though the World Health Organization states that the incidence of both dependence and overdose is rare [R].

All ketamine use should be performed under supervision. Reasons that some may not be good candidates for ketamine include [R]:

• Those who have reacted to it in the past
• Schizophrenic patients
• Are pregnant and/or breastfeeding
• Individuals with cardiovascular-related conditions such as aneurysms, myocardial infarction, and uncontrolled hypertension

On top of this, ketamine use can also lead to issues such as irritation to the urinary bladder and urethra as well as damage to the liver and gallbladder [R].

In rats, ketamine also had the effect of lowering follicle-stimulating hormone and luteinizing hormone and their downstream hormone testosterone [R]. However, recent studies haven’t found this replicated in humans.

Summary

Ketamine has shown promise as a fast-acting treatment for not just depression, but also numerous other mental afflictions like addiction, PTSD, OCD, and chronic pain.

However, there are some potential risks to this drug, which is why the therapy is always administered under close supervision.

If you are considering ketamine therapy, please seek the guidance of your physician. If you’re a candidate for therapy, check Prime’s listings for a list of ketamine infusion centers in your area.

The information on this website has not been evaluated by the Food & Drug Administration or any other medical body. Information is provided for educational purposes. You should consult your doctor before acting on any content on this website.