Melisa CoueyQ: I have seen advertising for clinics offering ketamine treatments for depression. How does this work and is it safe?
A: Ketamine was approved by the Food and Drug Administration in the 1970s as an anesthetic to sedate patients during medical procedures and is commonly used in veterinary settings. It also has a history as a "party drug," often used by club goers to get high. But today is it is being legally used "off label" (for uses other than what it was originally approved for) by some physicians to treat suicidal ideation and major depression.
The thinking behind using ketamine is that it prompts connections to regrow between brain cells that are involved in mood. Additionally, it works very quickly compared to traditional anti-depressants, which can take several weeks to begin to work.
Patients who undergo ketamine infusion therapy often report an almost immediate cessation of suicidal ideations, which can obviously be beneficial in an emergent situation. During the infusion process, patients report disorientation, feeling disconnected from their bodies. Once the infusion is completed, patients feel cognizant and able to function properly.
It's not clear yet if ketamine is safe and effective as a treatment for major depression. Studies at Yale University indicate ketamine may cause damage to the structures of the brain. It is not known yet at what level of ketamine use that damage occurs.
So while there are some promising studies about the efficacy of ketamine, there are still many unknowns about its safety and long-term effects.
- Melisa Couey, M.D., specialist in psychiatry and neurology; member, Chattanooga-Hamilton County Medical Society.