Ketamine, a derivative of phencyclidine, is an anesthetic drug that was developed in 1962 and has been widely used in a variety of settings. Ketamine acts as an antagonist of the N-methyl-D-aspartate (NMDA) receptor and targets glutamate, which is an excitatory amino acid neurotransmitter.
Ketamine has been used to induce and maintain general anesthesia for more than 30 years and is on the World Health Organization’s List of Essential Medicines. Ketamine is FDA-approved as an anesthetic and has a remarkably safe track record in clinical settings. Ketamine is commonly used to treat Complex Regional Pain Syndrome (CRPS), sometimes referred to as Reflex Sympathetic Dystrophy (RSD).
Over the past two decades, researchers have consistently found that low doses of ketamine, administered intravenously (ketamine infusions), produce a rapid anti-depressant effect.
Scientists are still exploring the exact mechanism by which depression is relieved, but research suggests that by blocking the NMDA receptors, ketamine prompts the brain to increase the production of synaptic signalling proteins in the prefrontal cortex. The prefrontal cortex is the region of the brain thought to play a critical role in a person’s ability to regulate his/her mood. Ketamine appears to promote the growth of new synapses in the prefrontal cortex, resulting in greater connectivity in the brain, while also switching certain connections on and off. This cascade of events is thought to be the reason for the rapid anti-depressant effect.
You haven’t heard of ketamine for the treatment of refractory depression because the practice of using ketamine to treat depression is in its infancy. Ketamine is most commonly known as a general anesthetic, used in surgical procedures. You may know of ketamine as a rave drug, used recreationally since the 1980s. The utilization of ketamine to treat depression is not yet FDA-approved, as the FDA approval process can take many years, due to the amount of funding, research and time required. Fortunately, the research being conducted continues to demonstrate that ketamine is effective in treating depression, and the use of ketamine in this population is becoming increasingly common.
* NOTE: Ketamine IS an FDA-approved drug for anesthetic purposes and is on the World Health Organization’s List of Essential Medications.
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