Ketamine for Depression

There is so much that we do not know about ketamine. In fact, there are many people who have not even heard about ketamine. Ketamine is used frequently in anesthesia. This synthetic substance was developed in the 1960’s and has gained in popularity throughout the last several decades. From an anesthetic perspective, unlike other medications, ketamine does not significantly depress breathing or blood pressure. Now this medication is starting to gain ground as a promising treatment for some cases of major depression, which is a leading cause of disability worldwide. In the US alone, 16 million adults had an episode of major depression sometime during the course of a year. Suicide rates rose substantially between 1999 and 2016, increasing by more than 30% in 25 states.

If a person responds to ketamine, it can rapidly reduce thoughts of suicide and relieve other serious symptoms of depression. Ketamine can be effective for the treatment of a variety of mental health conditions including things like anxiety, PTSD, bipolar depression, postpartum depression, and depression resistant to other forms of treatment. Other treatments for suicidal thoughts and depression often take weeks or even months to take effect, and some people need to try several medications or approaches to gain relief. This is true for talk therapies, antidepressant medicines, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT), which is currently the most effective treatment for major depression that fails to respond to other therapies. The success rate for these other modalities are also in the 30-40% range, where studies indicate that ketamine therapy success rates are in the 70-80% ranges, with many clinics seeing even higher numbers than this.


The truth is, we are not entirely clear on how ketamine works. Because it exerts an antidepressant effect through a new mechanism, ketamine may be able to help people successfully where other treatments have not worked. One thing that we do know about ketamine, is that it is an NMDA-receptor antagonist. When ketamine binds to these receptors, it appears to increase the amount of the neurotransmitter called glutamate in the spaces between the neurons. Glutamate activates connections in another receptor, called the AMPA receptor. When you have NMDA receptors blocked and you have activated AMPA receptors, there is a release of other molecules that help neurons communicate with each other along new pathways in a process known as synaptogenesis as well as new neurons to be formed in a process known as neuroplasticity. When NMDA receptors are turned off and AMPA receptors are activated, there is an increase in BDNF, or brain-derived neurotrophic factor. This protein plays a very important role in the growth and maintenance of brain neurons. The ketamine-based neuroplasticity is what is credited with ketamine’s ability to help with conditions like depression and anxiety. These new connections, or synapses provide the patient deeper insights in the brain as their mental circuitry is “rewired.”


All drugs have side effects. What each patient is going to have to do, is look at whether the symptoms that they are experiencing are more or less severe than the possible benefits that they may get from taking a drug. Ketamine acts as a sympathomimetic. It can lead to high blood pressure, nausea, vomiting, perceptual disturbances, and even a feeling of dissociation. The good news is there any changes in perception or dissociation are most noticeable during the first infusion, and end very quickly once the infusion is complete. In order to minimize these, patients are carefully monitored so that other medications can be administered quickly if the situation arises. At InVita Health and Wellness, patients are able to relax in a comfortable recliner with whatever they need to make them the most comfortable. Weighted blankets, eye masks, and noise-cancelling headphones are provided to patients so that they can reduce stimuli as much as they desire. Ketamine is a safe medicine when used in a clinical scenario by qualified medical professionals.


InVita Health and Wellness has taken a different approach to ketamine therapy in the St. Louis area. “For starters, we all practice anesthesia here. We all have been using this particular medication for years and both understand and respect what this drug is capable of,” owner and founder Sara Franco says. Patients at InVita Health and Wellness are screened in order to determine if they are suitable for Ketamine treatment. Franco described the process. “Prior to infusions, patients are made aware of the risks and benefits that can come along with Ketamine treatment. If the patient goes on to undergo treatment, they are carefully monitored by qualified and licensed personnel throughout their treatment. They are not just administered the medication and left in a room with a camera on them. We also use adjunctive medication, like magnesium and oxytocin, with the Ketamine infusions. At the end of the treatment, the patient is given as much time as they need to recover and they are discharged home with a responsible party.” Franco goes on to say, “A common theme that we hear from patients is that they are able to think about memories and experiences in a whole new way.”

The professionals at InVita Health and Wellness recommend a series of 6-8 ketamine infusions over the course of 2-3 weeks. Franco says, “Patients will often ask if they can just do one treatment. Unfortunately, this is not the way we have found ketamine to work. This would be like taking your antidepressant for a day or two and expecting relief. We individualize each infusion so that the patient gets the most out of their treatment. Since we are familiar with the drug, we are comfortable increasing the dosage beyond what other facilities are comfortable with if that is what the patient needs, although the lowest EFFECTIVE dose is always our goal.”

If you think ketamine infusion therapy can be helpful for you, please schedule a consultation with the staff at InVita Health and Wellness by calling 314-394-0950 or click here.