Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). Ketamine is only legal for medical use in the U.S. and we do not recommend or condone recreational ketamine use. Patients should speak to their doctor if they are considering ketamine therapy.
Ketamine is an anesthetic (pain reliever) with hallucinogenic effects. It was approved by the Food and Drug Administration (FDA) in 1970 as an anesthetic, but there are an increasing number of medical studies on the use of ketamine as a psychotherapy for depression and other mental conditions like PTSD.
But is ketamine actually proven to be effective for relieving depression and other mental conditions? Is the drug unsafe? Does it cause side effects? And how do real users describe its effects?
In this article we’ll answer all of these questions as we review clinical studies on ketamine for depression, anxiety and pain relief. We'll also explain how the drug works, document its side effects and share a video with a real user's experience using ketamine for psychotherapy in a clinical setting.
Is Ketamine Effective for Depression?
A recent clinical trial tested ketamine therapy’s effects on depression, and compared the results with patients taking a popular pharmaceutical antidepressant. The researchers found that one single ketamine infusion was more effective than the pharma drug, and sustained infusions (3x weekly over the course of 2 weeks) provided additional benefit.
59% of depressed patients achieved a significant (greater than 50%) reduction in their symptoms after ketamine infusions. This study was sponsored by a Canadian university so there are no funding bias concerns.
Medical trials as far back as the year 2000 show ketamine to be effective for depression, with the linked study finding a ketamine IV to be significantly more effective in treating depression than placebo.
A meta-study published in the Current Topics in Medicinal Chemistry journal assessed many individual trials on ketamine and depression, and found the therapy to be effective in reducing average depression scores. The reviewers noted that ketamine therapy was especially effective for patients who didn’t respond to pharmaceutical antidepressants.
The study authors of the above-linked review also found that ketamine was more effective for patients with depression and overlapping bipolar disorder compared to major depression alone.
We will conclude that ketamine appears effective for treating major depression when applied in a clinical setting.
Real User Tries Ketamine
The YouTube channel Bustle published a popular video of someone with anxiety using ketamine in a clinical setting. The video documents the preparation that's required, shows what ketamine use in a medical setting looks like and provides an update on whether the drug was effective for relieving the patient's anxiety:
What is Ketamine and How Does it Work?
Ketamine is an antagonist of n-methyl-d-aspartate (NMDA) receptors in the brain, and this is thought to be the main biological process by which it’s effective for depression, as previous research has shown NMDA dysfunction to be associated with depression.
By inhibiting NMDA receptors expressed in GABA neurons, ketamine can block excitatory glutamate signaling in the brain, as documented in medical research.
More recent research has also highlighted several biochemical pathways that may be positively influenced by ketamine. Specifically, ketamine inhibits hyperpolarization-activated cyclic nucleotide gated cationic (HCN1) channels, which may have sedative effects.
The above-linked review also reports that ketamine metabolites can activate mTOR which has effects on prefrontal cortex functioning, but the research is early-stage and the researchers aren’t exactly sure how ketamine influences these channels.
At a high level, what all of this means is that early research suggests that ketamine may have normalizing effects on brain function in depressed patients. Depression caused by specific types of chemical dysfunctions in the brain (such as NMDA receptor activity) seem to be aided by ketamine therapy.
A popular video published by Science Insider explains how ketamine affects the brain with engaging animated graphics:
Ketamine Side Effects
Ketamine is a psychoactive drug, which is why it’s so important that it’s used in a clinical setting, as accurate dosage plays an important role in patient safety.
The most common side effects of ketamine are psychiatric (mental) rather than physical, since it’s a hallucinogenic drug. A 2019 medical review on ketamine for depression documented that "acute psychiatric" side effects were described in 38% of studies, and 72% of studies referenced dissociative side effects.
Heart rate and blood pressure can increase with ketamine use, and headache and dizziness can also be experienced.
Researchers have noted that the safety of short-term ketamine use is well-documented, but long-term safety data is lacking. We hope that in the future more long-term trials emerge testing whether ketamine can be used as a standalone antidepressant for months-to-years.
Does Ketamine Relieve Pain?
Since ketamine was initially approved for pain management, it’s not surprising that there is significant medical data showing its beneficial effects on pain.
A medical review published in the Anesthesia & Analgesia journal assessed previous clinical trials of ketamine for pain, and found that the drug can provide significant short-term pain relief when applied in an IV.
Similar to the research on ketamine for depression, the study authors noted that while the short-term data was strong, there was lacking long-term data on ketamine for chronic pain.
So the current state of the research seems to indicate that ketamine may be effective for acute pain, but there’s not enough data to conclude it’s effective for long-term pain management for conditions like arthritis.
Can Ketamine Treat Anxiety?
Ketamine may be an effective anxiolytic (stress reliever). A placebo-controlled, double-blinded clinical trial from 2020 tested ketamine therapy on patients with treatment-resistant anxiety disorders.
The study found that ketamine was more effective than placebo for anxiety, and that the anxiety improvements after ketamine therapy persisted for up to one week after a single treatment.
Another medical study on ketamine for anxiety found similar results. Patients with treatment resistant anxiety or social anxiety disorder (SAD) were administered weekly injections of ketamine for 3 months. 18 of the 20 patients studied reported significant reductions in anxiety, and “marked improvements in functionality and in their personal lives.”
This study wasn’t placebo-controlled, so the results are weaker than the first one.
Research on ketamine for anxiety is more early-stage than ketamine for depression, but the compound does seem to be effective at least short-term for anxiety. We look forward to longer-term trials.
Is Ketamine Addictive?
According to a medical review in the Brain Research Bulletin, ketamine does have the potential for addiction due to its biological effects. This is somewhat unsurprising given that the drug is used recreationally.
The study notes that while ketamine has the potential for addiction, it also has the proven potential to help treat addiction to other drugs. This is why consulting with a doctor prior to ketamine therapy is so important. The research on ketamine for depression and other mental conditions is still so early-stage that only a medical professional can help a patient determine if ketamine is safe for them.
Given the addictive potential, it may be best for patients with a personal or family history of substance abuse to consider other antidepressants.