November 18, 2022 Addiction

Ketamine Therapy: Types, Therapeutic Uses, Benefits, and Side Effects

explained text: therapeutic uses of ketamine inducing general anesthesia, treating chronic pain, treating depression, treating anxiety and treating status epilepticus

Ketamine is authorized for use at high doses as an operating room anesthetic. Although not FDA-approved, lower dose “sub-anesthetic” ketamine injections are used “off-label” for the treatment of pain, depression, and other mental health and substance use disorders (SUDs).

Ketamine therapy is typically for patients suffering from depression who have tried all other types of therapies. It is very useful in treating treatment-resistant depression, post-traumatic stress disorder (PTSD), anxiety disorders, obsessive-compulsive disorder (OCD), and chronic pain.

Now, ketamine therapy is being used to treat drug-resistant depression because traditional treatments and medications for depression and suicidal thoughts often take weeks or months to work and have unpleasant side effects.

Furthermore, patients may have to test multiple medications before finding one that works. The same is true for support therapies such as talk therapy, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT).

Ketamine therapy is reasonably safe and effective for treating depression when administered in the proper dosage by a doctor. The issues with ketamine originate from its overuse and misuse. So, what exactly is ketamine therapy, and how does it work? Let’s find out.

What is Ketamine Therapy?

Ketamine therapy is an effective treatment option as part of a comprehensive treatment plan for depression and other mood disorders. The ability of ketamine to reduce self-harm automatically puts it into a very select group of medications, along with clozapine and lithium. Reducing self-harm is a result that no other conventional antidepressant, such as selective serotonin reuptake inhibitors (SSRIs), has ever been shown to have.

Ketamine blocks glutamate, a neurotransmitter associated with stress, whereas the majority of other traditional antidepressants target the neurotransmitters serotonin, dopamine, or norepinephrine.

Ketamine has also been proven to help in the rebuilding of neurons in a depressed brain, most likely through boosting brain-derived neurotrophic factor (BDNF). Suicidal ideation is one of the most serious symptoms of depression that can be treated with ketamine.

Multiple studies have shown that a single ketamine infusion rapidly decreased the intensity of suicidal thoughts in more than half of the patients, with effects observed for up to one week.

Types of Ketamine Therapy

Ketamine therapy is classified into four types and is used to treat major depression in people who have not responded well to two or more antidepressant drugs.

The first, most commonly used type is intravenous (IV) therapy. Other ketamine therapies include nasal sprays, intramuscular (IM) injections, and lozenges.

IV Ketamine Infusion Therapy

Ketamine, when administered intravenously, enters directly into the patient’s bloodstream. This is known as intravenous (IV) ketamine.

The treatment is a combination of two mirror-image molecules known as “R” and “S” ketamine. The FDA approved its usage as an anesthetic decades ago.

Doctors are using it off-label for individuals with treatment-resistant depression. IV Ketamine therapy is not recommended as a first-line treatment for depression.

Instead, it is used when antidepressant medications fail. Ketamine takes effect immediately after an IV infusion in the arm, and the effects can last for days to weeks.

As part of the “induction” phase, patients typically receive six infusions over two to three weeks. Following that, the maintenance period begins, with patients returning for one infusion every two to six weeks.

Ketamine has also been used to treat bipolar disorder; however, it is not recommended for children or people experiencing mania, active psychosis, or unstable cardiovascular disease.

Esketamine (Spravato) Nasal Spray

Esketamine (Spravato) is administered through a nasal spray. It just uses the “S” molecule rather than the combination of “R” and “S.”

Although this form of ketamine medication treatment is approved by the United States Food and Drug Administration (FDA), there is far less research on its effectiveness in the treatment of depression.

These two forms of ketamine interact differently with brain receptors. The administration method (IV versus nasal spray) also affects the drug’s efficacy and adverse effects. More study is needed to compare the effectiveness of esketamine (Spravato).

Intramuscular (IM) Injections

You may receive shots of ketamine into one of your larger muscles (arm or thigh). Similar to intravenous, the experience lasts roughly 40 minutes and is provided in a hospital or office setting.


Lozenges are administered orally and can be administered at home or in a clinical setting. They can be used as the primary treatment or as a preventative measure in between intravenous, intramuscular, or intranasal treatments.

Therapeutic Uses of Ketamine

The U.S. Food and Drug Administration (FDA) has approved ketamine for general anesthesia, but the drug also has some off-label uses. Such as:

Inducing General Anesthesia

Ketamine is used to induce general anesthesia alone or in combination with other general anesthetics, such as nitrous oxide.

