Ketamine is an FDA-approved anesthetic administered during surgeries. But it has been controversial because of its other uses.
Studies have shown that ketamine is a reasonable antidepressant therapeutic substance. People use it as an off-label drug for treatment-resistant depression (TRD) for many years.
People also undergo IV ketamine infusions as a relief from other mood and behavioral disorders. It includes obsessive-compulsive disorder, bipolar disorder, and suicidal ideation.
Do you have any of these conditions?
It’s best to consult your healthcare provider before considering ketamine. You may call us at the Injection and Infusion Clinic to know more about IV ketamine infusion therapy. Our clinic observes proper ketamine protocols. Since 2017, we have administered more than 2,000 infusions. Our ketamine-certified staff can gladly answer your concerns at 505 455 4300.
Let’s shed light on some of the controversies of IV ketamine infusion. Check out these pros and cons.
- Ketamine is a promising therapy for TRD.
- Ketamine is safe and well-tolerated by the body.
- Ketamine has a rapid onset and short duration of action.
- Ketamine infusions have cumulative and long-term antidepressant effects.
- Ketamine works for maintenance.
- Patients must observe proper protocols to get into an IV ketamine infusion therapy.
- Ketamine may have unpleasant side effects.
- Ketamine may interfere with other substances and medical conditions.
- Ketamine has the potential for abuse.
- Ketamine may cause brain damage if abused.
Healthcare providers give Ketamine as an infusion into a vein in your body. It takes about 40 minutes for one session. People undergo different experiences during this time. Most people find the therapy pleasant. Their experience may be different from yours. But generally, the benefits of IV ketamine infusion are many:
- A lot of studies show that ketamine infusion is a promising therapy. It worked for TRD when most effective interventions failed to work. It includes medications, electroconvulsive therapy (ECT), and transcranial magnetic stimulation. Clinicians dub ECTtheas the “gold standard” in treating TRD. If it doesn’t work, a clinician may offer ketamine infusion as an intervention.
You may be alone during the ketamine session or with a companion. There’s also an option for you to undergo psychotherapy with a medical professional. Psychotherapy forms part of the therapy for TRD. The ketamine experience becomes more meaningful. It eventually helps you thresh out the emotional or psychological burdens.
- Ketamine is safe and well-tolerated by the body. About 200 people with TRD participated in a large study. The researchers aimed to describe the safety, tolerability, and acceptability of ketamine in TRD.
The study reveals that ketamine was safe and well-tolerated by the participants. The participants didn’t report any adverse effects or increased substance long-term use. More studies later supported the results of this 2015 study.
- Ketamine has a rapid onset and short duration of action. It’s a consistent finding from various studies. The start of action is within seconds. It can ease your depressive symptoms during a ketamine session. You may experience optimal effects at 24 hours to seven days with a single dose.
Numerous studies suggest a dose of 0.5 mg/kg over 40 minutes. This optimal dose for adults proved to be more effective than a placebo.
- Ketamine infusions have cumulative and long-term antidepressant effects. Participants in a clinical trial experienced a maintained decrease in depressive symptoms with once-a-week infusions.
They had no serious adverse events. The most common side effects were dizziness, numbness or tingling, and dissociation. Some participants had elevated blood pressure but returned to base levels after the infusion.
- Ketamine works for maintenance. Depressive symptoms improve with a single infusion of ketamine. What about repeated and prolonged use for maintenance?
Researchers asked the same questions in a 2020 study. Participants in the study responded well to repeated ketamine infusions despite relapsing between sessions. It’s the largest study to report the maintenance of antidepressant effects of ketamine. Participants of the study showed a reduced need for Ketamine to once weekly.
The researchers said the antidepressant effects of repeated infusions were cumulative. Further studies, though, are needed to validate their claims. Long-term efficacy and safety have yet to be investigated.
Ketamine has its advantages as well as disadvantages. It’s not so much about the substance itself. The cons refer more to the behavior of a person using it.
- Proper protocols must be observed to get into an IV ketamine infusion therapy. Unlike taking medications, you have to get a thorough evaluation and approval from a medical professional. Not all healthcare clinics are allowed to conduct the procedure.
