Wednesday, May 25, 2022

How Does Ketamine Affect The Brain

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What Ketamine Actually Does To Your Brain

Global connectivity is the term used to refer to the connections both within and outside a brain region. Ketamine may improve depression and other mental disorders by increasing global connectivity in the prefrontal cortex, which will affect the ability of this brain region to coordinate control of other brain regions. For example, a study published in Neuropsychopharmacology states: The ketamine-induced subacute increases in prefrontal connectivity were positively associated with the antidepressant response.

Separate research, published in Frontiers in Psychiatry, highlights that MDD patients and suicidal patients have abnormalities in the connections between the prefrontal cortex and amygdala. The amygdala is responsible for our fear responses and in depression, this brain region is overactive, which likely creates a cognitive bias toward looking at the world and the self in a negative way.

This hyperactive amygdala seems to be the result of reduced connectivity between it and the prefrontal cortex. When this happens, the prefrontal cortex essentially loses control of the amygdala, making it harder for individuals to regulate their emotions, as well as increasing their negative thoughts and emotions.

Ketamine Is An Exceptional Tool In Medicine:

A lot of the detail of how a medication works breaks down when you look too closely how does Propofol work exactly? Or Prozac? Or Crestor? In many cases we dont fully know and in some cases we dont really know at all! The body is vastly complex, and our understanding of its functions and interactions with chemicals and environments is still very minimal in many cases.

About Me, Dr Allison Wells: I started Lone Star Infusion, here in Houston, to provide ketamine infusions for depression, anxiety, PTSD, CRPS and other mood disorders and pain conditions. I am a licensed, board-certified anesthesiologist. I am super passionate about being a partner in helping people feel their best with evidence-based medicine.

An Important Disclaimer: The information in this and other blog posts represents my informed opinion or the opinion of others, and does not constitute medical advice and should not be relied upon to make decisions regarding medical care. To address the specific details of your medical conditions and treatments please speak with your doctors.

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What Is Ketamine Used For

Ketamine was synthesized in the 1960s and immediately found use as an analgesic and anesthesia during minor surgical operations. Germany and Belgium patented the use of this drug as anesthetic in 1963. The U.S. followed suit in 1966, and four years later, the U.S. Food and Drug Administration approved it for use as an anesthetic. In 1985, it was added to the Essential Medicines list by the World Health Organization .

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Rebuilding Your Brain With Ketamine

    Ketamine infusion therapy is a game-changer for people suffering from symptoms of anxiety, depression, PTSD, chronic pain conditions and more, especially for patients who have tried traditional medicine without success.

    If youve heard about ketamine, you already know one of the benefits is how quickly it can relieve symptoms and ease your mind from the cobwebs that keep you down. Most people can feel it working almost instantaneously within three hours of their first treatment. What you might not know is ketamine infusion therapy isnt just a temporary solution.

    Studies show ketamine infusion therapy can trigger regrowth in your brain cells, so you can build your way to freedom from the symptoms that keep you in the shadows.

    Of mice and men

    In a recent study published in CE& N , researchers used ketamine on mice living under chronic stress. In rodents, this type of stress mimics depression. This is what they discovered:

    They found that a dose of ketamine helped first restore electrical activity and then rebuild physical connections between neurons that were lost during stress . The observations suggest ketamine has both immediate and more sustained effects on how neurons function in the brain.

    Obviously, this isnt just happening in mice. Researchers around the world have been testing ketamine in humans with similar results.

    Ketamine enhanced neuroplasticity

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    The Promise Of Ketamine: A New Approach To Depression

    K

    Thats when researchers began asking what would happen if they could target glutamate, the all-important excitatory neurotransmitter that helps turn on the key brain circuits that drive all forms of behavior.

    After studying the effects of altered glutamate neurotransmission in healthy people as well as schizophrenic patients, researchers figured out that a glutamate receptor blocker called ketamine had major psychological effects, inducing psychotic symptoms.

