Ketamine and prescription antidepressants are two different types of treatments for depression and other mood disorders with differing mechanisms of action. Traditional prescription antidepressants work by directly increasing the levels of certain brain neurotransmitters that help improve mood and reduce depressive symptoms. Conversely, ketamine is a dissociative anesthetic that blocks the NMDA excitatory receptor, which prompts the release of these same neurotransmitters, which include dopamine, serotonin, and norepinephrine. (1) This drug has also been shown to be effective in the treatment of depression and other mental health issues.
If you are seeking treatment for depression, ketamine therapy might be an appropriate option for you. While antidepressants are typically the first-line approach used for depression, anxiety, and other mood disorders, ketamine therapy may be warranted when these other treatments are ineffective. To learn more about the various treatments for depression, contact Bishop Health today. You can speak to a skilled treatment advisor who can explain our various treatment options and help you get started on the next step toward healing and recovery.
Introduction to Depression & Antidepressant Treatment Options
Depression is a complex and often chronic mood disorder that can have a significant impact on a person’s quality of life. This condition affects a person’s thoughts, feelings, and behaviors, causing them to feel sad, hopeless, and apathetic. It has also been associated with physical symptoms, such as fatigue, appetite changes, sleep disturbances, and difficulty concentrating. Depression can range from mild to severe and be triggered by many factors, such as life events, medical conditions, and chemical imbalances in the brain.
There are a number of treatment options available to help manage depression, the most common of which are antidepressant medications. (2) There are several different classes of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs).
Understanding How Antidepressants Work
SSRIs, the most commonly prescribed type of antidepressant, work by increasing levels of serotonin—a chemical responsible for mood regulation, pleasure, and reward—in the brain. Imbalances in serotonin have been associated with several health conditions, including depression, anxiety, and migraines. SNRIs work similarly but also increase levels of norepinephrine, a chemical known to help with focus and alertness. TCAs and MAOIs also increase serotonin and norepinephrine, as well as another vital neurotransmitter, dopamine. Like serotonin, dopamine is associated with feelings of reward and well-being.
The full effects of antidepressants may not be experienced for 4–8 weeks or longer after starting, and the types of medication and dosages that are most effective vary between individuals. (3) It’s important to note that antidepressants are not a cure for depression or other mood disorders, but can help manage symptoms and improve a person’s quality of life. They are often used in combination with other treatments, such as therapy and lifestyle changes, as part of a holistic approach to treatment.
Introduction to Ketamine Treatment for Depression
Ketamine treatment has been successful in treating symptoms of depression, especially in instances where traditional antidepressants, such as SSRIs, have failed. Although it has a different mechanism of action than typical antidepressants, ketamine works by increasing mood-regulating neurotransmitters in the brain. However, ketamine has a rapid onset of action, and for some, symptom relief has been experienced within hours of treatment.
Intravenous infusion is the most common method of administration, but there are others, including intramuscular injection and nasal spray. In any case, ketamine should only be given under the supervision of a qualified medical professional.
Advantages of Ketamine Treatment Over Traditional Antidepressants
While traditional antidepressants can take a prolonged period to take effect, ketamine has been shown to have rapid and significant effects on depression symptoms, often within several hours or a few days. Additionally, ketamine is thought to work through its own unique process, so it may be a potential option for those who have not experienced relief from other treatments.
Furthermore, during ketamine therapy, the drug crosses the blood brain barrier more efficiently than traditional antidepressants, such as SSRIs. (4) Because of this increased capacity to enter the brain, ketamine may provide more potent relief from depressive symptoms. It also comes with fewer side effects than other antidepressants, and they tend to be mild and short-lived, comparatively speaking.
