Ketamine and Anxiety

January 30, 2023 | Zora Neuro Spa | Informational

Introduction

Ever wonder how ketamine therapy might flip the script on persistent negative thought patterns? It’s all about the brain’s adaptability, folks! Glutamate isn’t just another chemical messenger; it’s the star player in mood regulation, memory, and learning. Imagine it as your brain’s personal trainer, pushing the boundaries of neuroplasticity to help you form fresh, positive pathways. We’ll dive into the fascinating mechanics of how ketamine can potentially “re-wire” your brain. Therefore offering a beacon of hope for those grappling with anxiety. Get ready to explore the transformative powers of this intriguing treatment!

What is Ketamine?

Ketamine is a novel drug that has been gaining attention in the treatment of anxiety disorders. It is an NMDA receptor antagonist, meaning it blocks the action of the a chemical in the brain called glutamate. Glutamate is often found to be elevated in anxiety disorders. It has shown results as a rapid-acting antidepressant and has significant effects on decreasing anxiety.

One of the main benefits of ketamine in treating anxiety disorders is its rapid onset of action. Unlike traditional antidepressants, which can take weeks or months to take effect, ketamine’s effects can be felt within minutes of administration. This is especially beneficial for those experiencing severe anxiety. It can provide fast relief from symptoms that can be long lasting.

Ketamine has also been found to be effective in treating anxiety disorders that are resistant to traditional treatments. This is due to its anti-inflammatory, anti-depressant, and anxiolytic effects. Because it works in multiple ways, ketamine can provide relief from symptoms of anxiety disorders that may not be alleviated by traditional treatments.

Ketamine Administration

Ketamine can be administered in numerous ways to help with anxiety.

IV Ketamine Infusions: The Fast Track to Relief

One of the most talked-about methods is IV ketamine infusions. It’s a direct and efficient way to deliver ketamine treatment, with many patients reporting rapid improvements. However, it’s essential to note that this is a procedure you’ll only find in a hospital or specialized clinic setting. And for good reason—it requires careful monitoring by medical professionals.

Intramuscular (IM) Shots: A Quick Jab for Long-Lasting Effects

Intramuscular shots are another option for those seeking ketamine treatment. These injections are administered into a large muscle. This delivers the drug into your system quickly, though not as rapidly as the IV route. It’s a bit like getting a vaccine, except the potential benefits extend far beyond preventing a seasonal flu. Like IV infusions, IM shots are performed in a clinical setting to ensure safety and efficacy.

Sublingual Troches: Ketamine at Home

For those who prefer the comfort of their own home, sublingual troches offer a way to self-administer ketamine treatment. It’s a less invasive method—just place a tablet under your tongue and let it dissolve. However, it’s worth noting that this form is slower to take effect and isn’t considered as potent. It is typically used after a course of IV Ketamine to prolong time between treatments. At low doses it can also be used in therapy to help process trauma.

Nasal Spray: A Breath of Fresh Air for Treatment

Last but not least, there’s the nasal spray form of ketamine, known as Spravato (esketamine). This method requires administration in a controlled environment, such as a hospital or doctor’s office. Medical staff can then monitor for any adverse reactions. It’s used once or twice a week initially, then less frequently during the maintenance phase. It’s usually paired with traditional anti-anxiety medication for a more comprehensive approach.

So, why are IV infusions, intramuscular shots, and nasal sprays considered the most effective forms of ketamine therapy? It all comes down to absorption. These methods allow for a significant amount of the drug to enter the bloodstream quickly. This leads to more immediate and noticeable effects.

Does Ketamine work in Treating Anxiety

Ketamine has been making waves in the world of psychology for its potential in treating various forms of anxiety. But just how effective is ketamine in battling the blues and calming the storms of anxiety? Let’s dive into the current research and understand the role of ketamine infusion in mental health care.

Understanding Anxiety and Its Impact

Anxiety can be crippling, and it’s no stranger to many of us. From the tightness in your chest before a public speech to the constant worry about everyday tasks, anxiety can manifest in many forms. These aren’t just temporary jitters; they’re persistent feelings that can severely impact one’s quality of life. So, where does ketamine come into the picture?

Ketamine Therapy and Anxiety: A Glimmer of Hope?

In the quest for effective treatment options, ketamine has emerged as a potential ally. A 2022 review in Wiley, a peer-reviewed journal, highlighted that single-dose ketamine infusions could reduce panic, irritability, and other anxiety symptoms in individuals with GAD and social anxiety disorder (1). Notably, higher doses of ketamine were more potent than lower doses, with the anxiety-reducing effects lasting up to two weeks.

A small 2017 study took this a step further, finding that 83% of participants with GAD and social anxiety disorder reported reduced anxiety symptoms within just one hour of receiving subcutaneous ketamine treatments (2). Yes, you read that right – just one hour!