    With the understanding that glutamate plays an important role in mood regulation as well as the regulation of monoamines, researchers began to wonder if lower doses of ketamine could be used to alleviate depression.

    Indeed, they discovered that low-dose ketamine infusions much lower than the amount that produces psychotic symptoms produced a surge of glutamate transmission in the brain that could reduce depressive symptoms quickly and dramatically, usually within a few short hours.

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    The Drug Promotes And Sustains Brain Cell Connectivity In Mice Reversing The Effects Of Chronic Stress

    Ruth Williams

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    Imaging of neurons in the brains of living mice reveals how synapses between cells are eliminated in response to stress and reinstated by an antidepressant dose of ketamine. The findings, which are presented in Science today , show that while ketamine-induced changes in behavior precede this synaptogenesis, the increased connectivity is required to maintain the drug-modified behavior.

    Its beautiful work. Its very elegant and technically sophisticated, says neuroscientist Jason Radley of the University of Iowa who was not involved with the research. I think this paper is poised to make a significant contribution.

    They trace the whole from before stress, after stress, and then after ketamine, says psychiatrist and neuroscientist Alex Kwan of Yale School of Medicine who also did not participate in the research, and they have some very interesting findings in terms of how ketamine affects prefrontal cortical circuits.

    The paper is also quite timely, continues Kwan, explaining that although last month the United States Food and Drug Administration approved esketaminea relative of ketaminefor use as an antidepressant, we still know very little about how works on the brain.

    R.N. Moda-Sava et al., Sustained rescue of prefrontal circuit dysfunction by antidepressant-induced spine formation, Science, 364:eaat8078, 2019.

    Ketamine Rebalances Glutamate & Gaba Levels

    Another role glutamate plays in the brain is producing and balancing Gamma Aminobutyric Acid , a calming neurotransmitter. Overactive glutamate receptor genes can cause an imbalance with GABA resulting in changes in mental health. High levels of glutamate and low GABA can lead to anxiety, for example, while depleted glutamate and GABA can result in depression. Ketamine works to treat this imbalance in three different phases:

    • Phase 1: Rapid EffectsDuring this phase, ketamine activates the brains opiate receptors which can affect symptoms of depression. Patients generally feel relaxed, free from pain and in a sedated like-feeling during this stage.
    • Phase 2: Sustained EffectsIn phase two, glutamate receptors are increased, which helps restore normal levels of glutamate and GABA. At this point, patients generally feel relaxed after treatment. Patients can experience feelings of invulnerability during this time.
    • Phase 3: Return to BaselineAfter the levels are stabilized, the brains reaction to ketamine causes new neural receptors to grow which may reset the depressed brain. Ketamine may be particularly useful for patients whose depression involves suicidal thoughts.

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    Cleaning Up Ketamines Action

    Ketamine is a dirty drug that acts on many receptors withmany side effects, and is thought to be addictive. But the researchers think itmay be possible to find a cleaner, safer antidepressant that acts through theNMDA receptor, and specifically through the 2A subunit.

    Henschs lab is also interested in exploring the potentialusefulness of modulating parvalbumin circuits in psychosis and other conditionsin which these cells are altered. Abnormalities in these cells are believed to playa pivotal role in autism, schizophrenia and other neurodevelopmental disorders.

    Were interested in how these cells develop faster orslower in different diseases, says Hensch.

    The study was funded by the Silvio Conte Center of the National Institute of Mental Health , the University of Tokyo International Research Center for Neurointelligence , the Rett Syndrome Research Trust, Rett syndrome.org, the National Institute of Neurologic Disorders and Stroke , the National Eye Institute , Pfizer, the Nancy Lurie Marks Family Foundation and the Canadian Institute for Advanced Research.

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    Before ketamine was a club drug, it was an anesthesia. Created in the 1960s, it was used for over a decade before physicians realized the duration of its anesthetic properties was shorter and less potent than other options. One of those options was propofol, which is still used in surgeries today.

