Unlocking Ketamine's Transformative Power for Depression
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Dr. Chris Romig, MD, Medical Director of Innovation at Stella Center recently spoke with US News about ketamine and its effectiveness in treating depression.
Ketamine's Therapeutic Evolution
Initially famed for its anesthetic potency, ketamine is emerging as a groundbreaking tool against depression. As explained by Dr. Ryan Sultan, depression is a complex condition influenced by genetics and comorbidities, requiring a nuanced approach to treatment. Despite its Schedule III controlled substance status, ketamine's various formulations have garnered attention for off-label use in depression treatment.
Ketamine's Role in Depression Treatment
Dr. Martha Koo emphasizes the importance of understanding ketamine formulations prescribed for depression. Operating as an N-methyl-D-aspartate receptor antagonist, ketamine acts on the brain's glutamatergic system, promoting neuronal growth, neuroplasticity, and improved brain connectivity. Ketamine therapy shines in treating Treatment-Resistant Depression (TRD), a subtype resistant to conventional treatments like SSRIs. Stella's Medical Director of Innovation, Dr. Chris Romig, notes reassuring literature on ketamine's efficacy in TRD, albeit with variability in effectiveness across populations.
Describing the ketamine experience as akin to a psychedelic "trip," Dr. Romig emphasizes the importance of post-treatment care, including journaling and follow-ups with mental health professionals. Romig gives the example of a patient wanting to focus on inner strength: "I tell them to picture themselves as having a ball of light that pulsates and grows brighter and bigger until they feel the darkness slipping away from them." If the patient wants to focus on letting go, he might instruct that "they sit on the end of a dock with a floating lantern next to them that they release to the current and drift away."
Benefits of Ketamine
Because ketamine can induce an altered state of consciousness, individuals may be more receptive to emotional processing and therapy. And unlike many other medications that may require four to six weeks to achieve remission, ketamine acts much faster, providing rapid relief.
Side Effects and Risks
Medical surveillance, dissociative effects, nausea, and headaches constitute potential side effects. While manageable, these underscore the need for controlled administration and post-treatment observation. "It's vital that people work with licensed psychiatric clinicians who can prescribe appropriately, watch for signs of misuse or dependence and continue to work with them to ensure the medicine is used safely and appropriately," says Dr. Romig.
Eligibility and Patient Considerations
Ketamine therapy is reserved for treatment resistant depression and those with active suicidal thoughts. Patient intake, contraindication checks, psychological assessments, and informed consent form essential parts of the eligibility process.