What Is Ketamine Therapy for Depression?

Ketamine therapy is a new treatment for depression. It offers rapid relief, particularly for those with treatment-resistant depression. Used for many years as a surgical anesthetic, it was later discovered to have fast-acting anti-depressant and anti-anxiety effects [1]. Read on to learn more about how it works, how long it lasts and other aspects of its use.

How Ketamine Works

Ketamine targets different neurotransmitters than conventional antidepressants, primarily affecting glutamate levels in the brain. It appears to promote the regrowth of synapses allowing for improved communication between neurons. Research suggests that people with long-term depression may have fewer of the synapses that allow these nerve cells to communicate. 

This mechanism may explain ketamine’s ability to rapidly alleviate depressive symptoms, often within hours or days, compared to traditional antidepressants (SSRIs) that can take weeks to become effective.

During the treatment patients may experience a range of effects, including a sense of detachment from their body and surroundings and a dream-like state. Some patients report feeling a sense of calm and relaxation, while others describe a feeling of floating or being in a trance-like state. These effects usually subside within a few hours after the infusion is completed and patients can return to their normal activities soon afterwards [2].

How It Is Administered

Ketamine therapy is normally administered in two ways:

1. Intravenous (IV) infusion: A low dose of ketamine is delivered directly into the bloodstream through a vein in the arm, with sessions lasting 40-60 minutes.
2. Intranasal spray: Eskatamine, and FDA-approved formulation, is administered as a nasal spray in a clinical setting.

Effectiveness

Studies have shown significant improvements in depression symptoms.

• A Yale University study found that ketamine therapy reduced depression symptoms within four hours, with effects lasting up to three days or more [3]
• Research indicates that over 70% of patients experience a significant reduction in negative symptoms after three infusions
• A single ketamine dose can show benefits within an hour and last up to 14 days [4]

Course of Treatment

Ketamine therapy typically involves multiple sessions over several weeks. The exact number of treatments varies based on individual patient needs. It is often used in combination with psychotherapy, such as Cognitive Behavioral Therapy (CBT) to enhance its effectiveness.

Considerations

Although ketamine therapy shows promise, it is generally considered only when at least two trials of standard antidepressants have failed to alleviate symptoms. As well, patients must be carefully screened for suitability as certain medical conditions or medications may contraindicate its use. And ketamine should only be administered under close medical supervision due to potential side effects and the need for ongoing evaluation.

How Long Do the Effects of Ketamine for Depression Last?

The effects of ketamine for depression can be rapid and significant, but their duration varies. A single ketamine infusion can produce positive effects that last for several days to a week. The onset of antidepressant effects is remarkably quick, often beginning within hours of administration and peaking at around 24 hours.

• Immediate effects: Significant improvement in depression and anxiety can be observed as early as 1 hour after the first dose.
• Short-term effects:  The antidepressant effects of a single ketamine infusion can last up to 7 days.
• Medium-term effects: Studies have shown sustained improvement in depression, anxiety and illness severity at 2 weeks and 1 month after the last dose of ketamine [5].

For longer-lasting effects, repeated treatments are often necessary. A series of six infusions administered over a six-week period is a common initial treatment protocol for depression. After this initial series, patients may receive maintenance infusions every 4-6 weeks to sustain the therapeutic effects [2].

The duration of ketamine’s effects can be extended through the integration of psychotherapy and adaptive behaviors. Additionally, while ketamine offers rapid relief, it is not a permanent cure, and ongoing treatment may be necessary to maintain its benefits

Factors That Influence Ketamine’s Duration of Effectiveness

There are a number of factors which influence the duration of ketamine’s effects:

1. Dosage: Higher doses of ketamine generally result in longer-lasting effects, both in terms of intensity and duration.
2. Method of administration: This significantly impacts the onset and duration of effects. IV administration provides the quickest onset and shortest duration. Oral administration leads to a prolonged effect due to slower absorption.
3. Individual characteristics: Factors such as age, weight, metabolic rate, and overall health can significantly influence how long ketamine’s effects last. 
4. Tolerance: Repeated use of ketamine can lead to tolerance, requiring higher doses to achieve the same effects, which may alter the duration of its impact.
5. Body composition: An individual’s height, weight and body fat content can affect how long ketamine remains in the system.
6. Genetics: A person’s genetic makeup can influence how they metabolize and respond to ketamine.
7. Liver and kidney health: These organs play a role in metabolizing  and eliminating ketamine from the body.
8. Hydration levels: An individual’s hydration status can affect how quickly ketamine is processed and eliminated
9. Drug quality: The purity and composition of the ketamine used can impact its effects and duration.
10. Concurrent use of other substances: Interactions with other drugs or medications may alter ketamine’s  effects and duration

These factors collectively contribute to the variability in ketamine’s effects among individuals and even in the same person at different times.

Improving Mental Health in Utah

Treatment is available in Utah. Are you or a loved one looking for a compassionate space to heal from trauma or PTSD, other mental health conditions, or addictions? Our licensed trauma-informed professional therapists and counselors at Corner Canyon Health Centers can provide compassionate help using ketamine therapy a range of therapeutic and holistic techniques.

Reach out to our Admissions team now at Corner Canyon. We’re in a peaceful setting bordered by the beautiful Wasatch Mountains.

Sources

[1] Ketamine for Depression: How It Works. 2024. Yale Medicine

[2] Handoo, I. 2023. Ketamine Infusion Therapy: Understanding the Duration of Treatment

[3] University Hospitals. Yale University. 2023. The Benefits of Ketamine Therapy for Depression.

[4] Wells, A. 2024. Ketamine: A Rising Star in Mental Health Treatment

[5] Mandal S, Sinha VK, Goyal N. Efficacy of ketamine therapy in the treatment of depression. Indian J Psychiatry. 2019 Sep-Oct;61(5):480-485.