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Ketamine Nasal Spray For Fast-Acting Depression Relief

Ketamine is a drug that is used to induce sedation in humans in a controlled environment. It is also used recreationally and is referred to as “Special K.” Ketamine is an NMDA antagonist that functions as a sedative, analgesic, and has therapeutic properties when used with an anesthetic. In regards to recreational usage, Ketamine has been used as a dissociative – meaning people can end up hallucinating and having out-of-body experiences. Recently, researchers have found that intranasal Ketamine spray is highly effective at treating symptoms of treatment resistant depression.

Where have we seen another NMDA receptor antagonist at play in depression? Oh yeah I wrote an article about Lanicemine for depression. Seems as though this medication was almost identical to Ketamine except the dissociative properties were stripped. The whole idea behind Lanicemine was to be used in cases of treatment resistant depression without having the major drawbacks of being labeled a dissociative substance.

Study 2014: Ketamine Nasal Spray for Major Depression

A study was recently conducted that included 20 patients that had been diagnosed with major depression. Intranasal ketamine hydrochloride was used on some of the patients, while a placebo “saline solution” (e.g. salt water) was given to other patients. This was a double blind, randomized, crossover study. Researchers measured the outcome by checking for changes in severity of depression every 24 hours using the Montgomery-Asberg Depression Rating Scale. A secondary outcome was graded based on persistence of benefit and self-report changes in depression.

Researchers also took into account the fact that Ketamine could result in dissociation or other adverse effects. All adverse effects were taken into account and measured based on symptoms and severity. As a whole patients showed major improvements in depressive symptoms within 24 hours of their first intranasal administration. A modest 8 out of 18 patients experienced an antidepressant effect from Ketamine in comparison to just 1 out of 18 following the saline “placebo.”

There were no major reports of adverse effects from the ketamine exposure. Apparently this was the first controlled study that showed how rapid the effect of ketamine can be via intranasal spray for depression. It boggles me to even think that an illicit drug wouldn’t improve depression quickly… That’s why they are illicit drugs – they make people feel good immediately, but over the long term, can lead to addiction / dependency and other psychological problems.

  • Source: http://www.biologicalpsychiatryjournal.com/article/S0006-3223(14)00227-3/abstract

Should you use Ketamine for depression? What this study means.

All that this study means is that researchers found another illicit drug that works to alleviate depression in a very small sample (just 20 people) over the short-term. I’m sure this same study could be conducted with other illicit substances and people would report improvements in mood with relatively few side effects if given at a normal dose. There’s no reason to think that this is a major breakthrough – researchers have been looking into this drug for years.

Unfortunately, this study has an extremely small sample size and cannot be generalized to the entire population. Although ketamine is effective at alleviating symptoms of major depression, so are many other things. My guess is that if you gave someone with major depression an Adderall, Ecstasy, Suboxone, Marijuana, or Psilocybin they would experience rapid depression relief as well.

If you are behind the times, AstraZeneca already developed the medication “Lanicemine” which has similar effects to Ketamine (NMDA antagonist) minus the dissociative properties. Unfortunately development for this medication stopped and no one really understands why. It seemed to be a promising new medication, but is no longer being produced… Go figure – something that works being halted after showing promise.

We also do not know whether ketamine is safe to use over the long term. What are the long term psychological effects of intranasal ketamine? There is some evidence that it may contribute to increased depression. It may also cause hallucinations if abused and/or out of body, dissociative experiences. What is going to prevent individuals from abusing this medication? In high doses it can also lead to respiratory problems.

Is dependency a concern? Absolutely. With any illicit drug, dependency is a major concern.  People that use Ketamine have been found to exhibit “cravings” for the drug.  I am all for individuals with major depression getting relief from symptoms. However, I am also for individuals with major depression getting treatment that will do more good than harm over the long term.

Since research for depression is advancing at a seemingly “snail’s pace” any breakthrough for treatment and/or management of depression symptoms, even with an illicit drug like ketamine, should be viewed as progress in the right direction.

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{ 9 comments… add one }
  • Sarah September 5, 2014, 2:23 am

    I’ve taken standard antidepressants for 15 years with very little benefit after the first seven or so. During a clinical trial receiving ketamine infusions at MGH about a month ago, I was definitely “tripping” during the infusions but only then. I was able to work (LSAT tutor) even the afternoon after a morning infusion. I felt better for three weeks than I had in many years. By contrast, since you mentioned it, adderall doesn’t help with the depression at all. Just thought I’d share.

