Ketamine Treatment

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Ketamine has been approved for the use in anesthesia since the early 70’s. The first reference to ketamine’s possible antidepressant effects was published in 1975. Ketamine is on the World Health Organization’s List of Essential Medicines. This is primarily because it is able to provide general anesthesia but does not interfere with a person’s ability to breath.  It is also frequently used in children in the emergency department for to provide anesthesia during painful procedures.

 

It was not until 2000 with the publication of a small study from Yale that the interest in using ketamine as an antidepressant began.  In October of 2012 Time magazine published a story entitled “Ketamine for Depression: The Most Important Advance in Field in 50 Years?”  While not FDA approved for the treatment of depression it is being used “off label” for this indication as well as others such as bipolar disorder, addiction, and chronic pain.

 

The excitement surrounding the use of ketamine in depression is based on the several findings.  For one thing, it works through a different mechanism than currently used medications.  Twenty to thirty percent of patients with depression do not respond to these traditional antidepressant therapies. However, ketamine has been shown to benefit 70% of these difficult to treat patients. Another remarkable difference between ketamine and other antidepressants is that a single infusion can produce almost immediate, within hours, benefits that can last for weeks to months.

 

The doses used in the treatment of depression are much lower than the doses given for anesthesia.  The typical anti-depressant dose is ½ mg per kilogram which is about 1/10th the dose for used for anesthesia.  Ketamine has been shown to be extremely safe as evidenced by the low incidence of fatalities associated with its widespread recreational use.  Despite its good safety profile we take every precaution to ensure the well being of our patients.

 

Richard L. Bowen, MD
217 Calhoun St., Unit 1
Charleston, SC 29401
Tel:  843-480-2273
Fax: 843-501-7698