Ketamine is an FDA-approved anesthetic that has been used safely for decades. However, the more recent discovery of ketamine as a highly effective and rapid-acting treatment for a wide range of mood disorders and neuropathic pain has been hailed as arguably the most significant development in psychiatry in the 21st century. But, what does ketamine do to your brain? In this article, we’ll explore how ketamine works, the changes in perception that can occur when using it, and the biological effects that underlie those changes.
What is Ketamine?
Ketamine is an anesthetic drug that was first developed in the 1960s used to sedate patients during certain medical procedures. Ketamine is an important medicine because it has the ability to sedate patients without the respiratory depressive effects of opiates.
When prescribed medically, ketamine treatment can be administered intravenously (IV), intramuscularly (M), or orally in the form of lozenges and troches. Since 2019, a ketamine-based nasal spray under the brand name Spravato is also available.
Ketamine works by blocking N-methyl-D-aspartate (NMDA) receptors in the brain. NMDA receptors play an essential role in regulating neurons’ excitability and the formation of memories and learning. Additionally, ketamine affects opioid receptors and glutamate receptors, making ketamine infusion therapy much more than an anesthetic medication.
Ketamine affects the brain differently than oral antidepressants, and ketamine has been used as a rapid-acting and highly effective treatment alternative to help treat depression by alleviating treatment-resistant depression symptoms and affecting some of the symptoms of other mental health disorders.
Types of Ketamine Affects and Treatments
There are two main types of ketamine: (S)-ketamine and (R)-ketamine. Both of these compounds interact with various receptors in the brain to produce an array of effects that can help alleviate treatment-resistant depression.
First and foremost, prescription ketamine and Spravato act as NMDA receptor antagonists, blocking the activity of NMDA receptors. Research shows ketamine increases the expression of Brain-Derived Neurotrophic Factor (BDNF). This results in enhanced neuroplasticity, or the ability of brain cells to form new connections with one another.
In patients treated with ketamine therapy, researchers have observed increased synaptic connections. This neuronal growth and increased neuronal interconnectivity have been shown to improve mood and cognition in as little as one hour.
Additionally, ketamine activates the limbic system (associated with memory, emotion, and behavior) and strengthens the interaction between the conscious and subconscious levels of the mind.
In patients treated with ketamine, researchers have observed increased synaptic connections and the growth of neurons. This neuronal growth and increased neuronal interconnectivity improve mood and cognition and allow patients to disengage from their routine thought patterns, heal unhealthy neural pathways and achieve clarity.
Changes in Perception
When someone undergoes ketamine treatment to treat major depressive disorder, they receive a much lower dose than is used for anesthesia. Ketamine is well-tolerated, however, side effects may occur. The most common side effect is dissociation, or temporary changes in perception and cognition. Other side effects can include the following:
• Derealization: Feeling disconnected from one’s environment
• Depersonalization: Feeling disconnected from oneself
• Euphoria: Experiencing feelings of intense pleasure and well-being
• Hallucinations: Seeing, hearing, or feeling things that are not real
• Increased empathy: Feeling more connected to other people
• Memory distortion: Difficulty remembering events or feeling as though memories have been altered
• Time distortion: Feeling as though time is passing more slowly or quickly than normal
Biological Effects of Ketamine
What is happening in the brain to cause these changes in perception? When ketamine blocks NMDA receptors, it increases the activity of gamma-aminobutyric acid (GABA) and glutamate, two neurotransmitters that play a major role in regulating emotion and treating depression or other mood disorders. This increase in GABA and glutamate may be responsible for the dissociative effects of ketamine.
Ketamine effects can also be seen in other brain regions, including the hippocampus, which is involved in emotion and memory formation. It’s thought that ketamine may interfere with the activity of certain brain regions and disrupt their ability to communicate properly. This disruption in communication could explain why users experience changes in their perception and cognition.
In the cerebral cortex alone, the most highly developed part of the brain, there are somewhere between 14 and 16 billion neurons. Neurons communicate with each other via neurotransmitters: chemicals that act as messengers between neurons.
Different neurotransmitters affect neurons in different ways. Glutamate is the most common excitatory neurotransmitter in the brain. It plays a particularly important role in neuroplasticity (the brain’s ability to form new synapses and neural connections over a lifetime), learning, and forming memories.
In addition to the subjective experiences people report when using ketamine, several biological effects occur in the brain. Here are some of the most notable ones:
• Increased glutamate levels: Glutamate is an excitatory neurotransmitter responsible for signaling between neurons. Ketamine increases glutamate levels in the brain, which is thought to be responsible for its dissociative effects.
• Increased dopamine and serotonin release: In addition to increasing glutamate levels, ketamine also increases the release of both dopamine and serotonin. This increase in these neurotransmitters can cause mood, arousal, and cognitive function changes.
• Neurogenesis: Ketamine has also been shown to stimulate the growth of new neurons in the hippocampus, a part of the brain associated with learning and memory. This neurogenesis may be one of the primary reasons why ketamine therapy has been shown to help improve cognitive functioning and benefit those suffering from depression.
What Are the Positive Effects of Ketamine Treatment?
When taken as prescribed, ketamine can provide a range of positive benefits. These include:
• Relief from treatment-resistant depression and anxiety
• Increased creativity
• Improved focus and concentration
• Heightened senses
• Enhanced emotional receptivity
• Pain relief without the side effects associated with opioids
To experience these beneficial effects, it’s important to take ketamine under the supervision of a qualified medical practitioner.
Are There Any Withdrawal Symptoms?
When taken as prescribed, ketamine does not cause any serious withdrawal symptoms. However, if taken in excess or abused for a long period of time, some users may experience mild to moderate withdrawal symptoms, such as anxiety, cravings, insomnia, and lethargy. These effects are usually mild and resolve within a few days.
By using ketamine treatment responsibly, users can experience its positive effects without having to worry about any serious side effects or withdrawal symptoms. However, if you do find yourself in need of help with your mental health issues, please seek professional help as soon as possible.
Who Should Take Ketamine?
The best candidates for receiving ketamine are those with treatment-resistant depression who have not responded to one or more oral antidepressants. Ketamine is also used to treat chronic pain (including fibromyalgia and neuralgia), PTSD, anxiety, and bipolar disorder.
While ketamine can be very effective in treating certain conditions, it is important to remember that it should only be used under the supervision of a qualified medical practitioner.
The Bottom Line
Millions of people struggle with psychiatric disorders, including anxiety, depression, and PTSD, and with chronic pain. Many of these conditions may be treatment-refractory, meaning they are not responding to antidepressants or other therapies. Spravato and other forms of ketamine therapy are safe and effective treatment options, especially for those who have not experienced satisfactory symptom relief from medications and talk therapy, for:
- Depression
- Anxiety
- Acute suicidality
- PTSD
- Chronic pain
Ketamine treatment works differently than oral antidepressants. Plus, ketamine has the ability to go to work rapidly. Symptoms tend to improve within just hours after the first infusion compared to the 6–12 week onset period of conventional medications. At Neuro Wellness Spa, we are dedicated to helping our patients find the best treatments for their mental health needs. Contact us today to learn more about ketamine and to get a referral to a trusted ketamine provider.