How Does Ketamine Therapy Work?

By Ashley Barnes, M.S.

Reviewed by: Mark Hrymoc, MD

Ketamine

Ketamine is a dissociative anesthetic that had previously been used as anesthesia during surgeries, especially in the Vietnam war. Due to ketamine’s safety profile, it is the most commonly used anesthetic worldwide; it also made the World Health Organization’s list of most effective and safe medications. Ketamine caught the attention of neuroscience researchers worldwide due to its miraculous benefits in treating treatment-resistant depression.

For the last two decades, Yale researchers have conducted “ketamine research by experimenting with using subanesthetic doses of ketamine delivered intravenously in controlled clinic settings for patients with severe depression who have not improved with standard antidepressant treatments. The results have been dramatic: In several studies, more than half of participants show a significant decrease in depression symptoms after just 24 hours. These are patients who felt no meaningful improvement on other antidepressant medications” (Yale Medicine, 2022).

How it works

Researchers have discovered psychological benefits stemming from ketamine’s ability to trigger glutamate production in the brain. Glutamate is a neurotransmitter that has a key role in neural communication, learning, and the formation of memory. This increased glutamate production prompts a series of complex neurological processes, ultimately leading to the formation of new neural connections (Yale Medicine, 2022).

The significance of these new neural connections resides in the resulting opportunities to form more positive thoughts and behaviors. There is a phrase in the neuroscience world that “neurons that fire together, wire together,” meaning that the neural pathways in the brain are formed and reinforced through repetition.

Thus, a depressed brain will have neural connections that create negative thought patterns, such as “life is hopeless.” With the help of ketamine, new neural pathways can form, such that the previous negative thought pattern could move more towards “life is hopeful,” ideally.

Ketamine as part of a treatment plan

Ketamine is most effective when part of a larger, more comprehensive treatment plan. Evidence-based therapy modalities such as cognitive behavioral therapy (CBT) also prompt new neural connections over time by helping patients develop healthier thoughts and behavior. When paired with other treatment elements (such as CBT), ketamine can catalyze more rapid, positive change.

Further, psychiatrists monitor patient’s reactions to ketamine and adjust the dose accordingly to maximize patient benefit and comfort as part of a larger treatment plan for treatment-resistant depression.

Ketamine Therapy Center

Ketamine Therapy Center is a treatment branch from the Mental Health Center that specializes in ketamine infusion therapy.

Two of our experienced doctors conduct Ketamine Therapy Evaluations, Dr. Hrymoc and Dr. Majid. During the evaluation, our doctors will gather information about a patient’s symptoms and will often discuss with patients the medications they’ve taken that haven’t been effective. Our doctors will determine based on the evaluation if a patient is a candidate for ketamine therapy, will provide psychoeducation on the ketamine process, and will collaborate with patients to develop a treatment plan.

Based on sound research, Ketamine Therapy treatment is to be conducted in 6 sessions over the course of three weeks for the best results. After the 6 sessions are completed, patients may schedule “booster sessions.” Though the standard 6 sessions will be consistent across all patients, the route of administration can vary. Routes of ketamine administration that the Ketamine Therapy Center offers include intramuscular injection (IM), intravenous infusion (IV), and nasally (Spravato).

Our highly experienced and talented nurses are well-versed in ketamine infusion therapy and help patients feel comfortable as they move through the treatment process.

Treatment may also involve Ketamine Assisted Psychotherapy (KAP), which involves a psychotherapist sitting in and conducting a therapy session during the ketamine experience; therapeutic guidance can enhance the psychological benefit of the treatment while simultaneously creating a grounded and safe space.

Our office in the Cedars-Sinai Medical Office towers houses rooms specially designed for patient comfort.

For more information about routes of administration, pricing, and other general information, view our Ketamine Therapy FAQ page. For general information, please do not hesitate to explore our website or contact our office!

Reference

Yale Medicine. (2022). How ketamine drug helps with depression. Yale Medicine. Retrieved January 19, 2023, from https://www.yalemedicine.org/news/ketamine-depression