Ketamine remains a fairly new player on the field of depression treatment. Here’s a quick snapshot of its history:
Healthcare professionals first began using ketamine as an anesthetic in the
Treatment-resistant depression refers to depression symptoms that don’t respond to two or more types of antidepressant medication. Estimates suggest
Antidepressants aren’t the only treatment option for depression symptoms, of course. You may have also tried:
These approaches don’t always relieve severe depression symptoms, including thoughts of suicide — and that’s where ketamine could make a difference.
Below, get the details on the potential benefits and risks of trying ketamine for treatment-resistant depression, plus guidance on getting a prescription from a qualified mental health professional.
Having thoughts of suicide?
If you’re thinking about suicide, know you’re not alone.
You can get free, confidential support 24/7 from trained crisis counselors by dialing 988 to reach the Suicide and Crisis Lifeline.
If you prefer text-based support, just text “HOME” to 741-741 to reach the Crisis Text Line.
Ketamine works by
Ketamine can also
Another major advantage lies in the fact that ketamine works very quickly, Eriksson says. With traditional antidepressants, it may take weeks before you notice improvement in your symptoms. Ketamine may offer relief in as little as
Ketamine may also help treat:
Ketamine comes in many different forms, including:
- Nasal spray: You can use Spravato nasal spray once or twice a week for up to
4 weeks. After 4 weeks, your care team will typically study your symptoms before recommending further treatment.
- Intravenous (IV) therapy: A slow, continual IV drip delivers ketamine directly into your bloodstream.
- Intramuscular (IM) injections: You may receive shots of ketamine into a large muscle, such as your shoulder or thigh.
- Lozenges: You may receive a prescription for oral ketamine tablets, which dissolve slowly under your tongue, to take at home. You can take these tablets between IV or IM treatments, or on their own. It may take longer to notice an effect, since your digestive system has to process the ketamine first.
You can only receive esketamine nasal spray, IV therapy, and IM injections at a clinic or hospital. This allows healthcare professionals to monitor your response and any side effects you experience.
According to Eriksson, IV therapy is one of the most widely studied forms of ketamine — in part because the treatment professional has more control over the dosage during treatment. However, Spravato nasal spray remains the only FDA-approved ketamine therapy, to date.
A growing body of research supports the benefits of ketamine for depression.
In a small
Future research may help determine whether repeated ketamine treatments have more of an effect than a single dose.
In a 2022 study, people with depression and thoughts of suicide received six IV ketamine infusions at three separate clinics over 21 days. Within 6 weeks of starting treatment, 20% of people with depression were considered “in remission,” meaning their depression symptoms had greatly improved, and 50% of people who had thoughts of suicide no longer experienced them.
In another small
Negative beliefs about yourself and the world — like “Nobody cares about me,” or “I’ll never succeed” —
In a small
While these results show promise, research on ketamine for depression remains in the early stages, says Julian Lagoy, MD, a California-based psychiatrist with Mindpath Health.
More studies are needed to figure out the ideal treatment dosages and frequencies to maximize the benefits of ketamine while minimizing its side effects.
Side effects of ketamine therapy tend to be fairly mild. According to a
- dissociation, or feeling disconnected from your body, thoughts, and feelings
- vertigo, or the feeling of spinning and losing your balance when you’re not moving
- dysgeusia, or altered sense of taste
- psychosis, which may include hallucinations and delusions
In rare cases, ketamine can
- panic attacks
- ataxia, or poor muscle control or coordination
- akathisia, or difficulty sitting still
- thoughts of self-harm
- autoscopy, or out-of-body experiences
Long-term ketamine use has been linked to bladder dysfunction and
Is ketamine right for everyone?
Since ketamine can increase blood pressure, it’s not recommended for people with hypertension, Eriksson says.
Keller advises avoiding ketamine treatment if you or your family has a history of psychosis. Ketamine can cause disassociation, which
You may also want to ask your healthcare professional about whether or not it’s safe to take ketamine if you have:
- heart disease
- a history of increased intracranial pressure
- a history of substance use disorder
Talk with mental health care professional or primary care doctor if you’re interested in trying ketamine for depression, says Yalda Safai, MD, a New York-based psychiatrist at Pasithea Clinics. They can help you decide if ketamine is right for you and refer you to a professional who specializes in ketamine therapy.
You can find freestanding clinics and online services that offer ketamine, but Safai cautions that many of them don’t offer adequate supervision.
“This is dangerous, as it’s important to be monitored for side effects by a nurse or doctor during the treatment,” she says.
Again, oral ketamine tablets are the only form of ketamine you can take at home. Your prescribing clinician will likely recommend having a friend, partner, or other trusted person present when you take them, just in case you experience any uncomfortable side effects or a negative reaction.
If you do try a ketamine clinic on your own, the American Society of Ketamine Physicians, Psychotherapists, and Practitioners recommends making sure it meets the following criteria:
- It’s been open for more than 2 years.
- It has board-certified physicians with mental health experience on staff.
- It offers additional mental health support services, such as individual or group therapy.
- You’re required to complete at least one or two consultations before starting ketamine therapy.
How much does it cost?
Since the Spravato nasal spray is the only FDA-approved treatment at this time, insurance companies often won’t cover other forms — though they may cover other types of ketamine treatment in cases of very severe depression, according to Lagoy.
The cost of other types of ketamine therapy can vary, depending on where you live, what form and dose you take, and other factors.
The cost of 1 month of Spravato treatment may run as high as $6,800, if you receive treatment twice a week. That said, insurance programs may offer some support with covering the cost of Spravato.
A single IV ketamine infusion can cost $400 or more, according to Eriksson.
Ketamine continues to gather interest as a potential treatment for depression, especially treatment-resistant depression.
That said, research on the benefits of ketamine for depression remains relatively new.
Rebecca Strong is a Boston-based freelance writer covering health and wellness, fitness, food, lifestyle, and beauty. Her work has also appeared in Insider, Bustle, StyleCaster, Eat This Not That, AskMen, and Elite Daily.