Ketamine is a medicine used as an anesthetic that works by blocking a specific receptor in the brain called the N-methyl-d-aspartate (NMDA) receptor, and recently, people have been exploring ketamine as a potential treatment for depression. When given through a vein, it has shown a significant reduction in depression symptoms within just four hours.
However, despite its positive effects in the short term, ketamine is now being misused as a recreational drug. In the United Kingdom in 2008/2009, about 1.7% of people were found to have a ketamine addiction.
When used regularly and in large amounts, ketamine abuse has been linked to lasting problems with thinking mood, and even experiencing brain activity like psychosis and feeling disconnected from reality.
1. What is Treatment-Resistant Depression?
Major Depressive Disorder (MDD) is a very serious and widespread condition. Treatment-Resistant Depression (TRD), which means not responding well to at least two standard antidepressant treatments, affects up to 30% of people with MDD.
When people with depression don’t respond to treatment, it becomes harder for them to get better with future treatments. This creates a cycle of ongoing disability. That’s why it’s crucial to find fast and effective treatments for those with Treatment-resistant depression.
One potential treatment for TRD is ketamine. Although known as an anesthetic, small doses of ketamine, different from its typical use, show promise for treating MDD.
Unlike many other psychiatric medications that take weeks to work, the effects of ketamine are quick (within hours), strong (across various symptoms), and somewhat lasting (usually up to a week) antidepressant effects, even for people with TRD.
2. How does Ketamine Work in the Brain?
When doctors use ketamine to treat mental health problems like depression, trauma, or anxiety, ketamine affects the brain in three main ways:
- Brain chemistry: Ketamine helps balance natural chemicals in the brain, like a “reset button” for mood regulation.
- Brain flexibility: It makes the brain more flexible and able to change, allowing it to heal and adapt better.
- New perspectives: With ketamine and therapy, you can see things differently, leading to positive changes in behavior and values.
So, ketamine helps improve brain regions, flexibility, and perspective, leading to improved mental health; think of it like this:
- Brain chemicals: Imagine your mood like a garden with different plants. Ketamine acts like a gardener, balancing the plants so they all grow well.
- Brain flexibility: Imagine your brain like a piece of clay. Ketamine helps soften the clay, making molding and creating new shapes easier.
- New perspectives: Imagine you’re stuck in a maze. With ketamine and therapy, you can see new paths and find your way out.
3. Does Ketamine have Long-term Effects on the Brain?
A recent study by Columbia biologists and biomedical engineers has shown that long-term ketamine abuse leads to a widespread structural change in the dopamine system of the brain.
People who use ketamine for a long time, compared to those who don’t, show several differences in their brains.
- They have less gray matter (the part of the brain with nerve cell bodies) or thinner outer layers in certain areas like the prefrontal cortex, dorsal anterior cingulate cortex, and back parts.
- The connections between the white matter (the part of the brain responsible for communication between different areas) in the front and sides are not as strong.
- The connections between the thalamus (a part deep inside the brain) and the outer layers and the connections between different outer layers are not working normally.
- Parts of the brain that are responsible for remembering where things are, and controlling movement are not as active.
- There is stronger communication between two specific areas in the front part of the brain, and the overall amount of white matter is bigger.
4. Other Effects on the Brain’s Ability
- Memory: Ketamine abuse use can lead to memory problems, but studies with depressed patients showed improved memory after treatment.
- Migraines: Some people report worsened migraines after ketamine, while others use it to treat them. This highlights the difference between recreational and therapeutic use.
- Hallucinations: Hallucinations after ketamine are rare in therapeutic settings.
- Brain benefits: Ketamine helps regulate a brain area called the lateral habenula, which plays a role in mood, sleep, pain, and behavior, thus improving symptoms of depression.
- Traumatic brain injury: Early research suggests ketamine could increase blood flow to the brain, potentially aiding in recovery from traumatic brain injury.
- Therapeutic ketamine seems safe for treating trauma, anxiety, and other mental health disorders, and ketamine’s antidepressant effects are effective, too. It is unlikely to cause psychosis in people without a history of it. Some people experience positive effects, like improved memory and blood flow. For optimal safety, seek professional help before starting any ketamine treatment or ketamine therapy.
5. Side Effects of Ketamine
Here are some things that could happen if you misuse ketamine:
- Feeling like you’re in a dream or not in your own body.
- Seeing things that aren’t real.
- Feeling really sleepy and drowsy.
- Getting confused and finding it hard to think.
- Forgetting things.
- Getting anxious and easily annoyed.
There are also some physical effects, like:
- Breathing slower
- Feeling sick and throwing up.
- Higher blood pressure.
- Slower or faster heartbeat, depending on the dose.
- Seeing double.
- Having seizures.
6. Concluding Studies
Ketamine helps with depression severity and affects other receptors in the brain, like opioid receptors, adrenergic, serotonin, and norepinephrine receptors. The trippy side effects of ketamine could also be linked to its ability to fight depressive symptoms.
However, because different studies on ketamine have small groups of people, the results might not match up. Also, the methods used in these studies and their limitations could be causing differences in the outcomes.
Because the results are inconsistent and ketamine has many different effects, it’s challenging to understand exactly how it quickly, strongly, and consistently helps with depression.
If you think someone has taken too much ketamine and might be in danger, call a doctor right away, and if you’re dealing with the problem of being addicted to ketamine, reach out to a medical professional.