Ketamine and Depression: Is it a Cause or a Cure?

The Effects of Ketamine

Ketamine is a medication primarily used for starting and maintaining general anesthesia. It induces a sedated, trance-like state while also providing some form of pain relief. Other medical uses for ketamine include treatment for chronic pain and some types of depression.^1-2

Ketamine is a dissociative drug that causes a person to feel detached from reality. Although a low-dose infusion properly administered by a doctor may be therapeutic for some patients with depression, the recreational misuse of ketamine is very dangerous and poses many risks to the user. At higher doses ketamine can cause adverse effects that can include:^3-4

• Delirium
• Amnesia
• Impaired motor function
• High blood pressure
• Bladder pain
• Depression
• Slowed breathing
• Seizures
• Brain damage
• Death

Ketamine and Depression

Some users may have difficulty coming out of their state of dissociation and may continue to feel disconnected from the world around them. Research has shown that ketamine causes changes in brain neurochemistry, and regular use can result in the development of ongoing symptoms of psychosis such as hallucinations.⁶

Ketamine hinders judgment, attention, and thinking, and it can exacerbate existing mental health problems such as depression. Regular use can also cause depression, and research shows that chronic users of ketamine tend to be more depressed than occasional users.⁷ It is therefore important that someone with depression avoid taking ketamine, outside of low-dose therapeutic treatments administered under the direct supervision of a doctor.

If you are suffering from depression, consider talking to your doctor about medical and non-medical ways of treating depression. It is important to be aware of the dangers associated with taking ketamine while depressed and to seek help if you currently use ketamine and are finding it difficult to quit.

Please contact a substance abuse professional about the available treatment options that can help you overcome your ketamine addiction, including integrated treatment plans for individuals with a dual diagnosis. These programs can address both your ketamine abuse and co-occurring depression, reducing the likelihood of relapse after treatment and making it much easier to stay on the path to sobriety. If you have developed a psychological dependence for ketamine, a medically supervised detox at a treatment facility may be needed to help you safely and comfortably overcome any withdrawal symptoms.

Ketamine and the Opioid System

The way that ketamine works in the brain is not fully understood. There is some recent evidence that ketamine binds to and activates opioid receptors, causing the release of naturally occurring opioids in the body.⁵ If ketamine does indeed work through the opioid system, chronic users can develop a tolerance to the drug and become dependent. For this reason, it is important that people receiving regular ketamine treatments for depression are monitored for any signs of opioid addiction.

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Sources

1. Bell, R.F., & Kalso, E.A. (2018). Ketamine for pain management. PAIN Reports, 3(5), e674.
2. U.S. Food and Drug Administration. (2019). FDA approves new nasal spray medication for treatment-resistant depression; available only at a certified doctor’s office or clinic.
3. Rosenbaum, S.B., & Palacios, J.L. (2019). Ketamine. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
4. Wood, D., Cottrell, A., Baker, S.C., Southgate, J., Harris, M., Fulford, S., …& Gillatt, D. (2011). Recreational ketamine: from pleasure to pain. BJU International,107(12), 1881-1884.
5. Williams, N.R., Heifets, B.D., Blasey, C., Sudheimer, K., Pannu, J., Pankow, H., …& Schatzberg, A.F. (2018). Attenuation of Antidepressant Effects of Ketamine by Opioid Receptor Antagonism. The American Journal of Psychiatry, 175(12), 1205-1215.
6. Stone, J.M., Pepper, F., Fam, J., Furby, H., Hughes, E., Morgan, C., & Howes, O.D. (2013). Glutamate, N-acetyl aspartate and psychotic symptoms in chronic ketamine users. Psychopharmacology, 231(10), 2107-2116.
7. Fan, N., Xu, K., Ning, Y., Rosenheck, R., Wang, D., Ke, X., …& He, H. (2014). Profiling the psychotic, depressive and anxiety symptoms in chronic ketamine users. Psychiatry Research, 237, 311-315.