Since the antidepressant effects of ketamine were discovered, its seems as though a Pandora’s Box of new uses for the medicine has been opened. Recent studies by the Columbia University Medical Center show that ketamine may prevent PTSD from developing in individuals who will experience a trauma – an especially hopeful discovery for our nation’s soldiers and first responders. Ketamine has also shown promise as an alcohol and cocaine addiction treatment. All of this on top of already being used to effectively alleviate chronic pain, treat depression and mood disorders, and – of course – as an anesthetic.
Information about ketamine effects and uses seems to be pouring out of the media on a daily basis. Here is a summary of what we already know and what is currently being studied and learned about the effects of ketamine:
KETAMINE AS ANESTHESIA | DISSOCIATIVE ANESTHETICS
Ketamine’s was developed in 1962 and FDA-approved for use as a fast-acting general anesthetic in 1970. Part of a group of dissociative anesthetics – meaning that the anesthetic distorts the patient’s perception of sight and sound while promoting a feeling of environmental detachment – it quickly became a popular battlefield anesthetic, used liberally in Vietnam. Currently, it is used as an anesthetic for radiation and burn therapy, for the treatment of battlefield injuries, and for children who respond adversely to other anesthetics.
KETAMINE INFUSION FOR DEPRESSION | KETAMINE FOR ANXIETY & MOOD DISORDERS
There is mounting evidence that ketamine could be the most groundbreaking new treatment for depression that researchers have seen in decades. Effective in about 70% of patients, ketamine works rapidly – sometimes immediately – to briefly block certain brain receptors while producing a protein that can help regrow and repair damaged neural connections. IV ketamine infusions for depression have become the preferred route of administration, though intranasal and sublingual ketamine are sometimes used as maintenance in between infusions. While ketamine is not yet FDA approved for the treatment of depression, an isomer of the drug, called esketamine, has been fast-tracked for approval. Ketamine infusions can be life-changing for those suffering from severe, treatment-resistant depression, anxiety, PTSD or other mood disorders.
KETAMINE FOR PAIN
Around the same time that the antidepressant effects of ketamine were being explored, the use of ketamine to treat chronic or severe pain started to gain popularity. Ketamine does not cause hypotension or respiratory depression, like morphine and other opiates can. Rather, ketamine blocks NMDA receptors in the brain, minimizing acute pain and decreasing the “wind-up” pain that can lead to chronic pain.
Ketamine is also used frequently in hospice care, to manage pain at the end of life.
KETAMINE AND ALCOHOL| KETAMINE FOR RELAPSE PREVENTION
Inspired by a pilot study showing that three doses of ketamine, in addiction to psychotherapy, can reduce relapse rates from 76% to 34% over the course of one year, psychologists at University College London have been testing the theory that ketamine can help problem drinkers reduce – or even stop – their intake. Ketamine effects the way memories are formed, which has the potential to disrupt the development of memories that can lead to addiction, relapse, and other destructive patterns of behavior. For an alcoholic trying to maintain his or her sobriety, hearing the sound of clinking glasses or seeing a pint of beer can trigger a strong desire to drink. Ketamine may be able to reduce the effects of these “triggers” by changing an individual’s memories.
KETAMINE AS A TREATMENT FOR COCAINE ADDICTION
The results of a Columbia University Medical Center study show remarkable findings that, due to its fast-acting antidepressant effects, ketamine could be used to reduce or eliminate cravings for cocaine. The long-term use of cocaine can, essentially, rewire a patient’s brain reward system, resulting in powerful cravings that may never go away – even years after drug use has stopped! Because of ketamine’s ability to repair damaged neural connections, researchers extrapolated that it could be used to treat cocaine cravings. A small study with 20 volunteers who were actively addicted to crack cocaine showed that, after receiving a dose of ketamine and given the choice between immediate access to crack cocaine or a sum of money to be paid the following day, volunteers only chose the cocaine 1.6 out of 5 times, compared to 4.3 out of 5 times in the placebo group. There is much research to be done to further validate these findings, but if they can be replicated on a larger scale, this could revolutionize the way we treat cocaine addiction.
KETAMINE TO PREVENT PTSD
The latest discovery of the effects of ketamine is its potential to prevent PTSD from developing in individuals who will be exposed to trauma. Researchers at Columbia University Medical Center found that, when given as a single dose about one week prior to a stressful event, ketamine acted as a buffer against a heightened fear response. There is still much research that needs to happen before ketamine could be used as a PTSD vaccine, per se, but there is huge potential for this drug to protect soldiers and first responders from developing PTSD.
At Vitalitas Denver, we are committed to providing ketamine infusions and sublingual ketamine to patients suffering from severe depression, anxiety, PTSD, mood disorders and chronic pain. While we do not use ketamine to treat alcoholism or cocaine addition, we are just as excited to watch the research unfold, as every ounce of positivity to emerge from current studies lends new hope to people who are suffering.
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