Grace Butcher has lived with major depressive disorder and PTSD since she was a teenager.
Starting at age 15, she was prescribed various treatments and medications, some more effective than others. The worst of her symptoms improved by last summer, but she still felt like she wasn’t living the “healthiest version” of her life.
“I was on every anti-depressant, every anti-anxiety drug. “I was inpatient three times,” she said. I felt like I’d just run the gamut of what was available for mental health and I felt like I’d kind of plateaued.
Then, late last summer, Bucher began taking ketamine at a clinic in the Milwaukee area.
While most people know ketamine as a hallucinogenic recreational drug that causes a dissociative state, recent research has shown that the drug can treat depression and other mental health disorders in some patients, especially those whose disorder has been resistant to other medications.
In the past decade or so, ketamine clinics that treat people with mental health conditions have sprung up in Milwaukee and across the country. Some use esketamine nasal spray to treat patients; others use IV ketamine infusions or fast-dissolving oral tablets. The nasal spray is currently the only FDA-approved form, although some testing has shown that other forms are effective.
Butcher began ketamine infusion treatments in 2022 at Edelica Health, a Milwaukee clinic that was among the first in the United States to offer infusions for depression and other mental health conditions.
“I stopped having nightmares. I didn’t have panic attacks. “The major depressive episodes that I had gotten used to having at least once a month just stopped,” she recalls.
Here’s what to know about ketamine treatments and their potential for treating mental health conditions.
What is ketamine?
Ketamine is a dissociative anesthetic with some hallucinogenic effects. The drug impairs users’ perception of sight and sound. It can also cause feelings of sedation, calmness and relaxation. It is classified as a Schedule III drug by the Drug Enforcement Administration, which means it has the potential for abuse that can lead to moderate to low physical dependence or high psychological dependence.
Ketamine can be effective for pain relief because it makes the user feel “off” from their pain.
Ketamine has been an approved medical product as a short-acting injectable anesthetic for use in hospitals and clinics since the 1970s, according to the US Drug Enforcement Administration. As of 2019, it is also approved for use as an esketamine nasal spray for depression.
Ketamine has a history of use as a recreational drug, used for its psychedelic effects. It is also used as a “date-rape” drug because in high doses it can cause people to lose consciousness, become confused and submissive, or forget what happened while under the drug’s influence.
What can ketamine treat?
When it comes to mental health uses, ketamine is only FDA-approved to treat depression.
However, Edelica and Perspective Wellness, another ketamine clinic in the Milwaukee area, offer ketamine treatment for the following:
- Major depressive disorder
- Bipolar disorder
- Nerve pain
- Post-traumatic stress disorder
- Suicidal ideation
How does ketamine work to treat depression?
Most antidepressants work on the brain’s monoamine system, targeting serotonin or similar neurotransmitters. Ketamine appears to target a completely separate glutamate system.
Because of this, ketamine stimulates a protein called brain-derived neurotrophic factor. The protein creates more connections between brain cells, which is thought to alleviate depression and reduce suicidal thoughts. Some research has shown that ketamine treatment is effective in about 70% of cases of treatment-resistant depression.
Additionally, because ketamine is different from traditional antidepressants, patients experience its effects within hours, rather than days or weeks.
What are some dangers of ketamine treatments?
Psychiatrist Dr. Smita Das, a professor at Stanford University and chair of the American Psychiatric Association’s Council on Addiction Psychiatry, cautions patients and others in the medical community to be skeptical of non-FDA-approved treatments.
“We have strong ways to treat things like depression that should be considered before ketamine,” Das said. “They include things like therapy, medication, combinations of those.
She said she doesn’t want patients to “spend their time, money and energy on treatments that are less proven, like ketamine infusions,” when they could benefit from more proven methods.
But despite the hesitancy when it comes to ketamine treatment, Das said he understands why it might appeal to patients, especially those who have long struggled with their mental health.
Not much research has been done on the long-term effects of ketamine treatment. However, Dr. Joshua Berman, who is helping develop the ketamine treatment program at Columbia University, told The New York Times that ketamine’s effects “may be transient,” meaning patients may need to continue taking it. medicine regularly after starting treatment.
Is ketamine treatment covered by insurance?
Insurance generally covers esketamine nasal spray because it is FDA-approved, but not other methods of ketamine treatment. Those treatments can cost on average between $400-$800 per treatment.
There are non-profit groups that help patients pay for treatment.
Is ketamine treatment safe for me?
Ketamine treatment is not recommended for people with certain health conditions. These include high blood pressure, thyroid problems, people in the manic phase of bipolar disorder and people with schizophrenia, as this can trigger psychotic episodes.
Das also cautioned against its use by people with a history of substance use disorders. As an addiction psychiatrist, she said she has seen an increase in patients starting ketamine treatments but when they can no longer access or afford it. to continue them, turn to other substances such as alcohol or street ketamine.
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