Ketamine is an FDA-approved anesthetic that has been used safely for decades. In recent years, ketamine’s fast acting antidepressant effects have emerged as a major breakthrough in the treatment of mood disorders, particularly among individuals with treatment-resistant depression (TRD) and certain chronic pain conditions. But, what does ketamine do to your brain?
Here’s an exploration of 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 first developed in the 1960s to safely sedate patients during certain medical procedures. It was considered a breakthrough medication because it could induce anesthesia and pain relief without causing the suppressed breathing associated with many opioids of the time. When prescribed medically, ketamine treatment can be administered intravenously (IV), intramuscularly (IM), orally in the form of lozenges and troches, or as Esketamine — a ketamine-based nasal spray under the brand name Spravato.
Ketamine works differently from traditional oral antidepressants — it blocks N-methyl-D-aspartate (NMDA) receptors in the brain, which play an essential role in regulating neurons’ excitability and the formation of memories and learning. It also influences opioid and glutamate receptors, making ketamine infusion therapy much more than an anesthetic medication. It has shown to be a rapid-acting and effective treatment alternative for TRD and to help alleviate symptoms of various other mental health disorders.
Related: Yes, There Are FDA-Approved Ways To Treat Depression Without a Pill
Understanding the Effects of Ketamine
There are two main types of ketamine: (S)-ketamine and (R)-ketamine. Both compounds interact with various receptors in the brain, producing an array of effects that can help alleviate TRD. For example, prescription ketamine and Spravato act as NMDA receptor antagonists, blocking the activity of NMDA receptors.
Studies show that ketamine increases the expression of Brain-Derived Neurotrophic Factor (BDNF) to enhance neuroplasticity — the ability of brain cells to form new connections with one another. Researchers have also observed increased synaptic connections, and this neuronal growth and enhanced interconnectivity have been shown to improve mood and cognition, and can help patients disengage from habitual thought patterns in as little as one hour. Another mechanism of action is that ketamine activates the limbic system, which is associated with memory, emotion, and behavior, strengthening the interaction between the conscious and subconscious levels of the mind.
Changes in perception
When someone undergoes ketamine treatment to treat major depressive disorder (MDD), they receive a much lower dose than what is administered for anesthesia. Although ketamine is typically well-tolerated, side effects may occur, including:
- Dissociation: The most common side effect, characterized by temporary changes in perception and cognition.
- Derealization: Feeling disconnected from one’s environment.
- Depersonalization: Feeling disconnected from oneself.
- Euphoria: Experiencing intense feelings of 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.
These effects are typically short-lived and dissipate as the drug is metabolized.
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 also be responsible for ketamine’s dissociative effects.
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 properly communicate. 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 — as well as in learning and memory formation.
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, which is thought to contribute to 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 can cause changes in 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 a key reasons why ketamine therapy has been shown to help improve cognitive functioning and help those overcome depression.
What are the positive effects of ketamine treatment?
When ketamine is taken as prescribed, it can provide a range of positive benefits. These include:
- Relief from depression, TRD, 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 mental health professional.
Related: Spravato FAQ
Does Ketamine Come With Any Withdrawal Symptoms?
When taken as prescribed, ketamine does not cause any serious withdrawal symptoms. However, if taken in excess or misused 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 misusing prescribed ketamine, please seek professional help such as an addiction therapist as soon as possible.
Related: Is Spravato Addictive?
Who Should Take Ketamine?
The best candidates for receiving ketamine are those with TRD who have not achieved adequate response after multiple trials of standard antidepressants. Ketamine is also used to treat chronic pain — including fibromyalgia and neuralgia) — post-traumatic stress disorder (PTSD), certain anxiety disorders, 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.
Related: Holistic Treatments for Depression
How Neuro Wellness Spa Can Treat Mental Health Conditions With Innovative Approaches
Millions of people struggle with psychiatric disorders, and 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. Additionally, ketamine begins to act rapidly, with effects typically beginning within seconds to minutes after administration. Symptoms tend to improve within just hours after the first infusion compared to the 6 to 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.