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veteran

PTSD, Military Veterans and Ketamine Infusion Therapy

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November 11th is Veteran’s Day, a day we honor those who have served in the military for our country. Unfortunately, many veterans who have served in combat come back home suffering from PTSD. Posttraumatic stress disorder (PTSD) is a debilitating condition affecting up to 8% of the population at some point in their lives. 

The statistics among veterans, however, are staggering in comparison. According to a 2020 survey, 83% of all US veterans and active duty service men and women have experienced PTSD since the 9/11 attack due to their military service. PTSD was the second-most reported severe mental injury sustained during service, after sleep issues, in the veterans and active duty service men and women participating in the survey. 

PTSD is a condition that can result from experiencing or witnessing any traumatic (physical or emotional) event. Up to 20% of individuals who have survived episodes of sexual assault, physical or emotional abuse, neglect, accidents, natural disasters, or military combat can develop this illness.

PTSD may affect some individuals for the rest of their lives, with or without therapy. PTSD is a condition where certain situations trigger the sudden onset of irrational and intrusive thoughts, memories, and fears related to the original stressor. This condition can bring about panic attacks, nightmares, flashbacks, and various phobias, leading to social avoidance, headaches, anxiety, depression, pervasive guilt, and withdrawal from friends and loved ones. PTSD can result in problems at work and with relationships, as well as difficulty with personal advancement and growth, and can increase the risk of drug and alcohol abuse and suicide.

Medical treatment for PTSD traditionally involves SSRI antidepressants, antipsychotics, anxiolytics, and other medications, all with variable success rates, high incidence of untoward side effects, and slow onset of benefits. Psychotherapeutic treatment modalities include cognitive behavioral therapy and eye movement desensitization reprocessing. These therapies have a significant role in treating PTSD but can take an extended period to have a lasting effect on the patient’s functioning. They also tend to provide variable and incomplete relief for many patients.

Ketamine infusions are a new tool in the treatment of PTSD. They lead to rapid improvement in PTSD symptoms, in many cases, after the first treatment. The efficacy of ketamine in the treatment of PTSD was noted in the 1990s when injured soldiers who were treated with ketamine, either as an analgesic or surgical anesthetic, rarely went on to develop PTSD, compared to 30% of soldiers developing PTSD if treated with opiates and other anesthetics during surgery.

It is surmised that ketamine blocks the N-methyl-D-aspartate (NMDA) receptors increasing glutamate in the regions of the brain involved in emotion and long-term memory formation. This causes the suppression of maladaptive emotions and memories, allowing access to more adaptive neural circuitry and leading to more positive emotions and fewer negative memories. However, ketamine infusions are not a cure for PTSD and should be considered an adjunctive therapy that may provide rapid and lasting symptomatic relief from this condition. Therefore, patients who have PTSD are advised to continue with other therapies with the guidance of a mental health professional.

If you or someone you know is suffering from PTSD and would like to learn more about Ketamine infusion therapy, click here or call (505) 639-4973

Antidepressants

Antidepressants Vs. Ketamine Infusion Therapy for Depression

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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.