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How Ketamine Works


Discover more about how ketamine works.

Ketamine binds to, and thereby inhibits, a receptor in our brain cells called the NMDA receptor, which controls synaptic plasticity and memory function. Inhibition of the NMDA receptor causes anesthetic and antidepressant effects, which was observed when scientists used other compounds to block NMDA receptors as well. However, when researchers used ketamine, they saw that the other NMDA blocking compounds turned off the production of some proteins, but ketamine actually caused the neurons (brain cells) to increase the production of a protein called BDNF (brain derived neurotrophic factor). Also, another difference between ketamine and other NMDA inhibitors is that ketamine only blocks NMDA receptors that are not being used to send a specific signal. Many of these receptors are firing in the background of the brain, and scientists have found a link between mood disorders and this “background noise” that ketamine apparently “resets”.

Why Does Ketamine Work?


See why ketamine is effective.

So why does ketamine work so well? Scientists aren’t actually sure, but a 2010 study published in Science suggests that by blocking proteins called NMDA receptors, the drug prompts the brain to increase the production of synaptic signaling proteins in the prefrontal cortex - a region thought to regulate complex cognitive, emotional, and behavioral functioning.

Ketamine’s medical usage has largely been curtailed because it can also be a drug of abuse. As a street drug it is known as Special K. However, resistance to medical usage is slowly changing, as more and more studies show benefit for illnesses that don’t have many treatment options. IV Ketamine has been most well studied as a treatment for resistant depression. A Washington Post article called ketamine for depression “the most significant advance in mental health in more than half a century.”

IV ketamine is slowly becoming more accepted and available for severe depression. In fact, several academic medical centers, including Yale University, the University of California at San Diego, the Mayo Clinic and the Cleveland Clinic, have begun offering IV ketamine treatments off-label for severe depression.

In one study, more than half of the patients who were treated with IV ketamine reported at least a 50% decrease in their pain levels. But these two studies only looked at immediate reduction of pain.

To assess for long-term benefits, other researchers gave one dose of IV ketamine and then tracked fibromyalgia pain levels after two weeks and then again at eight weeks. At two weeks, some residual pain benefits remained, but these had disappeared by week eight. There may be dosage or timing issues at play here, as extrapolating from research on CRPS sustained pain benefit was seen only after subjects received a series of several IV ketamine infusions over several weeks.

Office Protocol


Learn more about our procedures at the office.

The amount of infusions needed will vary from patient to patient, but generally, the patient will receive 2 or 3 infusions within four days and then 4 additional infusions over the next two weeks.

We have seen a significant decrease in the severity of depressive and anxiety symptoms despite the fact that the patients referred who are basically severe treatment resistant categories.

The first visit the patient is seen by the psychiatrist to assess if ketamine infusion would benefit the patient and the history of psychotropic medications that the patient has tried.

At all times, patients are under the care of the doctor during the treatment process.

Vitals are performed every 10-15 minutes, and a dedicated nurse is with the patient.

Quick Facts About Ketamine

  • Ketamine’s rapid effect is one of the main things that differentiates this treatment from typical antidepressants, such as Zoloft or Paxil, which don't expect their patients to show much improvement for a few weeks.
  • It reduces the need for addictive painkillers.
  • Ketamine helps other sedatives work.

Ketamine in the News

The videos and articles below are recommendeded for learning more about how ketamine can treat severe depression, pain, and many other illnesses and conditions, and how it can be helpful to you.

"Recent data suggest that ketamine, given intravenously, might be the most important breakthrough in antidepressant treatment in decades."
-Thomas Insel, Director, National Institute of Mental Health

For the past 15 years researchers have known that tiny does of ketamine can rapidly relieve depression symptoms when delivered via slow intravenous infusion. The first scholarly paper describing this discovery was published by Yale in 2000. Since then, dozens more studies have been conducted by Yale and other major institutions, including the National Institutes of Health and other places