    In hopes of better understanding ketamineâs Point A to Point B journey, Varley and his colleagues analyzed differences in the brains of macaques when they were on propofol compared to ketamine.

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    How Ketamine Treatment Effects The Human Brain

    HOW KETAMINE FIGHTS DEPRESSION

    Ketamine treatment relieves depression by blocking NMDA, which is a glutamate receptor. Well what is Glutamate? It is a excitatory neurotransmitter. This means that it makes neurons more active and likely to form new connections in the brain. Initially, it was thought that blocking NMDA would make the brain less active and make depression worse. On the contrary, studies have shown that this causes a reaction that strengthens the brain. This was stated by Dr. Nathalie Picard PhD in a recent study.

    Ketamine And Nmda Receptors In Rodents

    A 2017 study conducted by the Columbia University Medical Center verified that ketamine infusions can reduce major depression symptoms in hours compared to the weeks required for prior antidepressants to work. And other research has linked ketamine infusions to blocking N-methyl-D-asparate receptors in the brain.

    A 2018 study conducted by researchers at Zhejiang University in China further expanded on this research by tracking changes in the lateral habenula a very small region of the brain located deep in its center.

    The researchers found that rapid bursts of neuronal activity in the lateral habenula in rodents was directly linked to depressed behavior in the animals. The researchers then confirmed that the neuronal activity was dependent on NMDA receptors which ketamine blocks. The researchers treated the rats with ketamine which quickly reversed the depression symptoms.

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    How Does Ketamine Help Depression

    Ketamine is a rapid-acting medication in the treatment of depression, both in major depressive disorder and in the depressive phase of bipolar disorder. Positive effects of ketamine are often seen within hours of intravenous administration. This makes it very valuable in the treatment of severe depression, and suicidality is also decreased with ketamine treatment. Ketamine has also been shown to be very effective even in those with treatment-resistant depression. This development is important as those who are treatment resistant now have very few viable treatment options.

    Does Medicare Cover Ketamine Infusion For Depression

    Scientists Find The Brain Region That Ketamine Likely ...
    • Medicare prescription drug plans may cover esketamine for depression, but coverage depends on the plan. Medicare does not typically cover IV infusion of ketamine for depression treatment, but other treatment options may be covered.

    Ketamine is known to have some antidepressant properties, and a ketamine oral medication and nasal spray are approved by the Food and Drug Administration for treatment-resistant depression. The generic version of the ketamine-derivative medication and the name brand equivalent are approved for use in conjunction with an oral antidepressant for adults who have unsuccessfully tried other treatments for depression.

    Esketamine is a slightly altered version of ketamine. Because the FDA has only approved ketamine for use as an anesthetic, that means ketamine infusion to treat depression is not technically FDA approved and therefore isnt likely to be covered by Medicare.

    Because esketamine is a separate drug that has been approved for depression treatment, Medicare may cover it for depression in certain circumstances if specific conditions are met.

    You should talk with your doctor about whether Medicare will cover your depression treatment before you undergo esketamine or Spravato treatment. If you have a Medicare Part D prescription drug plan or a Medicare Advantage plan that includes prescription drug coverage, be sure to check with your plan carrier to find out if your plan covers esketamine or Spravato for depression.

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    What Are The Effects Of Taking Ketamine

    Ketamine takes effect within 30 seconds to 20 minutes, depending on how its taken. The effects can last for 45 to 90 minutes.

    Users experience a high in which they may feel happy and relaxed. They may also feel detached from their body . People who take ketamine can have hallucinations. It alters their perception of reality. They can see, hear, smell or taste things that dont exist, or can perceive them differently to how they really are.

    While the high might feel good, there are downsides too. While using ketamine, people can have blurred vision, slurred speech, become physically uncoordinated, sweat, have a raised temperature and heart rate, feel nauseous and vomit.

    When using it, people can:

    • feel disorientated and drowsy

    Find out more about how drugs and alcohol can impact your health, including where to find help and support.