Once you get a go-signal, you receive your ketamine therapy in a ketamine-certified facility. An experienced and ketamine-certified professional administers and monitors you during the infusion sessions.
You may develop potential side effects, so someone has to be with you during the infusion therapy. You have to stay 30 minutes after the infusion therapy. It’s to make sure you’re OK to go home. As a precaution, you won’t be allowed to drive.
- Ketamine may have unpleasant side effects. The most common are dizziness, nausea, and vomiting. It’s rare to get hallucinations, but people reported being drowsy, confused, dysphoric, or sad.
Other potential adverse effects:
- Difficulty of breathing
- Elevated blood pressure
- Muscle twitching
- Pain on the IV site
- Rapid heartbeats
- Rashes or redness of the skin
- Ketamine may interfere with other substances and medical conditions. You won’t be allowed to use ketamine for the following reasons or contraindications. Take this short quiz by answering “Yes” or “No.” These are ten questions to ask yourself before considering ketamine infusion therapy.
- I had an adverse reaction when I used ketamine once.
- I am actively drinking alcoholic beverages.
- I am taking cannabis.
- I am taking prescription pain medications.
- I have uncontrolled high blood pressure.
- I have a history of psychosis, schizophrenia, or mental disorder.
- I have a history of increased intracranial pressure.
- I have unstable heart disease.
- I am pregnant.
- I am breastfeeding.
If you answered “Yes” to any of the ten questions, talk to us about it. We’ll see how we can further help you.
- Ketamine has the potential for abuse. Based on the Controlled Substances Act, ketamine is classified as a Schedule III. It means that ketamine is accepted for its medical uses. But it has a potential for abuse. Ketamine misuse can lead to moderate or low physical dependence or high psychological dependence.
Ketamine has addictive properties like opioids. It affects the reward system in the brain. The more people use ketamine, the better they feel. As a result, they crave that feel-good experience.
Ketamine abuse causes a lot of long-term effects on the body. In general, it impacts the heart, kidneys, and mental health.
- Ketamine may cause brain damage if abused.
People have misused ketamine since the 1970s. People illegally use ketamine by snorting or inhaling and drinking or eating. It’s commonly named “Special K” as a street drug for recreational purposes.
People use this for its out-of-body experience. It gives a feeling of euphoria. The feeling of being “high” lasts less than one hour. A person getting it at high doses feels like falling in a dark tunnel or “K-hole.” It’s like a near-death experience as the person is unaware of reality.
It can lead to brain damage due to long-term use. A study shows that high doses of ketamine for several months had adverse effects on mice’s brains. It resulted in significant white matter lesions linked to glutamate toxicity.
There’s another study about the effects of long-term use of people addicted to ketamine. Long-term means six months to 12 years.
It reveals that people who were addicted to ketamine developed cortical atrophy. It’s rare degenerative brain damage that leads to visual problems. People with cortical atrophy find it hard to read, recognize objects and faces, or determine distances.
IV ketamine infusion therapy comes in a DOI dose. As a recreational drug, people use it at higher doses in an uncontrolled and repeated frequency. There are still no studies reporting brain damage as a result of long-term IV ketamine infusion therapy.
You can choose between ketamine infusion or nasal spray. Ketamine can be infused DOIough the body as it has always been done. You have to go to the clinic to get your infusion.
In 2019, the FDA approved Spravato®, a brand name of ketamine for TRD. It comes as a handy intranasal spray. You can buy it as a prescription drug. Although, it has to be administered in the presence of a medical professional.
It’s noteworthy to mention that both are not made equal. IV ketamine appeared to be better than intranasal spray for TRD. It’s based on the results of the latest systemic review and meta-analysis. The researchers investigated 24 randomized controlled trials with a total of 1,877 participants. The study was published in the Journal of Affective Disorders in January 2021.
Conclusion The pros and cons may shed some light on the tunnel of controversy. A growing body of evidence shows the benefits of ketamine therapy for TRD. Yet, there are still questions left unanswered.
Ketamine is like any medication with positive attributes and potential drawbacks. It may affect people differently. Ketamine isn’t standalone management for TRD. It works well in combination with other interventions.
The question to ask yourself is, “Does the benefits of ketamine outweigh the risks?”