Ketamine

Ketamine relieves symptoms of depression through mechanisms involving increased glutamate release, enhanced synaptic plasticity, and dissociative effects that facilitate neural circuit recalibration and mental flexibility.

Activates Glutamate: Ketamine affects the glutamate system by blocking NMDA receptors on GABAergic interneurons, leading to increased glutamate release and subsequent activation of AMPA receptors. This activation enhances synaptic plasticity and contributes to rapid antidepressant effects.

Strengthens Synapses: Chronic depression is associated with weakened synaptic connections in brain regions involved in mood regulation. By increasing glutamate release and activating AMPA receptors, ketamine enhances synaptic plasticity and promotes the formation of new synapses, thereby improving communication between these brain regions.

Dissociative Effects: Ketamine’s dissociative properties, which result from its NMDA receptor antagonism, can disrupt maladaptive neural circuits and create a “time window of mental flexibility.” This allows for the recalibration of neural circuits and can lead to rapid antidepressant effects. The dissociative experience may also help patients gain new perspectives on their life and access insights that contribute to therapeutic outcomes.

Ketamine is an anesthetic that has been used in medicine since it was first approved by the FDA in 1970. Ketamine’s profound effects Ketamine therapy is safe when administered under the guidance of certified clinicians. Our clinical staff follows protocols that meet the highest safety standards. 

Some patients do experience unwanted side effects, like nausea, elevated blood pressure, and heart rate changes. These side effects typically subside within hours of your treatment.  

There is no way to guarantee a positive dissociative experience. However there are things we can do beforehand to set you up for success. Oftentimes, anxiety about the ketamine experience can lead to what is known as a “bad trip,” exacerbating feelings of distress and paranoia. We always recommend patients spend some time setting their intentions before a session, as this can induce a calmer and more open mindset. 

Environment also plays a significant role in the ketamine experience. Here at Hudson Mind, our patients receive ketamine in a minimal room, intentionally designed with comfortable furniture and soft lighting. 

A k-hole refers to such intense feelings of dissociation that it becomes difficult to speak and control your body, which can create a scary sense of powerlessness. Our clinical team oversees your IV during your ketamine therapy session to monitor appropriate dosing for you and your body. 

*Please note: Fidelis Medicaid plan does not cover TMS.

Ketamine therapy has shown promise in the treatment of bipolar disorder, particularly for bipolar depression, however further research is needed to establish long-term efficacy. Several studies have demonstrated its rapid antidepressant effects and its ability to alleviate symptoms such as suicidal ideation, anhedonia, and anxiety.

In a real-world observational study, Fancy et al. reported that repeated ketamine infusions led to statistically and clinically significant reductions in depressive symptoms, suicidal thoughts, and anxiety in patients with treatment-resistant bipolar depression. The study also observed functional improvements and noted that the infusions were generally well-tolerated.

Most conventional antidepressants can be safely combined with ketamine treatment for bipolar disorder, however, it is important to disclose your full medical history (including current medications) during your consultation as some medications (benzodiazepines and lamotrigine) may interact with ketamine and affect its therapeutic outcomes.