What is Ketamine Treatment for Depression?
Ketamine is an anesthetic medication that has been used for many years. In the early 2000s it was found to be helpful for treating depression, especially in individuals who had not responded to antidepressant medication or psychotherapy. it is administered in Dr. Hubbard's office either as an intramuscular injection (IM) or as a nasal spray. Ketamine administrations take place only in our San Diego office and are medically monitored by Dr. Hubbard the entire time.
Ketamine can work rapidly, with improvements in depression seen within hours. A ketamine session typically lasts 90 minutes in a comfortable office setting, with time spent administering the ketamine, following up with Dr. Hubbard on drug effects or other prescriptions, and in some cases participating in psychotherapy with our on-site psychologist.
Ketamine, like many molecules, is actually made up of a 50:50 mixture of left and right hand versions of the molecule (AKA enantiomers). These different orientations of the molecule can have subtly different pharmacological effects on the body. In this case esketamine (S-ketamine), the right handed version of the ketamine molecule, is the far more potent of the two; the other being called arketamine (R-ketamine), the left handed version. Esketamine is the purified from of the right-handed version of ketamine (S-ketamine) and so provides the best form of the ketamine for depression treatment.
Esketamine is currently only available as a nasal spray, and is approved by the FDA for the treatment of depression under a strict protocol. The FDA requires patients receiving Esketamine to be monitored for two hours. Dr. Hubbard is certified to provide treatment both with Ketamine or Esketamine.
Is Ketamine Safe?
Ketamine as an anesthetic is extremely safe, with more than fifty years of use. It is often given to children in emergency rooms who have sustained injuries such as broken bones. It is even safer when used for depression, as it is given in much lower doses. Most patients remain conscious the entire time, although they will likely feel somewhat altered (“dissociated”) and experience perceptual changes.
Am I a Good Candidate for Ketamine?
Prior to initiating ketamine treatments, you will be scheduled for an initial psychiatric evaluation. On this first meeting, we will determine a diagnosis, develop a treatment plan, and assess for any medical or psychiatric issues that may interfere with ketamine treatment. We may also discuss other treatment options that don’t involve ketamine, such as other antidepressant medications, psychotherapy or transcranial magnetic stimulation (TMS). With Dr. Hubbard, you can make the best choice for your individual needs.