Ketamine has been found to provide rapid relief from depression when precise doses of pharmaceutical-grade ketamine is given IV or a derivative (esketamine) is given as a nasal spray.
Ketamine used for veterinary or “street” drug purposes are not safe for the treatment of depression and should not be used to treat depression.
Recently, Glue and colleagues published research on the use of an oral form of ketamine to treat treatment-resistant depression. How to access the article is described at the end of this blog.
Treatment-resistant depression is defined as the failure to resolve depression despite the use of two different antidepressants given sequentially or together at adequate doses for a long enough time to determine effectiveness.
The research utilized a long-acting ketamine tablet that is taken by mouth and swallowed like any other pill. Most research subjects took the medicine at home. This is different than IV ketamine and intranasal esketamine, which must be used with supervision in a healthcare setting.
Research subjects were given 120 mg of extended-release oral ketamine for 5 days. If they responded by day 8, they were given one of four different doses of oral extended-release ketamine or placebo twice a week for 12 weeks.
Research subjects taking the highest dose (180 mg) twice a week had fewer relapses (return of depression) than those taking a placebo. The relapse rate for placebo was 70.6%, whereas the rate for the oral ketamine was only 42.9%.
The researchers noted that “the most common adverse events were headache, dizziness and anxiety.” Also, “tolerability was excellent, with no change in blood pressure, minimal reports of sedation and minimal dissociation.”
Dissociation typically results from use of ketamine. Dissociation is defined by the Mayo Clinic as a “sense of being separated from yourself and your emotions, thinking that people around you are distorted and not real, a blurred sense of your own identity” and “amnesia of certain time periods, events, people, and personal information.” (Published Aug. 31, 2023; accessed online July 19, 2024.)
The research was published by Glue and colleagues in Nature Medicine 30, 2004-2009 (2024). To access the research, copy exactly what you see below onto a search engine such as Google:
https:doi.org/10.1038/s41591-024-03063-x
Peter M. Hartmann, MD
Family Medicine & Psychiatry
