Is Ketamine Therapy Effective for Treatment-Resistant Depression?

For some individuals, traditional depression treatments like talk therapy and antidepressants offer limited or no relief. This condition is known as treatment-resistant depression (TRD) and affects approximately 22% of Canadians diagnosed with major depressive disorder. 

In recent years, ketamine therapy has gained attention as a potential alternative when other treatments haven’t worked. Ketamine treatments may provide symptom relief for certain individuals under medical supervision. In this blog, we’ll explore what defines TRD, how ketamine is administered, and what current research says about its potential role in managing difficult-to-treat depression.

What is treatment-resistant depression?

TRD is a form of major depressive disorder (MDD) where a minimum of two separate first-line antidepressants have been ineffective in managing depressive symptoms. Treatments must contain a proper dosage and must be given for the correct duration (6–8 weeks) before a professional can diagnose TRD.

Selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) are known as first-line medications because they contain fewer severe side effects when compared to other treatments. TRD can occur in people who are unresponsive to treatment and those who were previously responsive, but no longer feel relief.

Symptoms

The symptoms are similar to MDD (sleep difficulties, depressed mood, changes in appetite), but patients are more likely to experience the following:

• Longer episodes of depression
• Severe symptoms
• Inability to experience joy or pleasure
• Anxiety
• A higher number of depressive episodes during their life
• Suicidal thoughts and behaviour

The Benefits of Ketamine Therapy for Treatment-Resistant Depression

Current research shows positive results from using ketamine therapy in managing treatment-resistant depression. Originally used as an anesthetic, ketamine treatment is now approved to help treat TRD. Delivered in low doses, it can provide quick symptom relief with the potential to last for days to weeks. The response rate was approximately 50-70% in clinical trials.

The results of clinical findings are as follows:

Reduction in Symptoms

Studies have reported that those experiencing treatment-resistant depression frequently experienced an immediate decrease in suicidal thoughts and depressive symptoms with ketamine therapy compared to individuals who used placebos or midazolam. The longest effect lasted for 28 days with a single dose.

Furthermore, the more serious side effects of ketamine, such as dissociation, were brief and rare.

Creates More Synaptic Connections

Ketamine therapy works differently when compared to traditional antidepressants. SSRIs (selective serotonin reuptake inhibitors) help with depressive symptoms by increasing serotonin levels. The function of serotonin is to act as a chemical messenger that carries signals between brain cells. SSRIs block serotonin’s reabsorption, making more of it available in your brain.

Conversely, ketamine facilitates the formation of additional synaptic connections between neurons in the brain. Usually, those with depression have fewer connections in this area. Ketamine is theorized to decrease suicidal thoughts and depressive symptoms by increasing the connections, thereby helping alleviate symptoms and providing depression relief.

Boosts Glutamate Production

Ketamine treatments help boost glutamate production. Some studies have observed that these treatments may increase the growth of new synapses in your prefrontal cortex. This area of your brain controls memory and regulates mood, which is why low dosages of ketamine have the potential to provide quick antidepressant effects. Ketamine is thought to alter the way the brain functions and fires, changing mood and brain communication.

Rapid Relief

Ketamine delivered intravenously has an almost immediate effect on the brain. Conversely, with antidepressants, it typically takes weeks before a patient experiences any changes in symptoms. One of the benefits of ketamine infusions is that they are administered intravenously, allowing the drug to be quickly absorbed into the bloodstream. IV infusions have the potential to provide fast relief from symptoms. 

Success in Treating TRD

IV ketamine infusions have shown as a promising treatment method. If you cannot receive relief from other treatments, ketamine infusions may be able to help. Due to its unique interactions in the brain, ketamine therapy has shown promise in helping those who struggle with MDD and TRD manage their symptoms. 

Special Considerations

Not all patients can take ketamine for depression. This therapy is not recommended for children or teenagers. Other people who cannot take ketamine include those with the following conditions:

• Schizophrenia
• Pregnant/breastfeeding
• Active substance abuse
• People with dementia
  
  

Ideal candidates, as mentioned, have previously taken two other antidepressants in the proper dose and time frame, but aren’t receiving relief.

Additional factors to consider include:

• Unknown long-term benefits: More research is being conducted on the long-term effects of ketamine therapy.
• Relapse is not uncommon: Individuals can relapse once they are off the drug. However, treatment resumes with frequent dosages administered according to a scheduled plan.
• Potential misuse: Ketamine is a Schedule 3 drug. There is always the potential for misuse and addiction, which is why use is carefully monitored and administered in clinical settings.
• Side effects: Patients may experience dizziness, visual issues, confusion, nausea/vomiting, feelings of detachment (floating) from the body, amnesia, anxiety, emotional numbness, bladder discomfort, digestive system problems, and increased heart rate/blood pressure.
  
  However, side effects typically last briefly and only occur during treatment and/or for a short duration afterwards. They also decrease in severity the longer the medication is taken.

Are you ready to experience depression relief?

If you’re struggling with treatment-resistant depression, Ketamine Therapy Toronto offers a patient-centred, evidence-based approach tailored to your unique needs. Our team of physicians combines expertise in psychiatry and anesthesia to deliver IV ketamine treatments in private, comfortable rooms, allowing for real-time dose adjustments and individualized care. 

All services are approved and regulated by the College of Physicians to ensure the highest standards of safety and professionalism. We also offer OHIP-covered psychotherapy to support your mental health journey.

To book an appointment, please contact us at 888-259-9755, email us at admin@ketaminetherapyclinic.ca, or complete our online form. We are located at 855 Broadview Avenue, Suite 403.