The drug is most widely known as a veterinary anesthetic and as a recreational “club drug” often abused for its hallucinogenic properties and dissociative effects in higher doses. It has also been used as an anesthetic in war.
But Dr. Richard E. Jackson, a psychiatrist at the Ketamine Treatment Center of East Tennessee located at Pinnacle Drive, says decades of compelling research led to it being approved as a new depression medication by the Food and Drug Administration in March 2019.
“Extensive research has shown that low-dose ketamine is also very effective for depression, bipolar depression and anxiety disorders — about 80% respond in most studies — even in patients who have suffered for years or have not responded to multiple trials of other medications,” Jackson says. “It also usually relieves suicidal thoughts and urges, and it often temporarily relieves some forms of chronic pain.”
Jackson said the drug’s anti-depressant effects are fast-acting, which differs from many other types of depression medications and treatments.
“It often works within hours rather than weeks. The effects are temporary, usually lasting days to weeks. A series of treatments often provides more complete and prolonged relief, and it can be safely combined with other treatments,” Jackson said.
Jackson’s clinic is the first clinic of its kind in the region that offers ketamine infusion treatment for major depressive disorder. According to the clinic’s website, “ketamine therapy can be rapidly effective for depression, anxiety and some chronic pain conditions, even when standard treatments have failed.”
Ketamine has also been used successfully to treat severe anxiety disorders, including post-traumatic stress disorder and obsessive-compulsive disorder, and Jackson said it can provide some relief for chronic pain from fibromyalgia and chronic regional pain syndrome.
According to a 2004-2016 University of California San Diego statistical analysis titled “Population scale data reveals the antidepressant effects of ketamine and other therapeutics approved for non-psychiatric indications,” patients treated with ketamine showed decreased depression and pain compared to those who did not. Side effects of opioid pain relievers and opioid cravings were also reduced.
Jackson said the drug is best-absorbed and most studied through the intravenous route, but intramuscular injections are also effective.
“Other routes are sometimes effective, but the drug is not well-absorbed by mouth. We use a much lower dose of ketamine compared to anesthetic doses. Ketamine is given in my office, over about 40 minutes. Side effects occur during treatment, often including a dream-like state, but the patient remains awake, able to speak and recall events. Patients rest for a short time after treatment, and driving is not allowed for the rest of the day,” he said.
Jackson and other researchers say clinical ketamine has not been shown to result in addiction or dependence.
He said a few studies have also pointed to ketamine’s potential in promoting sustained abstinence from other substances such as alcohol, but “most psychiatrists who administer ketamine use it as a uniquely effective anti-depressant drug.” In some places, he said, the drug is used to facilitate psychotherapy sessions.
While some of the drug’s “contribution of specific mechanisms is not completely understood,” Jackson said the properties of the drug and its multiple mechanisms of action in the brain are what makes it a unique form of treatment.
Ketamine-infused treatment is not yet covered by most insurance providers, but the clinic is currently accepting new patients.
For more information on the clinic, ketamine studies and how the drug works, visit Jackson’s website at www.ketamine-tn.com.