    What Is A Ketamine Infusion For Depression

    Just because ketamine infusion is not FDA-approved for depression doesnt mean it cant be legally performed or effective. Ketamine infusion can be used off-label for depression treatment, meaning the drug itself is FDA-approved but not for the specific treatment its being used for.

    Ketamine infusion has the ability to work faster and treat more severe cases of depression than antidepressant medication are capable of, while also showing fewer side effects. The infusion is administered through an IV in the arm and the effects can last days or even weeks. Patients often receive tapered treatments, meaning they undergo multiple infusions early on before moving on to less frequent sessions.

    There are various clinics that offer ketamine infusion for depression. Because it is not a FDA-approved treatment, most insurances do not cover it and patients generally pay for the service out of pocket.

    Ketamine infusion is also sometimes administered by psychiatrists on an experimental basis for people with severe depression or suicidal thoughts.

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    Regulates Gaba And Glutamate Levels

    Since its gone from a club drug to a treatment for depression, one cant help but wonder: how does ketamine affect the brain? One way ketamine affects the brain is by targeting glutamate receptor genes. Glutamate receptor genes can cause an imbalance in GABA, which regulates nerve cell communication in the brain. Any changes in GABA levels can lead to mental illnesses like depression. GABA levels are most commonly associated with dopamine production and mental illness. Experiencing high levels of GABA can result in depression while experiencing low levels of GABA can cause anxiety.

    What Does Ketamine Do To Your Brain 4 Critical Facts You Need To Know

    How Ketamine Treats Depression

    Much of how ketamine works is a mystery, but the picture is slowly coming into focus.

    Like MDMA before it, ketamine has gone from popular club drug to a potential miracle cure for treatment-resistant depression, but thereâs still a lot we donât understand about it.

    For Thomas Varley, who researches how different consciousness-altering drugs affect the complexity of dynamic brain activity, the mystery lies in how the complex science of ketamine translates into its physical effects.

    âWe know a lot about what is happening at the level of individual neurons and receptors,â Varley tells Inverse, âand we know what kind of mind-altering effects these drugs induce in humans, but how do you get from Point A to Point B?

    âHow do you get from Point A to Point B?â

    âHow is it that a small bundle of carbon interacting with the NMDA receptor results in out-of-body experiences, hallucinations, and other exotic states of consciousness?â

    Understanding what ketamine does in the brain could be vital in not only treating depression but furthering our understanding of other mood disorders. When an estimated 792 million people globally have mental health disorders, understanding how they work â and the mechanism by which certain drugs can alleviate them â is vital for public health.

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    How Does Ketamine Work For Depression

    Thousands have now tried ketamine treatment for major depressive disorder and bipolar depression leaving many people asking, How does ketamine work for depression? Because ketamine is a medication that acts on the brain, understanding how ketamine works is a little complicated and even a little unknown.

    Ketamine And Resistant Depression

    Astonishingly, about 16.1 million American adults are currently suffering from MDD . 66% of these people have tried antidepressant treatment but failed, while 33% do not respond to any treatment mode hence, they remain depressed.

    Interestingly, 60% of these patients who have used ketamine infusions have shown positive responses. Scientists believe this happens because ketamines effect on the brain isnt the same as other antidepressants.

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    Ketamine Works To Quickly Treat Depression

    Ketamine is growing in popularity as a treatment for treatment resistant depression. More research like the studies described above further explain why ketamine works so well for treating depression. And if the scientific evidence isnt enough, more people are sharing their success stories like this one from Thomas who suffered from severe depression, suicidality, and PTSD.

    Ketamine infusions are not a stand alone treatment for depression. Rather, they are an option when other treatments havent worked. And doctors recommend that they be administered in conjunction with other therapies. But, 70% of people whove received ketamine infusions have found relief from their treatment resistant depression.

    Are you curious whether ketamine infusions could help you? Simply schedule a free 15 minute consultation with one of the doctors at Virginia Infusion Therapies in Leesburg, Virginia.

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