Ketamine in the treatment of depression, posttraumatic stress disorders (PTSD) and obsessive-compulsive disorder (OCD)
Ketamine has been a well-known anesthetics over many decades, which can be used for short anaesthesia during minor surgical procedures or in the emergency medicine. It was noticeable for a long time that it led to an increased dream activity. For this reason it spread also in the drug scene.
This story seems to impede the dissemination of this safe and with few side effects medication.A lot of psychiatrists avoid the use ofnarcotics, others feel repelled by the image of the medicament as a “drug”. A psychiatrist said to me that we would replace one evil by another.
Ketamine has proved itself, in the meantime, worldwide also as an antidepressant. It is used especially where other medicaments fail, because it disposes of another mechanism of action. And it has a great advantage compared to all other antidepressants: It works immediately and reduces suicide thoughts on the same day.
To achieve the antidepressant effect from Ketamine, it is given in a very small dose as an infusion for 40 minutes. This method is nearly free of any side effect and if, they disappear immediately after the stop of the infusion.
Sometimes the patients have a feeling of warmth and feel slightly drunk.
Of course a thorough examination should occur before the infusion, so that in certain patients (high blood pressure, heart irregularities, psychoses) precautions can be taken.
However, the giving as aninfusion under supervisionis obvious too complex for many practices.
The majority of the patients already reports about a clearly improved mood and clearer thinking immediately after the infusion. This effect is usually even more pronounced on the following day, although the substance is no longer detectable in the body due to its extremely short half-life. This effect lasts for days to months, sometimes even years.
And here we have an additional chance: Ketamine apparently improves the neuroplasticity. Patients are thereby more receptive to psychotherapy and neurofeedback. This creates an important window of time, in which intensely can be worked therapeutically with the patient with the aim of achieving a lasting change.
Especially in the case of serious depressions the learning ability is reduced and complicates psychotherapy and neurofeedback therapy.
It also seems to be particularly effective in depression caused by chronic pain or depressions that express themselves in pain (Somatized Depression).
And gradually more and more studies on the effect of this substance appear: It proves itself not only in depression but also in posttraumatic stress disorders. In addition it reduces the urge for consumption with opioid dependency.
A so-called fast-track procedure for depression is currently underway in the US to get approval for depression. But the use of the preparation as an off-label therapy is also unproblematic in Europe:
Since the product is approved, it only requires the detailed information of the patient. Off-label therapies are completely normal and common in many fields of medicine.
Read more about Ketamin on the US National Library of Medicine National Institutes of Health: