brain chronic pain

Ketamine Infusion Therapy; An Alternative to Opioids for Chronic Pain

Experiencing daily pain for over 12 weeks is categorized by the medical community as Chronic Pain. Chronic pain affects a staggering 50-100 million adults in the U. S. yearly and over 1.5 billion people worldwide. Another disappointing statistic, chronic pain is the leading cause of long-term disability in the U. S. today. Traditionally, opioid analgesics are the first choice when treating patients with chronic pain.

Opioids and Addiction

Often, in the beginning, opioids provide pain relief for most patients. Unfortunately, these effects don’t last. Over a relatively short period of time, the neurons involved respond to the overexpression of the opiate receptors, leading to decreased effectiveness of these medications. As a result of the reduced efficacy, larger doses administered more frequently are needed. As a result, patients develop medication tolerance, dependence, and addiction.

 

Statistics on opioid abuse show a severe national crisis affecting public health and socio-economic welfare. According to the National Institute on Drug Abuse, approximately 21 to 29 percent of patients prescribed opioids for chronic pain misuse them. In 2019, nearly 50,000 people in the United States died from opioid-involved overdoses. 

Ketamine Infusion Therapy: An Alternative Treatment

Ketamine has been the choice for surgical use for its anesthetic properties for many decades. In recent years, Ketamine Infusions have been used to treat depression, chronic pain, and many other mood disorders. The administration of intravenous low-dose Ketamine is surprisingly effective in rapidly improving the symptoms of depression, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and other mental health conditions, as well as chronic pain syndromes. Numerous studies have been conducted at reputable research centers from 2000 to the present, supporting its use for these conditions.

The Science of Ketamine

When Ketamine binds to N-methyl-D-aspartate (NMDA) receptors in your brain, it helps increase the amount of a glutamate neurotransmitter. Glutamate activates connections in another brain receptor, which triggers the release of molecules that allow neurons to find new pathways with which to communicate in your brain. This process is called synaptogenesis, and it’s thought to affect your mood and thought patterns.

Ketamine Infusion Therapy for Chronic Pain

It has been shown that Ketamine infusions rapidly provide up to a 50% decrease in patient-reported pain levels in patients that respond to these treatments. Ketamine is particularly effective for many chronic pain syndromes, particularly neuropathic pain syndromes, such as chronic regional pain syndrome (CRPS). Ketamine is thought to improve chronic pain in a novel way by blocking the N-methyl-D-aspartate (NMDA) receptor. This NMDA blockade is believed to allow the pain pathways in the brain and spine to “reset,” allowing a more normalized response to pain signals from the body’s nerves. This resetting of the pain pathways may last for weeks to months and can be maintained with occasional booster treatments, as needed.

Ketamine allows a decrease in painful symptoms as well as a decrease in the need for opioid medications. In addition, there is an evident overlay of depressive symptoms and chronic anxiety for many patients suffering from chronic pain disorders. Therefore, Ketamine’s ability to decrease the symptoms of depression and anxiety can lessen the compounding effect these conditions have on the patient’s pain level.

To learn more about Ketamine Infusion Therapy, click here or call 505-639-4973 to schedule a private consultation.

Tranquility Ketamine Clinic is a leading provider of Ketamine infusion therapy in Albuquerque, New Mexico. Founded by two experienced emergency room physicians with over 50 years of combined practice administering Ketamine in the emergency department, the clinic provides effective treatments for depression, PTSD (posttraumatic stress disorder), chronic pain, OCD (obsessive-compulsive disorder), anxiety, stress, and burnout in comfortable private rooms at its Northeast Albuquerque location.

brain

How Ketamine is Helping us Better Understand Depression and the Brain

Ketamine is a dissociative anesthetic medication that was first synthesized in 1962 by a chemist searching for a novel compound with the anesthetic efficacy of older dissociative anesthetics such as PCP but with a much greater safety profile and lower incidence of “emergence reactions.” Emergence reactions are untoward, uncomfortable reactions that may be experienced while the medication wears off, causing hallucinations, anxiety, and other unpleasant psychic symptoms.

A dissociative anesthetic can, at higher doses, cause a sense of the patient being dissociated or “out of body” for a time, hence the name. This effect is not typical at the lower doses used for mental health disorders, but milder side effects such as altered perceptions or a sensation of floating frequently occur.

How is Ketamine Used?

Due to Ketamine’s favorable safety profile, it rapidly replaced morphine as the “buddy drug” given by soldiers to their wounded comrades in pain during the Vietnam War. It is still being used on battlefields today. Ketamine was found to be a much safer and more effective analgesic than the previously used opiate medications, as it did not lower the blood pressure or slow the patient’s breathing and did not require cardiac monitoring.

Ketamine is used extensively in emergency departments for analgesia and sedation in children. More recently, Ketamine has been administered to adults who are about to undergo painful or delicate procedures—creating a favorable dissociative, amnestic state. As a result, Ketamine is the anesthetic of choice for pediatric analgesia and sedation in the ED.

Most recently, the administration of intravenous low-dose Ketamine has been surprisingly effective in rapidly improving the symptoms of depression, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and other mental health conditions such as chronic pain syndromes. This effect is supported by numerous studies conducted at reputable research centers from 2000 to the present.

Ketamine as a Quick Treatment for Depressive Disorder

Ketamine has been shown to improve symptoms of depression in as little as several hours after the first treatment. This lifting of the depressive symptoms seems to last anywhere from several days to weeks or months and typically lasts longest after a series of six infusions over two weeks. In addition, single-dose “booster” treatments for two weeks to months after the initial infusion have been shown to prolong the antidepressant effect of the medication in many patients.

Antidepressants

For depressive disorder, typically, antidepressants are prescribed. Antidepressants work in line with what’s called the monoamine hypothesis of depression. The hypothesis, which emerged in the 1950s, says that depression is caused by low levels of chemical messengers in the brain called monoamine neurotransmitters, which include serotonin, dopamine, and noradrenaline. The idea is if you can increase levels of these neurotransmitters in the brain, you can reverse depression.

These drugs fall into several categories, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and the older tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). They all affect one or more of the monoamine neurotransmitters. These drugs cause monoamines to remain in the synaptic cleft — the space between neurons — for longer. Their success at treating depression is thought to be related to the birth of new neurons in a part of the brain called the hippocampus (an area responsible for learning, memory, and emotion) and the increased production of proteins such as brain-derived neurotrophic factor (BDNF), which is known to build neural connections. These processes take time and may account for the slow relief typically associated with antidepressants. It can take anywhere from weeks to months to alleviate depression symptoms.

How Ketamine Differs

Research suggests that one of Ketamine’s significant actions is as an N-methyl-D-aspartate (NMDA) receptor antagonist. That is, it blocks the activation of the NMDA receptor. This action leads to increased release of glutamate, which is involved in neuronal plasticity and synaptic growth and repair. These effects through complex pathways lead to the release of Brain-derived neurotrophic factor (BDNF), a substance responsible for maintaining healthy neurons and their connections, known as synapses.

Increased BDNF has been shown to bring about the repair and regrowth of damaged synapses and their neuronal connections caused by chronic stress in animal models. Likewise, in humans, Ketamine is thought to lead to the creation of new neuronal circuits and/or repair of the healthy neuronal connections that existed in the brain before the patient suffered from depression, PTSD, OCD, and/or chronic anxiety.

In 2014, Thomas Insel, former Director of the National Institute of Mental Health, stated, “Recent data suggest that ketamine, given intravenously, might be the most important breakthrough in antidepressant treatment in decades.”

If you or someone you know could benefit from Ketamine Infusion Therapy, please contact Tranquility Ketamine by clicking here or calling (505) 639-4973.

ketamine infusion therapy treatment

Ketamine Infusion Therapy; Treating mental and physical health

Ketamine, a dissociative anesthetic medication first synthesized in 1962, has been used extensively in emergency departments for analgesia and sedation in children. Over the last several decades, Ketamine has been used in adults about to undergo painful or delicate procedures, creating a favorable dissociative, amnestic state. These procedures include fracture reductions and repair of disfiguring or extensive lacerations in frightened children. As a result, Ketamine is the anesthetic of choice for pediatric analgesia and sedation in the ED.

Most recently, Ketamine Infusion Therapy, the administration of intravenous low-dose Ketamine, has been surprisingly effective in rapidly improving the symptoms of depression, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and other mental health conditions as well as chronic pain syndromes. This effect is supported by countless studies conducted at reputable research centers from 2000 to the present.

Treating Mental Health Disorders

Ketamine has been shown to improve symptoms of depression in as little as several hours after the first treatment. This lifting of the depressive symptoms seems to last anywhere from several days to weeks or months and typically lasts the longest after a series of six infusions over two weeks. In addition, single-dose “booster” treatments for two weeks to months after the initial infusion have been shown to prolong the antidepressant effect of the medication in many patients.

In 2014, Thomas Insel, former Director of the National Institute of Mental Health, stated, “Recent data suggest that ketamine, given intravenously, might be the most important breakthrough in antidepressant treatment in decades.”

Treating Chronic Pain

Traditionally, many patients with chronic pain are treated with opioid analgesics. Opioids bind to neuronal opiate receptors causing decreased activation of the neuronal pathways involved in pain perception. Unfortunately, these effects are short-lived, and over a relatively short time, the neurons involved respond by the overexpression of the opiate receptors, leading to decreased responsiveness and effectiveness to these medications.

Consequently, many people who are started on opioid analgesics, despite initial improvement in their daily pain levels, frequently require the need escalating doses, increased frequency of dosing, and the use of more potent opioids to control their pain over time. The use of opioids to manage chronic pain is, therefore, a treatment with diminishing returns, as the side effects and lack of efficacy rapidly overwhelm the benefits of this class of medications. Medication tolerance, dependence, and addiction are often the result.

Ketamine Infusion Therapy has been shown to rapidly provide up to a 50% decrease in patient-reported pain levels in patients that respond to these treatments. Ketamine is particularly effective for many chronic pain syndromes, particularly neuropathic pain syndromes, such as chronic regional pain syndrome (CRPS). Ketamine is thought to improve chronic pain in a novel way by blocking the N-methyl-D-aspartate (NMDA) receptor. This NMDA blockade is believed to allow the pain pathways in the brain and spine to “reset,” allowing a more typical response to pain signals from the body’s nerves. This resetting of the pain pathways may last for weeks to months and can be maintained with occasional booster treatments, as needed. Ketamine, which blocks these hyperstimulated pain pathways, allows a decrease in painful symptoms and a decrease in the need for opioid medications. 

In addition, many patients suffering from chronic pain disorders have a proven overlay of depressive symptoms and chronic anxiety. Ketamine’s ability to decrease the symptoms of depression and anxiety can also lessen the compounding effect these conditions have on the patient’s pain level.

If you or someone you know suffers from a depressive mood disorder or chronic pain, contact us for more information on Ketamine Infusion Therapy by calling (505) 639-4973 or clicking here.

balloons overcoming depression concept

Ketamine Infusion vs. Nasal Spray in Treating Depression

Depression is one of humankind’s oldest brain disorders. Major depressive disorder (MDD) is the most common psychiatric disorder in the world, affecting approximately 17% of the population in developed areas at any given time. The World Health Organization ranks depression third among the leading causes of global disease burden.

Ketamine infusion therapy has proven to be rapidly effective in remission of depressive symptoms of MDD, TDD, and BD, sometimes providing temporary relief within hours of the first infusion. It is remarkably effective in aborting suicidal ideations with a single IV infusion. Ketamine is 70% effective in TDD. Although the response to a single infusion is short-lived (a matter of days), repeat administration over a short period of time (typically two weeks) can extend the length of remission, with some patients enjoying improvement for as long as six months. Administering additional “booster” treatments can continually extend the length of remission of symptoms. Ketamine infusions are safe, rapid, and effective. Consequently, ketamine infusion therapy is revolutionizing the treatment of depressive disorders.

Ketamine IV therapy is considered “off-label,” while in 2019, the FDA approved the use of Ketamine for depression via a nasal spray. It is unclear why the FDA approved the nasal spray version. However, research by Bahji and colleagues—from Queen’s University in Canada and the National Institute of Mental Health in the US—suggests racemic Ketamine might be more effective than esketamine (nasal spray). Published in the January 2021 issue of the Journal of Affective Disorders, the article reports the results of the “first systematic review and meta-analysis that has compared the performance of intravenous ketamine to intranasal esketamine for the treatment of unipolar and bipolar depression.”

Sources of Data

The authors sourced electronic databases and found randomized controlled trials using intranasal esketamine or intravenous Ketamine to treat depression. They included studies where the drug was used alone and studies where it was used as an augmenting agent—meaning in addition to another antidepressant medication, such as a selective serotonin reuptake inhibitor (SSRI), like Prozac or Zoloft.

The final list of trials to be included in the meta-analysis and systematic review consisted of 24 randomized controlled trials—1877 participants; 61% females; average age ranging from 36 to 70 years; 98% with major depression and 2% with bipolar depression.

In most of the investigations included in the meta-analysis, the drug had been used as an augmenting agent. In three-quarters of the trials, participants had depressive symptoms that had not responded to previous treatments. In other words, they had treatment-resistant depression. However, depending on the investigation, treatment-resistant depression was defined differently. The most common definition of treatment-resistant depression (used in over 60% of trials) was a lack of response to two or more antidepressants.

Results: IV vs. Nasal Spray 

The results showed that, compared with esketamine, racemic ketamine (IV ketamine) produced a greater response (rate ratio = 3.0 vs. 1.4), remission rate (ratio rate= 3.7 vs. 1.5), and lower dropouts (rate ratio = 0.8 vs. = 1.4).

Thus, compared to “intranasal esketamine, intravenous racemic ketamine demonstrated more significant overall response and remission rates, as well as lower drop-outs due to adverse events” (p. 548).

Their findings also showed a “clear and consistent antidepressive effect of ketamine vs. esketamine treatment, relative to a variety of control conditions, beginning within hours of administration, and lasting up to 7 days after a single dose” (p. 549).

If so, why has the FDA approved only intranasal esketamine (Spravato) for the treatment of depression even though the present review showed a lower drop-out rate due to adverse events in patients treated with IV ketamine compared with Spravato? A likely explanation is that the lack of FDA approval is related to a lack of quality research on the long-term effects (e.g., safety, efficacy) of ketamine infusion.

So How Does It Work?

Ketamine is a dissociative anesthetic with various mechanisms of action and binds to multiple receptors in the brain. Consequently, it is difficult to pin down the precise mode of action, and it appears that there are numerous mechanisms through which Ketamine exerts its action on the brain.

Research suggests that one of Ketamine’s major actions is as an N-methyl-D-aspartate (NMDA) receptor antagonist, which blocks activation of the NMDA receptor. This action leads to increased release of glutamate, which is involved in neuronal plasticity and synaptic growth and repair. These effects through complex pathways lead to the release of Brain-derived neurotrophic factor (BDNF), a substance responsible for maintaining healthy neurons and their connections, known as synapses.

Increased BDNF has been shown to repair, and regrowth damaged synapses and their neuronal connections caused by chronic stress in animal models. Likewise, in humans, Ketamine is thought to lead to the creation of new neuronal circuits and/or repair of the healthy neuronal connections that existed in the brain before the patient suffered from depression, PTSD, OCD, and/or chronic anxiety.

Myths ketamine infusion therapy

Debunking the Myths around Ketamine Infusion Therapy

Our clinic specializes in Ketamine infusion therapy, treating chronic pain, treatment-resistant depression, anxiety, burnout, and addiction. Educating people about Ketamine has become of paramount importance to us, as there are many misconceptions about the drug itself and fear-based opinions. Myths around Ketamine Infusion Therapy are worth taking a look at. Therefore, we thought it would be productive to address some of the most common concerns we hear about from the general public.

Isn’t Ketamine a Horse Tranquilizer?

Ketamine is used in veterinary practice as an intravenous anesthetic agent, and it is commonly used on all types of animals, including cats, dogs, rabbits, and rodents. In addition, it happens to be the drug of choice for equine medicine. However, while Ketamine was first synthesized in the 1960s as a veterinary anesthetic, it received FDA approval to be used as a human anesthetic in 1970 and has been used extensively since that time during surgery, as a procedural anesthetic in emergency departments, and in the battlefield to treat wounded soldiers since the Vietnam War with great success.

I Heard Ketamine is a Dangerous “Street” Drug

According to the National Drug Intelligence Center, Ketamine is a controlled substance. Specifically, it is a Schedule III substance under the Controlled Substances Act. Schedule III drugs, including codeine and anabolic steroids, have less potential for abuse than Schedule I (heroin) or Schedule II (cocaine) drugs. Unfortunately, Ketamine and the other “club drugs” have become popular among teens and young adults at dance clubs and “raves.” Ketamine is manufactured legally as a powder or liquid. Powdered Ketamine can also be formed from pharmaceutical Ketamine by evaporating the liquid using hot plates, warming trays, or microwave ovens, which results in the formation of crystals, which are then ground into powder. According to the DEA, distribution of Ketamine typically occurs among friends and acquaintances, most often at raves, nightclubs, and private parties; street sales of Ketamine are rare. As with any drug, misuse of Ketamine may lead to physical or psychological dependence.

Can You Have a “Bad Trip” on Ketamine?

Like any controlled substance, Ketamine, when not appropriately dosed, can have a dangerous effect. When used as an anesthetic in humans, it puts the patient in a “twilight” state, where they are conscious but unaware. Ketamine has a combination of pain-relieving, analgesic, and memory-suppressing, amnestic qualities. In medical circles, this is commonly referred to as “dissociative anesthesia,” a term coined by the wife of Dr. Edward Domino. Along with Dr. Guenter Corssen, Dr. Domino was the first to publish a clinical study of Ketamine as a human anesthetic in 1966. In their research on Ketamine, Domino and Guenter found that patients appeared to be conscious in this dissociative state, based on preserved airway reflexes and respiratory drive, but couldn’t respond to sensory input.

With that being said, when administered in sufficient doses in an unsupervised, recreational setting, users may experience a state of dissociation with visual and auditory hallucinations similar to the effects of LSD.

In our clinic, patients can experience an alteration of perceptions and may feel “weird,” for lack of a better term. Most patients find the experience intense yet pleasurable and report a sensation of “being in a dream,” of deep relaxation or floating on a calm ocean’s surface. Frank hallucinations are rare, though you may feel that you are briefly “out of your body.” Note that this is not a common experience at typical dosages.

Each treatment experience may feel different, depending on your mood and what’s on your mind that day. Experienced meditators may find they can achieve a prolonged sense of inner stillness and peace that they have only briefly glimpsed during previous meditation sessions. Although anxiety reactions can occur, these are usually short-lived and become less frequent with repeated treatments. 

The discovery of the anti-depressive benefits of Ketamine in 2000 has been described as the single most critical advance in the treatment of depression in more than 50 years. Moreover, this discovery has forever altered the direction of antidepressant research and development. We are proud to be able to serve our patients with this ground-breaking treatment.

If you or someone you know wants to learn more about the benefits of Ketamine Infusion Therapy, click here or call (505) 639-4973

brain view after ketamine treatment method

Ketamine Treatment Methods: In-Clinic Ketamine Infusions vs. At Home Ketamine Tablet

Ketamine is a dissociative anesthetic with various mechanisms of action and binds to multiple receptors in the brain. There are various ketamine treatment methods being used, let’s look at the two most popular.

Regarding depression, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and chronic anxiety, these mental health disorders are all thought to be due to the destructive effect of continual stress on the brain, leading to neuronal damage and the creation of maladaptive neural activity and abnormal thought patterns indicative of these disorders.

How Ketamine Works

Research suggests that Ketamine can block activation of the NMDA receptor, leading to neuronal plasticity and synaptic growth and repair. These effects lead to the maintenance of healthy neurons and their connections, known as synapses. Ketamine is thought to lead to new neuronal circuits and repair of the healthy neuronal connections that existed in the brain before the patient suffered from depression, PTSD, OCD, or chronic anxiety.

Two Popular Ketamine Treatment Methods

It is easy to see why Ketamine is being used to treat these conditions with research like this. Currently, there are two popular ketamine treatment methods used to administer the drug. The first is a reasonably new method that involves the patient taking a dose of Ketamine at home after filling out some online forms and agreeing to follow some specific guidelines given by a virtual doctor. The Ketamine dose is in the form of a tablet dissolved under the tongue. In addition, the patient must agree to have a person present (a friend or loved one) to ensure their safety.

The other, more traditional method of treatment is Ketamine Infusion Therapy. Here the treatment is administered via IV in a medical setting with the guidance of doctors or nurses. The treatment takes about 40 minutes on average, followed by 45 minutes of relaxation, giving the medication time to wear off.

Each treatment experience may feel different, depending on your mood and what’s on your mind that day. Experienced meditators may find they can achieve a prolonged sense of inner stillness and peace that they have only briefly glimpsed during previous meditation sessions. Although anxiety reactions can occur, these are usually short-lived and become less frequent with repeated treatments.

Tranquility Ketamine Clinic Treatment Method

At Tranquility Ketamine Clinic, medication is given intravenously, using National Institute of Mental Health dosing protocols. These protocols vary depending upon whether you are being treated for mental health or chronic pain syndromes. However, we understand that the NIH dosing protocol was decided upon arbitrarily. Depending on the individual, both up and down dosage adjustments may be necessary for maximum effect and comfort. If the patient experiences more severe or prolonged anxiety reactions in our setting, they will be treated by administering an anxiolytic medication as needed. Nausea may rarely occur and can be treated with anti-nausea medications. We believe our medically trained staff gives an added layer of care, allowing us to address any discomfort or reactions immediately.

As with any treatment, it is essential to evaluate the options available before deciding which treatment method is suitable for you. If you or someone you know is suffering from depression, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), or chronic anxiety and would like to learn more about Ketamine Infusion therapy, click here or call 505-639-4973

 

depiction of burnout syndrome

Burnout Syndrome: Fast And Effective Treatment with Ketamine Infusion Therapy

According to the WHO, burnout syndrome is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. It occurs when one feels overwhelmed, emotionally drained, and unable to meet constant demands. As the stress continues, one begins to lose the interest and motivation that led to taking on a particular role in the first place. Estimates suggest anywhere between 4 and 7 percent of the working public can experience burnout syndrome, while workers in certain fields, such as healthcare, tend to experience burnout at much higher rates.

Burnout syndrome shares many features with PTSD, differing mainly in the degree of symptom severity. Both syndromes are maladaptive responses to a traumatic event or extreme stressor. Both are associated with feelings of fear, helplessness, or horror toward the event or stressor. Nightmares and sleep disturbances involving trauma or stressor are common symptoms. Also, patients with PTSD and burnout suffer from increased frequency of depressive symptoms, withdrawal, mood swings, and irritability. Avoidance of any situations that recall the trauma or stressor is a hallmark of PTSD and can lead to problems with work, relationships, and social activities. Substance abuse is a frequent complication as the sufferer attempts to numb the mental anguish caused by these conditions. 

Unfortunately, traditional burnout treatment centers around counseling that has variable efficacy and may take a long time to become effective. Given the painful symptoms of burnout and the risk to professional and social relationships it causes, a more rapid and effective treatment strategy is needed. This improvement is particularly robust and long-lasting when combined with CBT.

According to a recent study, “Stressful experiences cause a reduction or retraction of spines and synapses. As a result, the brain is less able to control or regulate the emotional state,”. However, when ketamine is administered, there is an almost immediate increase in the creation of critical spine and synaptic proteins. 

In his presentation at the 2021 American Psychiatric Association Virtual Meeting, Richard C. Shelton, MD, the Charles B. Ireland Professor in the Department of Psychiatry and Behavioral Neurobiology at the University of Alabama at Birmingham and the Director of the UAB Depression and Suicide Center, discussed the functions and concerns of ketamine.“When you add ketamine to the system, you produce a rapid return and restoration of those spines and synapses. We see an effect within 24 hours,” Shelton continued. “Ketamine has the ability to restore the regulatory control to the brain and helps to theoretically normalize mood.”

While ketamine is not FDA-approved to treat burnout syndrome or PTSD, several clinics worldwide have begun using subanesthetic ketamine infusions successfully to treat and improve the symptoms of burnout rapidly. If you or someone you know is currently suffering from burnout syndrome or PTSD, contact us by clicking here or calling our clinic at (505) 639-4973

 

Antidepressants

Antidepressants Vs. Ketamine Infusion Therapy for Depression

According to the ADAA, depression affects 40 million adults in the United States, yet it remains a mystery as to what really causes depression and how it can be effectively treated. Traditionally, doctors will prescribe antidepressants known as SSRIs. But unfortunately, this medication isn’t always effective. So in the 1990s, Dr. John Krystal, MD, chief psychiatrist at Yale Medicine, was pioneering research into ketamine as an antidepressant. To understand why ketamine is such a game-changer when treating depression, we must first understand how traditional SSRIs work.

The Discovery of SSRIs

It is believed that people with depression have low serotonin levels. This theory came about by observing patients given certain drugs to treat other diseases like high blood pressure and tuberculosis. These drugs seemed to affect people’s moods drastically. Those that lowered serotonin levels caused depression-like symptoms; others that raised serotonin levels created euphoric-like feelings in depressed patients. As a result, a new class of drugs meant to treat depression, known as selective serotonin reuptake inhibitors (SSRIs), were introduced. The first of these drugs to come to market was Prozac. But eventually, it was revealed that serotonin levels alone didn’t fully explain depression. 

GABA and Glutamate

Based on data collected, SSRIs were of little help to more than one-third of people given them for depression. Still, growing research showed that the neurotransmitters these drugs target (like serotonin) account for less than 20 percent of the neurotransmitters in a person’s brain. The other 80 percent are neurotransmitters called GABA and glutamate.    

The two neurotransmitters form a complex push-and-pull response, controlling electrical activity in the brain. Researchers believe they may be responsible for regulating most brain activity, particularly mood. In addition, intense stress can alter glutamate signaling in the brain and affect the neurons, making them less adaptable and less able to communicate with other neurons. This indicates stress and depression make it harder to deal with challenging events, a cycle that can make matters even worse for people struggling with complex life events.  

How Ketamine Differs

Research suggests that one of ketamine’s significant actions is as an N-methyl-D-aspartate (NMDA) receptor antagonist; that is, it blocks activation of the NMDA receptor. This action leads to increased release of glutamate, which is involved in neuronal plasticity and synaptic growth and repair. Through complex pathways, these effects lead to the release of Brain-derived neurotrophic factor (BDNF), a substance responsible for the maintenance of healthy neurons and their connections, known as synapses.

Increased BDNF has been shown to repair and regrowth of damaged synapses and their neuronal connections caused by chronic stress in animal models. Likewise, in humans, ketamine is thought to create new neuronal circuits and/or repair of the healthy neuronal connections that existed in the brain before the patient suffered from depression, PTSD, OCD, and/or chronic anxiety.

“I think the interesting and exciting part of this discovery is that it came largely out of basic neuroscience research, instead of by chance,” says Gerard Sanacora, MD, PhD, a psychiatrist at Yale Medicine who was also involved in many of the ketamine studies. “It wasn’t just, ‘let’s try this drug and see what happens.’ There was increasing evidence suggesting that there was some abnormality within the glutamatergic system in the brains of people suffering from depression, and this prompted the idea of using a drug that targets this system.”

Research and studies continue to be conducted on Ketamine Infusion Therapy and its effectiveness in treating depression, anxiety, and PTSD. If you or someone you know is suffering from any of these disorders, find out how Ketamine Infusion therapy could help by clicking here or calling our clinic at (505) 639-4973

Substance Use Disorders Treated with Ketamine Infusion Therapy

Addiction in America continues to grow and impacts millions of lives. Whether the substance use disorder is due to alcohol, cocaine, opioids, or any other illicit drug, the impacts are the same. Relationships, marriages, friendships, and careers are often destroyed, and addiction can threaten one’s physical health and safety. According to Dr. Kima Joy Taylor, director of the CATG Initiative, “23.5 million Americans are addicted to alcohol and drugs. That’s approximately one in every 10 Americans over the age of 12 – roughly equal to the entire population of Texas. But only 11 percent of those with an addiction receive treatment.” In addition, our society has been slow to view substance use disorder as a chronic but treatable illness.

The Science Behind Substance Use Disorders And Why Ketamine Infusions Can Be Effective 

Substance use disorders share similar stress-related triggers to PTSD and OCD. Many disease models suggest similar dysfunctions in the N-methyl-D- aspartate and glutaminergic systems as being behind the development of this condition. In addition, it appears that addictive disorders share neuroadaptations similar to depressive and anxiety disorders. Experts theorize that ketamine may also affect addictive disorders as quickly and effectively as depressive disorders, PTSD, and anxiety because of these similarities. 

Ketamine Infusions Combined With Substance Abuse Counseling Proves Promising

Psychedelic therapy with subanesthetic ketamine infusions has shown promise in treating substance abuse disorder, particularly when combined with intensive rehabilitation and substance abuse counseling. However, higher dose IV ketamine infusions may also prove effective on their own. It appears the success of ketamine therapy may be related to the psychoactive effects of higher dosages. These increased doses bring about a profoundly spiritual and transformational experience that allows the patient to reexamine his current life path, leading to creating new values, goals, and strategies more conducive to a life of sobriety. When used in a supervised setting to treat substance use disorders, there is no evidence that ketamine infusions are associated with future ketamine abuse, dependence, or the triggering of other drug cravings during or after the completion of therapy. 

The Latest Medical Evidence

In fact, two clinical trials — one looking at cocaine addiction and the other at alcohol dependency — showed that people who were prescribed ketamine, alongside therapy, had a better outcome than those who had therapy without ketamine treatment. The people who had cocaine addictions got ketamine through an IV for five days, in addition to 5 weeks of mindfulness relapse prevention therapy. The people dependent on alcohol got ketamine through an IV during the second week of a 5-week motivational enhancement therapy session. In both studies, the researchers concluded that ketamine lowered the chances of restarting or relapsing into addiction.

While research on how ketamine affects addiction continues to be conducted, evidence shows it may change how your brain deals with cravings, motivation to quit a drug, and controlling behavioral reactions. Ketamine treatment might also make behavioral therapy more effective, a big part of overcoming addiction. However, it must be stressed that for ketamine to be helpful in addiction treatment, it must be used under the close care of medical professionals. 

If you or someone you know is suffering from substance use disorder, find out how Ketamine Infusion therapy could help by clicking here or calling our clinic at (505) 639-4973.

Brain image of ketamine infusion

The Ketamine Infusion Experience

Ketamine is a dissociative anesthetic with various mechanisms of action and binds to multiple receptors in the brain. Consequently, it is difficult to pin down the precise mode of action, and it appears that there are various mechanisms through which Ketamine exerts its action on the brain. Ketamine Infusion Therapy is used to treat depression, PTSD, OCD, chronic anxiety, and chronic pain. One question that gets asked often is what does it feel like during and after the treatment?

 

Just like any drug therapy, ketamine infusion therapy can be different for everyone, and experiences may be different from one infusion to the other  In our clinic, the infusion itself is done intravenously, typically over 45 minutes, followed by a 45-60-minute period of rest while the effect of the medication wears off. The dosage and time vary depending on the individual and the disorder being treated.

 

How Will I feel During treatment?

The initial sensations begin about 5 minutes into the treatment and can last about 90 minutes. These effects wear off quickly after the infusion is stopped. Some describe the sensation of being in a dream or of being deeply relaxed. Others report an altering of perception and feeling a bit “out of their body.”  Avid meditators find their ability to achieve a prolonged sense of stillness and peace is heightened beyond anything they have experienced during a regular mediation session. Overall, patients find the experience to be intense yet pleasurable. Although the benefit from Ketamine does not require dissociation, many providers, including ourselves, believe the dissociative state is an essential and desirable state for profound psychological and spiritual growth and feel it to be a critical factor in our patient’s healing journey.

 

Will I Feel Sleepy or Sedated?

Low-dose Ketamine does not typically cause a sense of sedation, and many patients report they are pretty sharp mentally and can work through their thoughts and feelings clearly and calmly for the first time in their life. While the intensity of the effects wears off quickly, we always caution there may be some feeling of imbalance and delayed reaction time for a few hours, and we advise you not to drive or operate heavy machinery following your treatment. We require that you have someone to drive you home before we begin the infusion and ask that you abstain from alcohol or recreational drugs for at least 24 hours before and after treatment.

 

How Quickly Does It Take Effect?

For some patients, temporary relief of symptoms can occur within hours of the first infusion. However, it is important to note; this relief is typically short-lived. After several infusions over two-to-three weeks, this lifting of the depressive or anxious symptoms can be complete or markedly improved. However, it may last several weeks or months before beginning to fade. In addition, single-dose “booster” treatments at a period of two weeks to a few months after the initial induction infusions have been shown to prolong the antidepressant effect of the medication in many patients.

 

If you or someone you know suffers from Major Depressive Disorder, PTSD, OCD, anxiety, or chronic pain and you would like to learn more, call us at 505-639-4973 or click here to schedule an appointment.