They use it in the emergency room to create short-term sedation when:

  • Treating joint dislocations
  • Reducing fractures
  • Repairing wounds in uncooperative individuals, like children

Treating Chronic Pain

Practitioners use low dosages that do not cause dissociation to relieve chronic pain from the following conditions:

  • Trauma
  • Abdominal pain
  • Leg or arm pain
  • Low back pain
  • Fractures

Treating Depression

According to a 2017 study, ketamine can quickly relieve depression in those who do not react well to conventional treatments and medications.

Despite these positive results, the authors caution that research on using ketamine for this condition is limited, and practitioners should evaluate the drug’s risks before prescribing it.

According to a 2016 study, the improper use of ketamine is a worldwide health issue due to its hallucinatory properties. With this in mind, doctors are urged to first prescribe standard antidepressants before trying ketamine for depression.

Treating Anxiety

There has been little research into the use of ketamine for anxiety. However, one study shows that it may benefit those suffering from social anxiety disorder. This syndrome is characterized by a fear of social situations.

The drug was tested on 18 people in a clinical trial in 2017 and found to be effective in treating social anxiety disorder.

Because multiple other studies have found ketamine to have considerable anti anxiety effects, the authors of the study encourage future studies to explore this potential benefit further.

Treating Status Epilepticus

Status epilepticus is when an individual has a seizure that lasts longer than five minutes or has more than one seizure within five minutes.

Refractory status epilepticus (RSE) is a type of status epilepticus that does not respond to normal antiseizure medications. It is a serious condition that can result in brain damage and even death.

According to 2015 research, ketamine may be an effective treatment for RSE. However, more in-depth research is required to verify the study’s findings and prove the safety of ketamine usage for treating this condition.

Benefits of Ketamine Therapy

Ketamine is quickly emerging as one of the most promising alternative therapies for depression, anxiety, PTSD, other mood disorders, and chronic pain. Here are some of the most promising benefits of ketamine therapy.


One of the issues thought to be at the root of depression symptoms is impairment in neuroplasticity, which is the ability of the brain’s neural networks to change via growth and reorganization.

Depressive symptoms become more chronic when the brain lacks this ability. Ketamine contributes to increased neuroplasticity by boosting glutamate transmission, which helps neurons to communicate along new pathways.

As a result of these new connections, ketamine can help patients experience improved mood and thought patterns. This shift occurs immediately, which is why ketamine produces such rapid antidepressant effects.

Psychological Healing

Ketamine improves synaptic connections in the brain by stimulating the mTOR (mammalian target of rapamycin) pathway. Part of this signaling system also helps in the repair of damaged synapses.

During ketamine therapy, these repairs typically occur in areas of the brain linked with learning, memory, and emotional control. This promotes antidepressant effects while preparing the patient for a psychological healing process.

Over time, this may even help patients develop resilience, which can help them avoid relapsing into depression.

Blocking Pain Signals

In addition to treating depression, anxiety, and other mental health disorders, ketamine can be used to treat complex regional pain syndrome (CRPS) and chronic pain. These disorders occur when the amount of pain signals being sent within the body significantly increases.

Ketamine Therapy can help by suppressing excessive pain signals and allowing the body to “reboot.” Ketamine, in particular, can inhibit NMDA receptors in peripheral nerves, allowing impulses to be intercepted before they reach the brain and spinal cord.

Mental Breakthroughs

Ketamine has been known as a psychedelic substance that, when used recreationally, creates dissociative effects.

However, ketamine’s effects may lead to major mental breakthroughs and attitudinal shifts in patients with depression and other mood disorders when administered in much smaller, controlled dosages over a fixed length of time in a clinical setting.

These effects can differ from one person to another, so while one person may experience deeper introspection, another may reconnect with feelings they had lost touch with during their depression, such as joy or peace.

Minimal Side Effects

One of the most intriguing benefits of ketamine infusion therapy is that it has mild short-term side effects and no known long-term side effects. Patients may have mild dissociative effects during the painless infusion, which are often reported as pleasant or soothing.

Some people suffer mild nausea, although medication can help to decrease or eliminate this side effect. Patients may feel tired afterward, so they should rest and avoid driving or returning to work for the rest of the day.

In comparison to the adverse effects of antidepressant medications, which include everything from weight gain, dizziness, and constipation to sleeplessness and decreased sexual desire, ketamine’s side effects are pretty mild.

Rapid Improvement

One of the most exciting things about ketamine therapy is how quickly it might provide relief from mood disorder symptoms. It might take months to observe any real improvements with treatments like psychotherapy and antidepressant medication.

Ketamine infusion therapy can offer patients with notable relief from symptoms and mood improvement by the day after the third infusion, which generally occurs one to two weeks into treatment.