Potential Risks & Side Effects of Ketamine Treatment
Ketamine therapy comes with risks and side effects that should be considered before treatment is attempted. Psychological effects can occur, such as visual and auditory hallucinations, dissociation, agitation, and confusion. Physical risks may include increased heart rate and blood pressure, nausea, cramps, and vomiting. Although recreational ketamine use is known to cause a number of complications, the potential long-term effects of ketamine delivered for therapeutic purposes at lower doses are still unknown. (5)
It’s important to note that therapeutic doses of ketamine and means of delivery are different from those for recreational use. Moreover, the risks associated with ketamine misuse are increased compared to controlled, clinical administration, including the potential for dependence and addiction.
Who Is a Good Candidate for Ketamine Therapy?
Ketamine therapy has shown promising results for individuals with treatment-resistant depression, anxiety, post-traumatic stress disorder, and chronic pain. It may also be helpful for those experiencing suicidal thoughts or behaviors. Because there are some circumstances in which ketamine therapy might not be appropriate, good candidates will not have a medical history or any health conditions that may impede the safety or effectiveness of this treatment.
Persons Who Are Not a Good Candidate for Ketamine Therapy Include:
- Women who are pregnant or breastfeeding, as there is limited research on ketamine’s safety for expectant mothers and their unborn children.
- People with a history of schizophrenia or psychotic symptoms because ketamine can worsen these effects in those who are predisposed to them.
- People who are experiencing or recovering from active addiction to substances, due to ketamine’s potential for misuse.
- Patients with uncontrolled high blood pressure, because ketamine can increase blood pressure and heart rate.
- Older adults who have symptoms of dementia.
- Individuals for whom ketamine therapy is not suggested may want to seek adjustments in their medications or other treatments for depression if they are not currently experiencing relief from their symptoms.
Making an Informed Decision About Your Depression Treatment
Ultimately, the decision to use antidepressants or ketamine is one that must be directed by a health provider. Treatment using SSRIs and similar medications for many mental health conditions is common, considered safe, and has a favorable success rate. (6) When administered by a qualified health professional, ketamine has also been shown to be safe and effective and may be beneficial for individuals who have not responded well to traditional antidepressants or other treatments. (7)
To make an educated decision, it’s important to discuss these treatments with your doctor or a qualified mental health provider who understands the advantages and disadvantages of ketamine therapy and when its use may be appropriate.
Other Factors To Consider Include:
- Speed of Onset—Ketamine works rapidly, sometimes within hours, while traditional antidepressants can take several weeks to achieve full effect.
- Duration of Effect—The effects of ketamine are not as long-lasting as traditional antidepressants in many cases.
- Side Effects—Ketamine and traditional antidepressants cause different side effects that vary in severity, so you and your doctor may have to determine which of them you are most likely to tolerate.
- Cost—Traditional antidepressants are generally more affordable than ketamine treatment in terms of out-of-pocket expenses. They are often paid for by insurance, whereas ketamine is not currently covered by many insurance plans.
Contact Bishop Health Today to Begin
At Bishop Health, we provide an evidence-based range of treatments that are both unique and effective, delivered by highly trained clinicians in a comfortable, safe, and supportive environment. If you have been struggling with a mental health concern, including antidepressant-resistant depression, and you have had limited success with traditional medications, our ketamine therapy may be an ideal option. Contact us today to learn more about our mission to provide individuals with comprehensive, state-of-the-art care that fosters long-term recovery and completely transforms their lives for the better.
SOURCES
(1) https://www.ncbi.nlm.nih.gov/books/NBK519495/
(2) https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046273
(3) https://www.goodrx.com/healthcare-access/medication-education/how-long-does-it-take-for-antidepressants-to-work
(4) https://www.sciencedirect.com/topics/neuroscience/ketamine
(5) https://www.ncbi.nlm.nih.gov/books/NBK541087/
(6) https://www.theguardian.com/science/2018/feb/21/the-drugs-do-work-antidepressants-are-effective-study-shows#
(7) https://www.health.harvard.edu/blog/ketamine-for-treatment-resistant-depression-when-and-where-is-it-safe-202208092797