    • GLOOM September 5, 2014, 1:33 pm

      Glad to hear that Ketamine worked for you… The preliminary research suggests that it’s very effective. How long did the antidepressant effect last after receiving the infusions?

  • Brian Carrall November 29, 2014, 4:27 am

    I have proved to be highly resistant to all anti-depressants & ECT. I’ve had 1 injection of Ketamine & my depression ( 7 years ) disappeared after 3-4 days for about 9 weeks. Why can’t I get this drug in Australia under medical supervision of my GP. My life has nil joy without it. Please. please legalise this drug for use under MP supervision before I end it all. I now live with daily thoughts of Suicide. Can anyone help me. ??

    • howard malan March 5, 2016, 4:10 pm

      After reading Dr. Steven Hyde’s book, KETAMINE for DEPRESSION, I assumed it was rather common in Australia. He practices in Launceston, Tasmania and uses a low-dose sublingual protocol.

  • Gregory Scott April 10, 2015, 2:27 am

    It’s odd that this article repeatedly refers to Ketamine as an ‘illicit’ drug, when it is no such thing. It’s a controlled substance, legal under certain conditions, illegal under others. The assertion that the study’s participants would have experienced similar outcomes if administered with [random drug Z] is completely baseless. The positive outcome here was not simply to “alleviate depression”, it was to achieve unprecedented reduction in depressive symptoms in cases that were completely resistant to every other known form of therapy, chemical or otherwise.

    Of course the sample is too small to generalize; of course this drug has potential downsides. Caution and ethical approaches are always warranted with drug research, it’s a given. But AFAICT, a sizable portion of the population is perpetually addicted to SSRI’s, Ambien, benzo’s and hosts of other drugs, none of which actually remedy the underlying conditions.

    Bone up on Ketamine’s effects in PTSD, alcoholism, and CBT regimes; it seems to literally allow for a ‘re-wiring’ of otherwise recalcitrant and entrenched neural pathways, thus breaking mental and physical habits and patterns in ways that endure long after the drug ceases to be administered. That, to my thinking, is infinitely more preferable to drugs which simply suppress symptoms for a half-life’s spell.

  • L DeMarcus August 9, 2015, 11:05 pm

    Ketamine is a life saver for both pain ( instant relief ) of intense pain and four days later it cured a depression that has been in me for 35 years. I find that amazing. Its just that every month my prescription of it runs out two weeks early. I don’t know if its because it is intranasal or what. Someone said that it does not work the same each day?

    I can relate to that. And the facts that unless someone mixed it up knew what they were doing you could be wasting your time. Also, someone said that it would be better to use intranasal in a IM way and not in an IV situation. Does anyone have any input on that. Does anything need to be done to the nasal spray to prep in for an IM injection? Any input would be appreciated. Thanks a lot.

    • Jessica August 9, 2016, 5:50 am

      DeMarcus were you a patient under ketamine therapy? What is the nasal spray called? I’ve long known of the rewiring effects of ketamine as well as its amazing ease of pain in CRPS patients. I was diagnosed with the aforementioned and also have severe depression. I am seeing my doctors soon and would be grateful to know the name so I can ask for a possible prescription. I have been prescribed ketamine troches but my neurosurgeon prescribed them.
      Please help. Thank you.

  • Marky Mark August 28, 2015, 7:22 am

    I think that, given what is presently known about Ketamine and in terms of its potential use for treatment of mood disorders, there is probably a legitimate place for it, with regard to this treatment target, but I would assert that any legitimate medical or psychiatric use of Ketamine would need to be done under fairly tightly controlled conditions, as well as after additional focused research has been conducted on the drug, for this type of use.

    The potential for abuse, misuse, diversion, addiction, and harm to users (up to and including death, dismemberment, or other types of permanent harm) are well-known. However, I think that there is potential to design a legitimate strategy or strategies for use of Ketamine to treat mood disorders, through which the overall benefits of the treatment could outweigh the negative aspects, but as said above, it would need to be done in a judicious manner.

    Further, focused research could potentially elucidate an effective, evidence-based method or methods, by which Ketamine could become a boon for the treatment of mood disorders and for certain subsets of the groups of individuals suffering from them. It would be a shame if fear or other stigma of the drug were to prevent the realization of its potential benefits for those individuals who might otherwise not have much hope in finding an avenue for improvement of a highly treatment-refractory condition, as various mood disorders are, in reality, for a subset of individuals who suffer from them.

  • Nick Earl June 14, 2016, 4:41 am

    Very interesting article, I’m going to do more research on this particular treatment. I believe that we need a new paradigm in the treatment of depression, and this view that SSRIs are always effective needs to be updated.

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