Let’s delve into some intriguing research that highlights the potential of ketamine therapy for anxiety disorders. A small-scale study involving 12 patients with either GAD or SAD tested three different doses of ketamine against midazolam, a medication typically used for its sedative effects. Administered at one-week intervals, ketamine not only improved scores on the Fear Questionnaire but also mirrored the effects of traditional anxiolytics by reducing theta frequency in the right frontal sites, as measured by electroencephalogram (EEG) (4).

What about long term? Does it keep working?

The research didn’t stop there. A follow-up study evaluated the long-term effects of maintenance ketamine therapy in 20 patients with GAD and/or SAD. These participants weren’t currently experiencing depression, which is an important distinction as depression can often co-occur with anxiety disorders. Increasing single-dose at weekly intervals, patients reported a significant reduction in anxiety within just one hour of dosing. This reduction in anxiety symptoms persisted for up to seven days, suggesting a potentially transformative impact on the lives of those with chronic anxiety. The findings were encouraging: 18 out of the 20 patients reported sustained improvements in social and work functioning during the maintenance phase. The researchers proposed that maintenance therapy with ketamine might be a viable alternative for patients who haven’t found relief from traditional treatments for GAD and SAD (3).

Ketamine Therapy’s Broader Anxiety and Phobia Applications

Beyond GAD and social anxiety, ketamine has shown potential in treating specific phobias. A 2021 study revealed that participants experienced lower levels of agoraphobia after receiving subcutaneous ketamine injections. This suggests that ketamine could help alleviate the intense fear associated with certain places or situations (5).

IV Ketamine and OCD

Obsessive-compulsive disorder (OCD) is another area where ketamine infusion has been researched. A 2013 study involving participants with almost constant obsessive thoughts showed promising results. After receiving ketamine, participants reported a significant improvement in obsessive thoughts, with the effects lasting for more than a week for some (6).

Conclusion

While the research is still in its early stages, and most studies involve small sample sizes, the evidence pointing to ketamine’s effectiveness in treating anxiety and related disorders is hard to ignore. Ketamine therapy, particularly through infusion, appears to offer rapid relief for some individuals struggling with anxiety, depression, and OCD.

However, it’s crucial to approach this treatment option with caution and under the guidance of a medical professional. Ketamine therapy is not a one-size-fits-all solution, and its long-term effects are still being studied. If you or someone you know is considering ketamine for anxiety, it’s essential to consult with a healthcare provider to discuss the potential risks and benefits.

As we continue to explore and understand the capabilities of ketamine in treating mental health conditions, it’s clear that this once-overlooked medication may hold the key to unlocking new doors in anxiety treatment. With further research and careful application, ketamine therapy could become a game-changer in the world of mental health.

As we continue to explore the frontiers of mental health treatment, the role of ketamine therapy in managing anxiety disorders remains a beacon of hope. For those who have struggled to find effective treatment, the future of anxiety management could lie in the further research and development of this unconventional therapy.

References

Tully JL, Dahlén AD, Haggarty CJ, Schiöth HB, Brooks S. Ketamine treatment for refractory anxiety: A systematic review. Br J Clin Pharmacol. 2022; 88(10): 4412-4426. doi:10.1111/bcp.15374
Glue P, Medlicott NJ, Harland S, et al. Ketamine’s dose-related effects on anxiety symptoms in patients with treatment refractory anxiety disorders. J Psychopharmacol. 2017;31(10):1302-1305.
Glue P, Neehoff SM, Medlicott NJ, Gray A, Kibby G, McNaughton N. Safety and efficacy of maintenance ketamine treatment in patients with treatment-refractory generalised anxiety and social anxiety disorders. J Psychopharmacol. 2018;32(6):663-667.
Shadli SM, Kawe T, Martin D, McNaughton N, Neehoff S, Glue P. Ketamine effects on EEG during therapy of treatment-resistant generalized anxiety and social anxiety [published online April 24,2018]. Int J Neuropsychopharmacology. doi:10.1093/ijnp/pyy032
Truppman Lattie, D., Nehoff, H., Neehoff, S., Gray, A., & Glue, P. (2021). Anxiolytic effects of acute and maintenance ketamine, as assessed by the Fear Questionnaire subscales and the Spielberger State Anxiety Rating Scale. Journal of psychopharmacology (Oxford, England), 35(2), 137–141. https://doi.org/10.1177/0269881120953991
Rodriguez, C., Kegeles, L., Levinson, A. et al. Randomized Controlled Crossover Trial of Ketamine in Obsessive-Compulsive Disorder: Proof-of-Concept. Neuropsychopharmacol 38, 2475–2483 (2013). https://doi.org/10.1038/npp.2013.150