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A New Hope for Treatment Resistant Depression: Ketamine Infusion Therapy

Aug 20, 2022
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Depression is miserable. But depression in Denver, where everyone apart from you exudes that “wellness vibe” as they come back from hiking another 14’er, seems particularly cruel.

A New Hope for Treatment Resistant Depression: Ketamine Infusion Therapy

Treatment Resistant Depression Sucks

Depression is miserable. But depression in Denver, where everyone apart from you exudes that “wellness vibe” as they come back from hiking another 14’er, seems particularly cruel. The worst part? No one else seems to understand what’s going on in your head and brain, which can leave you feeling totally alone. Even if people do recognize how hard it is for you, they may not know that there are treatments that can help when nothing else has worked. These treatments aren’t just options for the super rich or elite—they’re affordable and available across Colorado so anyone with depression can get the help they need to start living their life again. While Axis Integrated Mental Health offers multiple treatment options for depression, today’s blog is going to focus on Ketamine.

What is Treatment Resistant Depression

Treatment Resistant depression (TRD) is a serious mental illness characterized by episodes of depression that have not responded to two antidepressant treatments. The intense sadness and overwhelming feelings of hopelessness don’t go away and when left untreated, it can often lead to suicide.

What is Ketamine?

Originally developed as an anesthesia drug in the 1960’s, Ketamine was approved by the FDA in the 70’s and used in combat medicine during the Vietnam War. Ketamine provokes a dissociative experience, and it can sedate, incapacitate, and cause short-term memory loss in patients. While safe to use in a controlled medical practice where it can be properly dosed, it became stigmatized when casual users began using it due to its hallucinogenic effects.

How Does Ketamine Infusion Therapy Help Treatment Resistant Depression?

The science behind Ketamine Infusion Therapy is fascinating. The NMDA receptor is an ion channel that plays a role in learning and memory. It also regulates glutamate, which is one of the brain’s primary neurotransmitters. Ketamine works by blocking NMDA receptors in the brain. When you block these receptors, you can prevent them from binding with glutamate molecules—which means less depression and anxiety in treatment resistant depression patients. However, the real treatment occurs after the hallucinogenic effects subside and the brain begins to regrow connections after being exposed to Ketamine. While not everything is known about Ketamine, the current research supports that stress can cause damage to the brain’s synapses. The brain prunes these damaged synapses to be more efficient, and as a result, people with long-term depression lose these important connections which allow nerve cells to communicate effectively. This loss of connections leads to an imbalance in the brain’s communication between neural networks. This imbalance is known as the Default Mode Network model of depression.  Research shows that within 24 hours of the first dose of medically supervised Ketamine, those lost connections start to regrow. The more synapses they grow, the better the antidepressant effects of Ketamine are for them. In other words, Ketamine’s most profound effects happen after the medication leaves the body, in contrast to antidepressants which only work when they are present in the body. This is due to ketamine’s effects on those NMDA and glutamate receptors. We now know that downstream, the effects of ketamine lead to an increase in Brain Derived Neurotropic Factor (BDNF) and neuroplasticity within the brain. This neuroplasticity helps the brain to rebuild the pruned connections, allowing a balanced communication between neural networks and a decrease in depression, anxiety, and more.
 

What does a typical Ketamine Infusion treatment look like?

During a typical Ketamine infusion, you will be escorted to one of our spa-like treatment rooms by our highly-trained staff. We will offer you a choice of essential oil scents, spa socks and foot balm to help you relax, and your choice of soft music before placing an IV in your hand or arm. During your treatment, your blood pressure and other vital signs will be monitored by medical professionals to ensure complete safety in the procedure. Most infusions last between 40-minutes to 2-hours and you’re welcome to having a companion in the room with you during treatment.

After treatment, we will offer you a light snack and beverage. You will discharged to a responsible driver after treatment, as you will not be able to drive for 24-hours post treatment.

How long does it take to see relief from treatment resistant depression symptoms after using Ketamine?

Ketamine is an excellent option for improving symptoms of treatment resistant depression. However, like any other treatment, it will require repeat treatments (usually over 2-3 weeks) until you are well. Patients typically see immediate relief and more profound changes after the 3rd or 4th treatment. 

Axis Integrative Mental Health customizes a ketamine infusion plan for each patient and we will come in on the weekends if you want to reduce your time away from the office during treatment.

What are some of the side effects of Ketamine Infusion Therapy?

Ketamine treatment can cause high blood pressure, nausea and vomiting, perceptual disturbances (time appearing to speed up or slow down; colors, textures, and noises that seem especially stimulating; blurry vision), dissociation (sometimes called out-of-body experiences). Some patients experience a strong urge to urinate after treatment. These side effects are temporary and go away within a few hours after treatment. It is highly recommended that prior to coming into the clinic for treatment, that the patient chooses relaxing activities like meditation or massage and avoids all traumatic or negative television or movies. 

What advantages does Ketamine have over antidepressants when it comes to treatment resistant depression?

Ketamine treatment offers immediate relief, rather than having to wait a few weeks to take effect. For this reason, it is especially helpful in cases where suicidality is a real possibility. The total duration of treatment (typically 2-3 weeks) is also shorter than other treatments which can typically last a month or longer.  

Some disadvantages for the treatment are that is it not covered by insurance, and requires downtime after treatment to recover.

Is Ketamine Infusion Therapy covered by insurance for Treatment Resistant Depression?

Ketamine is not covered by most insurances, even for treatment resistant depression. At Axis Integrated Mental Health, we work hard to make Ketamine treatment accessible to many patients, including offering convenient, low-interest payment plans and can help you secure low cost financing for medical treatments.

Is Ketamine Infusion Therapy safe?

You may have heard that Ketamine is used as a horse tranquilizer, and you may have concerns about its safety on Humans. But don’t worry—Ketamine has been proven to be a safe treatment option for depression by the FDA. In fact, studies have shown that Ketamine is just as safe as other options such as electroconvulsive therapy (ECT). 

Ketamine infusion therapy is very safe when administered by medical professionals like the team at Axis Integrated Mental Health. Our providers have been board certified to administer Ketamine in patients and have spent years working in hospitals, where anesthetic doses can be as much as 5 times the dose that is administered for therapeutic purposes. Ketamine is used safely every day in hospitals and clinics around the world. including pediatric patients (please note that we do not administer Ketamine to anyone under the age of 18). The side effects are minimal and most only occur while the medication is being given.

Is Ketamine addictive?

While there is a potential for Ketamine abuse, it is very low when administered in the safety of a clinical setting like Axis Integrated Mental Health.

Who should avoid Ketamine treatment?

Ketamine is not for use in patients with a history of psychosis. Active substance abuse would also prevent treatment. Those with heart conditions, uncontrolled hypertension, or similar may require further testing or medical clearance for treatment.

Ketamine for treatment resistant depression in Denver

Ketamine is not for use in patients with a history of psychosis. Active substance abuse would also prevent treatment. Those with heart conditions, uncontrolled hypertension, or similar may require further testing or medical clearance for treatment.

More Resources for Managing Treatment Resistant Depression

Photo by Anthony Tran on Unsplash

Depression is a complex issue, and you or your loved one deserve someone who cares about you and your symptoms as much as you do. There is no reason to suffer with depression when there is a viable treatment option available.

We hope this article has helped you understand the benefits of using Ketamine to treat depression. We also want you to know that if you’re still suffering from depression, we can help. Talk to one of our providers at Axis Integrated Mental Health to understand which options would be best for you. Or check out our FAQs on Ketamine.