Many people report subtle improvements even earlier than that, and some experience dramatic and quick improvements within days after their first infusion. As the patient proceeds through therapy and completes a full series of infusions, the benefits become more obvious.

Lasting Relief

Ketamine infusion therapy is one of the most effective treatments for mood disorders. With ketamine therapy, patients experience long-lasting relief, especially if they follow the recommended aftercare plan.

Considering the minimal time and effort necessary to finish this treatment, the highly effective, long-lasting payoff is remarkable.

Side Effects of Ketamine Therapy

Ketamine therapy has relatively mild side effects. The following are the potential side effects of ketamine at prescribed doses:

  • drowsiness
  • dizziness
  • feelings of dissociation from your body, thoughts, and feelings
  • nausea
  • blurred vision or double vision
  • feelings of spinning and losing your balance when you aren’t moving
  • psychosis, which may include hallucinations and delusions
  • headaches
  • altered sense of taste

In rare cases, ketamine can induce the following adverse events:

  • mania
  • poor muscle control or coordination
  • difficulty sitting still
  • panic attacks
  • thoughts of self-harm
  • autoscopy, or out-of-body experiences

Risks Associated with Ketamine Therapy

Study shows that ketamine is safe for use in persons of all ages when taken appropriately. However, ketamine is only considered safe when an individual takes the drug as prescribed by their doctor.

Despite its overall safety, the following risks are associated with ketamine:

  • instability of heart and blood vessel function
  • respiratory depression
  • cognitive deficits
  • increase in intracranial pressure
  • emergence reactions
  • liver injury

Doctors do not recommend ketamine for persons of any age who have illnesses in which high blood pressure could result in:

  • heart attack
  • aneurysm
  • aortic tear

The drug is inappropriate for those with schizophrenia or who are pregnant or breastfeeding.

Am I Eligible For Ketamine Therapy?

Maybe you have treatment-resistant depression and wonder if ketamine therapy is the solution. Before recommending any treatment, including ketamine therapy, mental health experts perform a comprehensive medical examination to ensure that ketamine therapy is right for you.

You may be eligible for this therapy if you meet the following criteria:

  • You have already tried different medications
  • You haven’t responded well to individual or group therapy sessions
  • You have tried other therapies, including transcranial magnetic stimulation (TMS)

Although IV ketamine therapy is not used as a first-line treatment for depression, it may provide you with the relief you deserve.

Individuals may not be eligible to receive ketamine therapy if they:

  • Are pregnant
  • Have an acute cardiovascular disease
  • Had a previous negative response to ketamine therapy
  • Have uncontrolled hypertension
  • Have a history of substance abuse, psychosis, or increased intracranial pressure

Frequently Asked Questions (FAQ)

What is ketamine Infusion therapy like?

On average, it takes 5-10 minutes to experience the effects of ketamine infusion. Unlike other types of ketamine therapy, you can control and change the amount of your infusion at any point throughout your treatment session.
Following are the most common experiences on ketamine:
Heightened senses
Feeling happy or euphoric
Deep relaxation or dissociation
Safely revisiting past memories or trauma
While no two experiences are the same, most individuals report that ketamine is pleasant. Ketamine treatment is often compared to getting tipsy after having a cocktail.
If you feel adverse effects such as anxiety or nausea, your healthcare provider can reduce your dose or prescribe extra medication to alleviate these symptoms.

How is ketamine used for depression?

Ketamine works by rapidly increasing the activity of the neurotransmitter glutamate in the brain’s frontal cortex while simultaneously allowing new synapses to grow in the same area.
Ketamine produces an antidepressant effect quickly because it skips the usual serotonin pathway and goes straight to activating glutamate.
This is very different from typical antidepressants, which first increase serotonin activity in different areas of the brain before affecting glutamate. This process often takes two to four weeks to complete, whereas ketamine has an almost immediate impact.

What are the pros and cons of ketamine? Is it worth it?

Are you thinking of trying out ketamine therapy to treat substance use issues or mental health conditions? Ketamine therapy is widely known as one of the latest and best treatment methods for the treatment of mental health disorders and types of conditions.
Here are some of the pros and cons of ketamine therapy to consider:

Pros of ketamine therapy are:
Ketamine provides fast-acting relief
Ketamine therapy is highly successful
Ketamine therapy has little to no side effects

Cons of ketamine therapy are:
Ketamine causes patients to have dissociative effects
Ketamine has the potential to be an addictive substance
Despite some cons, ketamine therapy is regarded as one of the latest and greatest treatment options for depression, chronic pain, and other mental health disorders. With proper medical supervision, you can benefit from the therapy and hope to see the change soon.