Anxiety is one of the most common mental disorders worldwide. The Anxiety and Depression Association of America states that 6.8 million adults in the US suffer from generalized anxiety disorder (GAD). Beyond that, a recent CNBC report indicates a 25% increase in anxiety-related book sales at Barnes & Noble between 2017 and 2018. These figures demonstrate that you’re not alone, and there are available solutions. New research is revealing the potential of ketamine, a medical anesthetic and FDA-approved depression treatment, to treat anxiety symptoms, especially when other methods have failed.
What is Ketamine?
Initially introduced as an anesthetic medication in the 1960s, ketamine was used on Vietnam War battlefields. Over time, it has been incorporated into hospital pain management protocols in smaller doses. In some instances, ketamine has been shown to boost the efficacy of sedatives and decrease post-surgical painkiller requirements.
In more recent history, ketamine has been used to treat cases of depression that don’t respond to traditional antidepressant medication. Spravato, a brand of esketamine that is administered as a nasal spray, became FDA-approved as a depression treatment in 2019. For thousands of people who had given up hope of finding relief from depression, ketamine quite literally changed their lives. As part of a comprehensive treatment plan at clinics like Bespoke Treatment, ketamine therapy is effective for over 60% of patients.
So, what sets ketamine apart from conventional antidepressants? Examining the biological mechanisms of both medications can provide insights. They function quite differently within the body.
Selective serotonin reuptake inhibitors (SSRIs) work in individuals with depression by elevating serotonin levels. This is a temporary change in brain function, so as soon as you stop taking an SSRI, it stops working. Many people fear becoming dependent on a daily medication or worry that they will forget to take the pill and immediately feel the effects. This is where ketamine can make a significant impact, as it does not depend on increasing serotonin levels.
In a study conducted by Dr. Connor Liston and his research team, they investigated how ketamine infusion therapy affects the brain in reducing depression symptoms in mice exhibiting depression-like behaviors. The results showed that after a single ketamine dose, the mice no longer displayed these symptoms, and brain scans indicated an increase in the formation of dendritic spines, or neuronal extensions, which were fully functional. This finding implies that ketamine may be altering the neurons themselves, enabling the regrowth of lost neural connections and fostering enduring changes in brain function.
The Yale School of Medicine points out that growing evidence suggests ketamine functions by causing a sudden surge in glutamate neurotransmission in the brain. This process is thought to underlie ketamine’s unique effects.
Ketamine and Anxiety
In light of its outstanding ability to treat even the most stubborn cases of depression, research has continued around ketamine as a treatment for a variety of mental disorders, including anxiety.
In fact, a three-month study involving patients with treatment-resistant anxiety who received weekly ketamine doses demonstrated its safety and tolerability. According to Paul Glue, M.D., a professor at the University of Otago’s School of Medical Sciences in New Zealand and study participant, most patients saw significant improvements in their work and social functioning.
Naji C. Salloum, M.D., from the Department of Psychiatry at Massachusetts General Hospital and Harvard Medical School, recently performed a secondary analysis of data from a randomized, active placebo-controlled trial of intravenous ketamine. Participants were patients with unipolar treatment-resistant depression. The results indicated a positive response to ketamine treatment and its potential as a treatment for various forms of depression. Salloum and his team state that their data suggests patients with anxious depression respond as well to ketamine as those with non-anxious depression, unlike monoaminergic antidepressants’ results.
Another fascinating study investigated ketamine’s impact on anxiety patients and its effect on brain waves. Twelve participants received three different ketamine doses weekly, and their brain activity was monitored using an EEG. Researchers observed changes in brainwave patterns, noting a decrease in theta brainwaves associated with relaxation. Following the study, eight of the twelve participants reported reduced anxiety symptoms, suggesting that ketamine may hold promise for anxiety sufferers.
Clinical trials have also examined ketamine’s effects on other disorders, such as PTSD and OCD. While more research is necessary for conclusive evidence, the results are encouraging thus far.
Ketamine is not available as a prescription medication and must be administered in a clinic on an outpatient basis. It is typically given intravenously or via esketamine nasal spray, both under close supervision. Treatment plans, dosing, and monitoring are carefully managed throughout the patient’s treatment.