How Does Ketamine Therapy Work?

Ketamine therapy is an effective alternative to traditional antidepressant medications. It interacts with the brain’s neurons, increasing their ability to communicate and regulate mood.

Health care professionals can administer intravenous (IV) ketamine therapy or SPRAVATO™ (esketamine) nasal spray medication. Both methods occur in a health care facility under a medical professional’s supervision so patients remain safe and comfortable during and after treatment. Understanding how ketamine treatment works can help you determine if it’s right for you.

What Is Ketamine Treatment?

Professionals originally introduced ketamine to the medical field as an anesthetic, but it now also serves as a major depression treatment. Due to its antidepressive properties, health care providers can use ketamine to address treatment-resistant depression. A person has treatment-resistant depression when they experience major depressive disorder (MDD) and find no relief from two or more adequate antidepressant treatment doses they receive over an adequate duration of time.

Medical providers can prescribe IV ketamine infusion therapy or ketamine in the form of a nasal spray. The FDA approved SPRAVATO™ nasal spray treatment in 2019. This approval makes the medication available within a restricted distribution system, allowing individuals to receive it while under a medical professional’s care.

How Does Ketamine Therapy Work?

Ketamine therapy is an IV treatment or self-administered nasal spray received under a medical provider’s care and supervision. If you and your health care provider determine you would benefit from IV ketamine therapy or SPRAVATO™, you must sign a Patient Enrollment Form that states you understand the medication’s safety precautions.

What Happens Before Ketamine Therapy?

Before receiving ketamine treatment, your provider will ask you questions about your depression symptoms and check vitals such as your pulse and blood pressure. They may also review your medical history and invite you to ask any questions you have about the treatment.

Talking about your medical history and mental health conditions allows your provider to identify any underlying conditions that could cause adverse effects. Your provider can use this information to determine the best course of treatment.

How Is It Administered?

When you receive ketamine therapy intravenously, you rest in a comfortable chair while the medicine enters your bloodstream for approximately an hour. IV ketamine therapy and SPRAVATO™ nasal spray show similar positive results, but individuals receiving the IV therapy may require fewer treatment sessions to experience the same results as those using the nasal spray.

While SPRAVATO™ therapy is self-administered, a medical professional oversees the medication’s administration. After checking your vitals, your provider instructs you on how to use the nasal spray device and monitors you after you administer it to check for side effects. You administer SPRAVATO™ by spraying into both nostrils. The nasal spray then remains at the health care facility.

Many patients experience an elevated mood and feel relaxed during and after ketamine treatment. For the first four weeks of ketamine therapy, you use SPRAVATO™ or receive IV therapy twice a week. Following the first four weeks, you can receive less frequent treatments or stop altogether.

How Does Ketamine Work in the Brain?

How Does Ketamine Work in the Brain?When you spray SPRAVATO™ into your nasal passage, the ketamine enters the brain’s olfactory bulbs and reaches the nerve cells or neurons throughout the brain. When you receive ketamine intravenously, it reaches your brain’s neurons through your blood.

Ketamine works in the brain by binding to N-methyl-D-aspartate (NMDA) receptors, reorganizing brain activity and increasing neuroplasticity. Depression occurs when the brain’s neurons struggle to communicate. Neurons communicate through synapses, and ketamine can increase the number of synapses in the brain. Ketamine can also block NMDA receptors from hindering neuronal communication.

Some neurons use glutamate to communicate. When glutamate reaches a receiving neuron, it stimulates AMPA receptors and opens channels to allow calcium in. As calcium enters a neuron, the neuron releases a chemical that the brain needs to grow and strengthen neuronal connections.

Neurons that use glutamate can shut down if they come in contact with too many GABA neurons. Researchers believe GABA neurons can hinder antidepressant medications’ effectiveness and block them from working. Medical professionals also believe that ketamine may block NMDA receptors on GABA neurons, allowing primary neurons to release glutamate and communicate effectively. IV ketamine therapy and SPRAVATO™ can stop NMDA receptors from hindering healthy brain activity.

What Happens After Receiving Ketamine Therapy?

After receiving ketamine therapy, you remain under your provider’s care for two or more hours. They will check on you periodically during your stay to ensure you are healthy and responding well to the medication.

You must make arrangements to get home safely and avoid operating a vehicle or heavy machinery for the remainder of the day. SPRAVATO™ can have the following side effects:

  • Sedation, drowsiness or fatigue
  • Attention difficulties
  • Dissociation or impaired judgment
  • Substance misuse
  • Potential suicidal thoughts or actions
  • Increased blood pressure
  • Nausea

While dissociation is a possible side effect of ketamine, health care providers administer a small enough dose to prevent dissociative symptoms in the vast majority of cases. If dissociation occurs, it is short-lived and easily manageable during the infusion. Remaining under a provider’s care during and after therapy ensures you remain safe.

How Ketamine Therapy Differs From Antidepressants

Ketamine therapy works differently from antidepressants because it works more quickly, in a matter of days rather than weeks. In addition, you do not need to take ketamine on a daily basis like you do with oral antidepressants. In some cases, after you finish ketamine therapy, there is no need to continue receiving treatments unless your depression returns. In other cases, your provider may recommend that you receive periodic booster treatments to maintain your mood.

When Should You Receive Ketamine Therapy?

Ketamine therapy is a highly effective treatment option for all types of depression as well as other mental health and mood conditions. Consider trying ketamine therapy if you experience any of the following conditions:

Does Insurance Cover Ketamine Therapy?

Most insurance companies do not cover ketamine IV infusion therapy because it’s an off-label treatment, but most companies do cover the medication in SPRAVATO™. In this case, your insurance can cover the cost of SPRAVATO™ if your provider is in-network, but you must pay for the ketamine therapy appointments out-of-pocket.

Book a Ketamine Therapy Appointment With Principium Psychiatry

Ketamine therapy can significantly improve major mental health condition symptoms. It helps the brain’s neurons communicate effectively, producing more results than typical antidepressant medications. Principium Psychiatry offers ketamine therapy through IV treatment and SPRAVATO™ nasal spray to help individuals find relief from conditions such as major depression.

The treatment providers at Principium provide compassionate care and have extensive experience treating mental health conditions. We are dedicated to helping each patient find relief from their symptoms through effective treatment methods. The Principium team works closely with each patient to determine if ketamine is the ideal approach, and we guide patients through the process to ensure comfort and facilitate positive results.

Contact us to learn more about ketamine therapy or schedule an appointment to see if ketamine treatment is right for you.

Book a Ketamine Therapy Appointment With Principium Psychiatry

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