The Story of Ketamine
Ketamine began its journey as an anesthetic for animals in the 1960s. Later in 1970, the Food and Drug Administration validated its usage on people as an anesthetic. It made its way through the battlefields of the Vietnam War for the treatment of injured soldiers.
It was not much later that some medical practitioners started to use ketamine doses on people with suicidal intentions at their peak. It gave them peace of mind and made their extreme suicidal thoughts go away in a poof! Not just that, people also witnessed the absence of sadness and depression for a considerably long period after the usage.
This was when the medical professionals identified ketamine’s effect on depressive disorders. Ketamine brought dissociative experience to the patients, which significantly impacted their mood, thoughts, and behavioral patterns.
Ketamine worked completely distinctive from other anti-depressive drugs. Conventional drugs like valium had an impact on the person until its effect lasted in their system. Once it goes away, it’s the same old story! And with valium, the aftermath gets people into rebound anxiety, which makes it even worse. But ketamine facilitates reactions in the brain which allows connections to rebuild their paths. Therefore, with Ketamine, it’s the reaction and not how long it stays in the body.
Antidepressants and Depression
Depression and its cause seemed too elusive to many. Researchers found it too challenging to decipher the symptoms and relate them back to their origin. But that didn’t stop them from researching medications to cure or control depressive disorder.
In their expedition to find antidepressants, they stumbled upon several hypotheses through experiments. One such well-known hypothesis was the serotonin hypothesis. It came out accidentally as they identified certain drugs that brought down serotonin neurotransmitter levels in the brain. These drugs were given to patients for the treatment of tuberculosis and hypertension. The lowered serotonin levels had a radical impact on people’s moods, as in they experienced depressive symptoms. While, increased serotonin levels resulted in euphoric experiences, especially in depressed patients.
Selective serotonin reuptake inhibitors (SSRIs), a novel category of antidepressant medications, were introduced as a result of this finding. Prozac was the first medication created for the general population.
However, in later research, it was evident that serotonin hypotheses could not fully account for depression. This was elaborated with the understanding that the serotonin neurotransmitters only make up 20% or less of the brain’s neurotransmitters. Neurotransmitters identified as GABA and glutamate compose the remaining 80%.
These neurotransmitters are believed to have a major role in synchronizing most of the brain functions, even the person’s mood. GABA and glutamate neurotransmitters bring about fluctuating electrical signals within the brain through a complicated push-and-pull activity. These neurotransmitters are also found to significantly impact schizophrenia and seizures.
A person with severe stress or depression could have an altered glutamate response that in turn affects the neurons, making them less capable to adapt and interact with other neurons.
This suggests that anxiety and sorrow themselves make it tougher to deal with adverse situations, creating a vicious cycle that makes things even harder for people already dealing with stressful events.
Ketamine as Antidepressant: What to Expect?
The anesthetic drug Ketamine was proven to accelerate glutamate production after an intricate series of neural activities that generate new pathways. This allows the neurons in the brain to become more adaptable and be more interactive with other neurons to produce new neural connections, enabling the patients to inculcate more optimistic thoughts and engage in good behavioral patterns.
Ketamine drug came out with ground-breaking research discoveries that made it look more like a part of neuroscience that helps to target specific neurotransmitters like glutamate in the brain of people with severe depression.
After these mind-blowing discoveries and understanding of Ketamine, researchers went ahead to experiment with it on patients in authorized settings. The sub-anesthetic dose of ketamine was introduced to the patient’s system. The conclusions of the experiment have been phenomenal. After just 24 hours, more than half of these patients showcased a significant improvement in their depression symptoms. These patients experienced no appreciable improvement while taking alternative antidepressants.
The rapid results with ketamine can be bolstered through ongoing ketamine treatments under standard depression treatment plans. Ketamine also incapacitates the ability to induce strength against the reappearance of depression.
Why did Esketamine Enter the Scene?
The FDA eventually approved ketamine as an antidepressant in 2019. However, ketamine being readily available wasn’t a good call. Under recreational spaces, ketamine as a drug had the same effects as in LSD, PCP, and such.
Esketamine is a nasal spray drug that constitutes half of the ketamine anesthetic composition. Esketamine comes in super-handy to treat people with Treatment-Resistant depression. This version of ketamine wouldn’t have any damage if it is quickly available. Having said that, mental health professionals do not incorporate Esketamine as soon as a depressive patient walks in their door. They only prescribe Esketamine if the standard depression treatments didn’t have any effect on them.
The chemical composition of Esketamine contains more tightly bound glutamate receptors, making it even more effective when compared to the anesthetic version. This implies that only smaller doses of Esketamine will do the job. Being more chemically potent, it can be made more accessible to patients in an outpatient clinic. The nasal spray version of Ketamine is no threat when it comes to its availability.
However, like any novel medication, Esketamine has its own downfalls (side effects). Some patients witnessed a rise in their blood pressure, while some felt dizzy post their Esketamine dose. In addition, there are still chances for this drug to go abused, in case it ends up with a bad crew.
Moreover, Esketamine isn’t the first treatment option for severe depression. If a patient hasn’t responded well to at least 2 anti-depressants, mental and behavioral health practitioners prescribe Esketamine as their final option for treatment.
Depression is a serious disorder that has brought people to the verge of some serious life decisions. Some face anxiety and depression on a daily basis while some never notice the symptoms until really late. It’s time to come forward and put an end to the never-ending loop of mental illness by joining together for its recovery.
The trajectory toward recovery from depression isn’t likely to arrive anytime soon. However, we could build our arsenal against depression and ensure our mental sustenance. At the end of the day, the way we strive would impact some lives and cultivate new levels of hope in people.