Patient Education ►
Ketamine
Can it Aid with Depression or Pain ? by April Hatch , RN , contributing writer
With the anticipated FDA approval of MDMA in 2024 , studies examining the mental health benefits of psilocybin psychedelic use being decriminalized in some states and cities , many are taking a second look at the potential these once exclusively underground psychedelics may offer .
Ketamine , often remembered as a party drug in the nineties , is now being offered nationwide in clinics and via telehealth in the forms of infusion , injection , nasal spray , and orally dissolving preparations . As a nurse who primarily works in the cannabis space providing education to both patients and the industry , I was approached because of my appreciation for “ alternative ” therapies . I was asked to be a Nurse Guide for patients utilizing Ketamine in their own homes to treat a range of conditions that include PTSD , depression , bipolar disorder , anxiety , neuropathic pain , and fibromyalgia . However , Ketamine is most often claimed to be a very promising option for those suffering treatment-resistant depression with or without suicidal ideation because of its ability to work almost immediately versus the weeks it can take most traditional options .
I first heard about the effectiveness of Ketamine for depression shortly before Spravato™ nasal spray was approved in 2019 . Before that , I was only familiar with its medical use as an anesthetic . We occasionally used it in the emergency room for medical procedures that needed to be done quickly . It didn ’ t affect the heart or lungs like most sedatives do and had a short duration , so its administration didn ’ t require much intervention , like an ICU bed .
28 March 2022
So how does Ketamine work ?
Scientists don ’ t have all the answers , but one mechanism of action frequently cited is Ketamine ’ s ability to stimulate the growth of new neural pathways . A theory is that depression and chronic stress can damage neurons , and Ketamine can trigger them to regrow within hours . It also affects a neurotransmitter , similar to the antidepressants Selective Serotonin Reuptake Inhibitors ( SSRIs ), which target serotonin , commonly known as the feel-good neurotransmitter . Depression may lead to overactivation of the glutamine receptors and more depression . Ketamine acts by blocking these glutamine receptors .
Some studies report it can improve pain by the same mechanism because some chronic pain patients have an increase in some glutamate receptors , which amplifies pain .
One Missouri patient who has completed six Ketamine sessions reported one dose of it provided similar pain relief to approximately eight doses of cannabis and emphasized the spiritual and emotional benefits she has experienced with the treatment as well . “ It helped me open up and be able to heal all areas .”
Speaking of opening up and the emotions often associated with Ketamine therapy , how does one best integrate these experiences into their lives ? Well , that ’ s the keyword — integrate , and many believe that is a critical piece to Ketamine therapy . Medical providers will often encourage you to meet regularly with a professional counselor , but there are also some who have started to offer Ketamine Assisted Psychotherapy ( KAP ) as one of their services .
Michael VanderWaal , a licensed therapist who provides both traditional psychotherapy and KAP , finds “ that traditional talk therapy helps individuals build coping skills , but if the root of the problem is much deeper , skill-building is only going to scratch the surface .” He states what is unique about Ketamine-Assisted Psychotherapy is that it “ provides a context where you can go deeper into your mind and experiences with KAP in a safe and supportive context and can be some of the most insightful and transformative experiences of your life .”
Michael states , “ Our clients will often come back with insights that help them tap into their authentic-self and understand the roots of their problem .” A patient who worked with Michael agrees and states that the integration portion of the therapy helped her decipher her experience during the treatment and understand what needed to be processed . Michael says , “ These insights often provide you with the emotional resources to make big and lasting changes that go beyond skillbuilding …. You can go from ‘ getting by ’ to ‘ getting better .’”
It all sounds great , right ? What are the side effects or potential downfalls of using Ketamine to treat depression or chronic pain ?
Most healthcare professionals offering Ketamine therapy as a service say that it is very safe under the direction of a physician , and issues , such as dependency , are more likely to be seen when used unsupervised recreationally and in high doses . It is also not a one and done , therefore after the initial