Ketamine Hydrochloride, colloquially known as horse tranquilizer, is an unexpected contender for life-saving depression treatment. It was serendipitously discovered in 1962 by Dr. Calvin Lee Stevens. At the time PCP (angel dust) was used for anesthesia, though with less than desirable side effects (i.e. delirium) researchers were hoping to uncover an anesthetic more suitable for human consumption. Ketamine was determined safe for anesthesia in the later 1960s. Additionally, Ketamine is classified as a dissociative hallucinogen, meaning in broad terms, it can produce experiences that are detached or distorted from reality. Ketamine can also induce a trance-like state or create feelings of euphoria.
While the mechanisms that enable Ketamine to work as an antidepressant are still being studied. There are a few key takeaways that have been shown through clinical research. Ketamine can provide antidepressant relief after a single dose for bipolar and treatment-resistant major depression. Repeated Ketamine doses may improve depression symptoms comparable to or even more rapidly than ECT (electroconvulsive therapy). And most notably Ketamine can reduce suicidal ideation, which can be incredible for a long-term patient who has previously not experienced relief through other medication. It has been shown that selective serotonin reuptake inhibitors or SSRIs (commonly prescribed antidepressant pills) have symptom decrease success rates of as low as 30% up to 50% depending on the study. Many Ketamine clinics I have seen show success rates falling between 70% – 90% for patients.
Our very own University of Utah has a clinic for Ketamine treatment at the University Neuropsychiatric Institute (UNI). Unfortunately, Ketamine treatment is not covered by insurance, and clinics like the U or Ketamine SLC can be considered costly by patients in need of treatment – around $300 per infusion. The recommended therapeutic plan also varies by the clinic but is usually substantiated by 6 – 10 doses for the first round, with subsequent follow-up doses if necessary. Most importantly, these clinics aim to release patients, not wanting them to be reliant on Ketamine for the rest of their life.
Tragically there are many misconceptions surrounding psychedelics, from stereotypes about club drugs and hippies to being dangerous to society because patients are getting “high”. I would like to refute these claims as harmful and completely misleading. Any substance can be abused, and oppressive government seeks to criminalize behavior exhibited by people who would not support their policies. The drug war and research ban have stolen the ability to lead meaningful lives for many potential Ketamine candidates. While these stigmas remain, insurance will continue to not cover the treatment. However, its recent legal status is still a huge win for everyone, myself included.
Personally, I have referred several close people in my life to Ketamine treatment. All have had successful results. I am often their “trip-sitter” sitting with them as a familiar face or shoulder to cry on when they come out of their infusion. From my own experience with psychedelics and watching my loved ones, if you are considering Ketamine, allow me to share my wisdom with you. It is impossible to explain what to expect Ketamine to feel like without an understanding of other psychedelics. But to make an attempt: Ketamine will take you out of your current headspace and transport you to a new one. Previously stressful or concerning things will melt away. Your sense of identity will change. You will not be the you that you normally are. You will process emotions and thoughts in new ways perhaps healing from or resolving issues if they come to mind. You could see things, hear things, or have tactile hallucinations. I would also strongly suggest listening to music that is pleasant and that contains few words as language can fall apart at higher doses and trying to understand lyrics might become disorienting. After your experience, you will feel a bit groggy and out of it for quite some time. Due to the altered state of mind you have just left, you may forget the specific details of what you experienced, possibly to have them replaced by vague feelings or emotions.
Ultimately your takeaway after an infusion should be “I feel great right now, what changes can I make in my life to continue this feeling?”. Not in a chase-the-dragon way, but rather as an act of self-love. Where have you been too harsh on yourself? What anger is keeping you from happiness? Where do you need to step out of your comfort zone to change your life for the better? Do you have a greater purpose that you should be chasing? I think that Ketamine has the potential to be increasingly viable as an option for treating depression, the only thing that stands in its way is the stigma surrounding psychedelics.