Ketamine’s History of Addiction and its Therapeutic Effects on Depression

 

Ketamine (street name Special K, Vitamin K, cat tranquilizers)  is commonly used in veterinary medicine. It is a fast-acting anesthetic and painkiller used for animal surgeries. Recently research has been begun to explore its therapeutic effect, specifically on treatment-resistant major depression and suicide ideation. Research on its possible therapeutic effects have just recently been explored but it has been known as a party drug since the mid-1980s.

 

Ketamine Abuse and Addiction

 

Ketamine has been used as a recreational drug. It became popular in the party, dance, rave culture originally used to increase the effects of MDMA (ecstasy). On its own those that use it are seeking a detached high, involving a dream-like state. It can produce vivid dreams and the feeling like the body is separate from the mind known as dissociation. It is a very powerful dissociative anesthetic, which means it provides the feeling of detachment from the body.

 

What does it look like?

Ketamine in the medical field is a colorless, odorless, and tasteless liquid that can be injected. When it is sold illegally it is usually converted into a white powder. It can be sold in tablets, in capsules or powder that people may snort or mix in a drink.

 

How does it make you feel?

 

Several factors can influence how the drug makes you feel including:

  • How much you take
  • How often you take it
  • How long you have taken it for
  • The method you use to take it
  • Your environment
  • Interaction with other medication or drugs in your system (alcohol, illegal, prescription, herbal, or over the counter medications)
  • Pre-existing medical conditions, mental health or psychiatric conditions
  • Your age and body weight

 

Ketamine can have a stimulant effect if taken in a low dose. There can be numbness in the body, dissociation, or a sense of floating. When it is taken in a higher dose it can cause the user to become withdrawn. They may not remember where they are, who they are, have a hard time walking, increase heart rate and difficulty breathing. A high dose can result in loss of consciousness often called a “the K hole”.

Visually one could experience blurred vision, seeing tracers, or intense hallucinations. Users have reported having a “near-death” or “out-of-body” experience. This experience can be terrifying, or people report a state of utter bliss and happiness which contributes to its addictive properties.

Ketamine is felt between 1 and 30 minutes after taking it. This is impacted by how the drug was taken, orally, snorted or injected and lasts for an hour or less. It does not incapacitate the user for an extended period of time and is used for a quick party high.

Many people use drugs to self-medicate to treat underlying mental health issues with drugs or alcohol and ketamine has been found to rapidly alleviate depression and suicide ideation. There is a high potential for abuse for those that attempt to self-medicate in this way. There is growing research and hope that clinicians will have this format of treatment available to they can access additional support and treatment.

Ketamine and It’s Therapeutic Effects

 In recent research, ketamine is effective in treating treatment-resistant major depression. It has also been shown to reduce suicidal ideation. Within a clinical setting, a subanesthetic intravenous dose of ketamine has been shown to a rapid antidepressant effect and has provided hope for those who have not responded to the traditional antidepressants and other psychological treatments.

Ketamine is a non-competitive glutamate N-methyl-D-aspartic acid (NMDA) receptor antagonist that influencing the glutamatergic system. Ketamine is able to block NMDA receptors, which is activated by the neurotransmitter glutamate. This is a different system then contemporary antidepressants that work on the brains serotonin, noradrenalin, and monoamine oxidase system. Ketamine appears to target and treat different forms of depression than regular antidepressants. Research has begun to explore its effect on different mental health disorders such as bipolar depression.

In recent research, Ketamine has shown to have an antidepressants effect in 3-72 hours after injection. Since Ketamine is so fast-acting and directly reduces suicide ideation it has the ability to manage acute suicidality. We recurrent do not have many treatments that act this fast with acute suicidality other than close monitoring and hospitalization.

This effect has been shown to last 6 days to greater than 3 months after a single dose. It is suggested that an individual may need repeated doses over time. Once a person is pulled out of major depression or suicide ideation, they can work to address the underlying feelings or events that are causing the depression. They can then be put in programs and be receptive to additional treatment after they have been given ketamine to help maintain the effects so they can create a life of wellness.

 

 

Future research and tests are needed to understand ketamine’s future role in treating treatment resistant depression and suicidal impulses. But this treatment holds promise for many people that are not responsive to traditional depression treatments. Drug companies are working to create the first ketamine-based antidepressant on the market. There are other illegal recreational drugs that are beginning to show promise in the treatment of mental health such as MDMA for Post-Traumatic Stress Disorder and Psilocybin (Magic Mushrooms) in treating depression in clinical trials.

 

References

Almond, K., & Allan, R. (2019). Incorporating MDMA as an adjunct in emotionally focused couples therapy with clients impacted by trauma or PTSD. The Family Journal, 27(3), 293-299.

McCorvy, J. D., Olsen, R. H., & Roth, B. L. (2016). Psilocybin for depression and anxiety associated with life-threatening illnesses. Journal of Psychopharmacology, 30(12), 1209-1210

Sayar, G. H., Ozten, E., & Savas, H. A. (2015). Ketamine infusion in treatment resistant depression: A case report and brief review of the literature. Journal of Mood Disorders, 5(2), 78.

Zanos, P., Moaddel, R., Morris, P. J., Georgiou, P., Fischell, J., Elmer, G. I., . . . Gould, T. D. (2016).  NMDAR inhibition-independent antidepressant actions of ketamine metabolites. Nature, 533(7604), 481-486