Epilepsy Talk
Ketamine — party drug or pain manager? | March 12, 2024
Almost everybody knows about actor Matthew Perry’s tragic death.
But not everybody knows about the ground-breaking benefits of Ketamine.
How it’s helping some people with drug-resistant depression, unrelenting pain, crippling anxiety.
“This has been life-changing for my friend who used to call me all of the time in tears from some emotional drama or another.
I used to have to talk her off a cliff, now we just talk like healthy people.” – Beth, Colorado
The question is: what is your resistance like? What is your threshold?
For some, Ketamine is a psychedelic roller coaster ride. For others, it’s a fast-acting anti psychotic.
The line drawn can be pretty thin.
There’s a good reason why Ketamine remains a controlled substance regulated by the Drug Enforcement Administration and is subject to strict safety controls.
It’s because of its potential for abuse.
For decades, Ketamine was known best as an anesthetic, used in hospitals worldwide.
In the 1990s, it became a popular club drug known by the street name “Special K”.
Now it’s enjoying newfound fame as a revolutionary treatment for depression, anxiety, PTSD, and other mental health conditions.
Ketamine practitioners stress that the drug’s emergence as a mental health treatment is driven by a desperate need.
“Ketamine has been a life saver for me. It is the only medicine that can pull me out of deep, depressive, suicidal despair nearly instantly…Elbarto
How does Ketamine work?
Scientists believe that depression may be due to a connection problem between nerve cells in areas of the brain that regulate mood.
Research suggests that people with long-term depression may have fewer of the synapses that allow these nerve cells to communicate.
Medically supervised Ketamine infusion therapy has been found to reactivate existing connections and to grow new ones, helping the brain to “shake loose” negative thoughts and shift out of depression.
Because the brain has actually been “reshaped,” it may explain why antidepressant medications that didn’t work in the past, may help after Ketamine therapy.
How Ketamine might disrupt chronic pain
Doctors think that constant pain can rewire the nervous system, making it hypersensitive and easily triggered.
This is called centralized pain, or central sensitization, and it can happen in many different kinds of conditions, including arthritis or fibromyalgia.
When this happens, the body starts to make its own pain, in a sense, called neuropathic pain.
“Probably like 15% to maybe 35% of people with arthritis, with neck pain, or back pain, have a very large component of central sensitization, so they have some arthritis, but their pain is much more severe than their X-rays would would suggest,” said Dr. Steven P. Cohen, professor of anesthesiology and critical care medicine at Johns Hopkins School of Medicine.
Ketamine practitioners stress that the drug’s emergence as a mental health treatment is driven by a desperate need.
“If you are feeling hopeless and like nothing is going to work for you, don’t give up. I thought I was out of options but I was wrong. This treatment along with therapy has changed my life. I am very grateful to have found the Ketamine Clinic and want to thank the entire staff for their help...” Mark C.
Depression is the leading cause of disability in the United States for individuals ages 15-44, according to the National Institute of Mental Health, and around 25% of adults experience a diagnosable mental disorder in any given year.
Meanwhile, many insurance plans cover mental health services at lower rates than physical health care, despite laws requiring parity.
Thus, many patients with disorders receive little or no care early on and are desperate by the time they visit a ketamine clinic, said Steven Siegel, chair of psychiatry and the behavioral sciences at the University of Southern California’s Keck School of Medicine.
What forms does Ketamine come in?
- 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.
- Transdermal patches. A gauze-like patch is adhered to your body for extended, long term, relief. Doses vary as do duration of the relief, but it can be an economical and and low maintenance treatment.
What are the possible side effects of Ketamine?
All drugs have side effects. When someone is suicidal or severely depressed, possible benefits may outweigh possible risks.
Ketamine given by infusion may cause:
- High blood pressure
- Nausea and vomiting
- Perceptual disturbances (time appearing to speed up or slow down; colors, textures, and noises that seem especially stimulating; blurry vision)
- Dissociation (sometimes called out-of-body experiences); rarely, a person may feel as if they are looking down on their body, for example.
Generally, any changes in perception or dissociation are most noticeable during the first infusion and end very quickly afterward.
Esketamine nasal spray may cause the same side effects. However, the timing and intensity of those effects is different.
Long-term or frequent use of ketamine may have additional side effects. More research on this is needed.
How much does Ketamine therapy cost? Will insurance pay for it?
Many insurance companies cover mental health services at lower rates than physical health care, despite laws requiring parity.
On average, a single Ketamine infusion costs about $450-$500, said Sandhya Prashad, medical director at Houston Ketamine Therapeutics and president of ASKP3, the society of ketamine physicians.
Six Ketamine infusions over two to three weeks at a psychiatrist’s office, including an in-depth, pretreatment consultation and post-treatment follow-up, can run up to $4,500.
At-home Ketamine businesses typically offer the therapy at a lower price point: Mindbloom, for instance, charges $1,158 for a six-session treatment plan with virtual support; it’s $768 for six follow-ups.
While some people achieve remission after one round of treatment, some others require monthly boosters.
In general, insurance covers Spravato for mental health, but not other forms of Ketamine.
There are some exceptions. Blue Cross Blue Shield of Massachusetts covers Ketamine but requires prior approval and rigorous criteria for use.
In some cases, providers say, insurers that won’t reimburse for Ketamine treatment might cover some of the related services, so it’s worth checking the details of particular plans.
On the other hand, telehealth services like MindBloom and Joyous, which connect potential patients with physicians who can prescribe Ketamine remotely and send it through the mail at charges of $129 a month.
What’s wrong with this picture?
It’s a matter of choice and urgency, I think.
For those who have been down the road for many miles, this may be seen this as a ticket to an unencumbered life, free of pain and depression.
As one former sufferer said: “Ketamine has given me my life back.”
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Resources:
Real Stories of Using Ketamine for Depression, Anxiety, PTSD
https://www.forbes.com/health/mind/ketamine-for-depression/
https://www.healthline.com/health/depression/ketamine-depression-treatment#how-it-works
https://www.uhhospitals.org/blog/articles/2023/03/the-benefits-of-ketamine-therapy-for-depression
https://www.joyous.team/pricing
https://www.cnn.com/2023/12/26/health/chronic-pain-ketamine?cid=ios_app
https://apnews.com/article/ketamine-pain-drugs-psychedelic-fda-2c67eeac1932962a7b0affc07d24c09a.
https://www.drugs.com/comments/ketamine/?page=2
https://www.pharmather.com/ketamine-patch.html
Tags: anxiety, drug-resistant depression, ketamine, mental health, pain, PTSD
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