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Doctors primarily use ketamine as a general anesthetic for medical procedures during which a person must be unconscious, but muscle relaxation is not required. Ketamine is also a dissociative medication, and researchers have been exploring the use of sub-anesthetic dosages of ketamine for treating depression for some time.
Researchers at the University of Exeter in the United Kingdom have reported that an analysis of existing studies confirms that ketamine therapy offers fast-acting, short-term relief from depression and, to some extent, suicidal thoughts and other mental health symptoms.
The meta-analysis of 83 existing studies has assessed the value of ketamine therapy for treating a wide range of mental health conditions. These studies include 29 randomized controlled trials, 21 observational studies, and 33 systematic reviews/. The study features in the British Journal of Psychiatry Open. The team carried it out in collaboration with the University of British Columbia and with support from the Society for the Study of Addiction.
The strongest effect that the studies document is the value of intravenous ketamine therapy for relieving depression.
A reduction in unipolar depression severity occurred within anywhere from 1 to 24 hours, and it lasted for 1–2 weeks. In comparison, oral doses took up to 2 weeks to have an effect.
Bipolar depression relief was also rapid, occurring as quickly as 4 hours after administration and consistently by 24 hours. The full effect lasted for up to 3 days, with some relief still apparent after 7 days.
The studies also support the use of ketamine for treating affective disorders and thoughts of suicide.
Of suicidal ideation, co-author and University of Exeter Ph.D. candidate Ozden Merve Mollaahmetoglu told GMHCN.
“It is really interesting that there is some evidence of an effect on suicidal thoughts independent of depressive symptoms, and it would be great to understand the mechanism of this effect. This finding is important because there is a risk of suicide in several mental health problems, so it would be interesting to see if we could treat suicidal thoughts in other conditions, such as substance use disorders.”
Mollaahmetoglu also noted: “Since the effect of ketamine on suicidal thoughts was short-lived, it would also be important to determine how this can be extended — for instance, in combination with psychotherapy. We also don’t know whether multiple doses of ketamine are more effective than a single dose for reducing suicidal thoughts, as this hasn’t been directly compared.”
Other research found some therapeutic benefit to the use of ketamine for other psychiatric disorders such as “post-traumatic stress disorder, obsessive-compulsive disorder, anxiety, and substance use disorders.” However, write the authors, “the evidence base comprised a small number of mostly nonrandomized trials with often short follow-up periods, therefore requiring corroboration and extension.”Safe in a clinical setting
The study emphasizes the importance of restricting the administration of ketamine to carefully controlled clinical circumstances.
Mollaahmetoglu told GMHCN:
“Ketamine is a very safe drug in a clinical setting. When people are given ketamine, we see mild increases in blood pressure and heart rate, which can be monitored and managed in clinical settings.” She also noted that people who might be at “increased risk of negative psychological reactions to ketamine, like people with a personal or family history of schizophrenia, can be screened out.”
Additionally, in such a setting, “People are provided with preparation and psychological support during and after the ketamine infusions, which likely reduces [the] risk of adverse psychological reactions.”
Finally, it is possible to protect individuals in a clinical setting from accidental injury and physical vulnerability due to ketamine’s dissociative effect. This effect promotes a “reduced awareness of their environment, lack of coordination, inability to communicate, and considerably diminished sensory input.”Ketamine requires caution
Dr. Alan F. Schatzberg, a professor of psychiatry and behavioral sciences at Stanford University, told MNT that “whether, in fact, these drugs are effective enough to be worth it is still unanswered.”
Dr. Schatzberg cautioned, “I haven’t seen enough real data to say that we [have] got a huge winner there.”
His concern is that, “ketamine works through an opioid mechanism, and ketamine in certain forms and in certain situations, it’s highly addictive.”
Dr. Schatzberg also noted the difficulty of conducting unbiased, blind studies of ketamine’s effect on mental health due to the disassociation it produces because “a patient, in fact, has a sense of what drug or placebo they got.” He recalled that in some approved esketamine trials, “they didn’t ask the patients, ‘Hey, do you think you got [the] drug or placebo?’”
“The way the study frames it,” said Dr. Schatzberg, “is positive, positive, positive. But you know, you have to wonder when you’re dealing with something like ketamine.”
Ketamine therapy has a swift short-term effect on reducing symptoms of depression and suicidal thoughts, according to a review of all the available evidence. A systematic review led by the University of Exeter and funded by the Medical Research Council analyzed evidence from 83 published research papers. The strongest evidence emerged around the use of ketamine to treat both major depression and bipolar depression. Symptoms were reduced as swiftly as one to four hours after a single treatment, and lasted up to two weeks. Some evidence suggested that repeated treatment may prolong the effects, however more high-quality research is needed to determine by how long
Similarly, single or multiple doses of ketamine resulted in moderate to large reductions in suicidal thoughts. This improvement was seen as early as four hours following ketamine treatment and lasted on average three days, and up to a week.
Lead author Merve Mollaahmetoglu, of the University of Exeter, said: “Our research is the most comprehensive review of the growing body of evidence on the therapeutic effects of ketamine to date. Our findings suggest that ketamine may be useful in providing rapid relief from depression and suicidal thoughts, creating a window of opportunity for further therapeutic interventions to be effective. It’s important to note that this review examined ketamine administration in carefully controlled clinical settings where any risks of ketamine can be safely managed.
For other psychiatric disorders, including anxiety disorders, post-traumatic stress disorders and obsessive-compulsive disorders, there is early evidence to suggest the potential benefit of ketamine treatment. Moreover, for individuals with substance use disorders, ketamine treatment led to short-term reductions in craving, consumption and withdrawal symptoms.Published in the British Journal of Psychiatry Open, the review synthesizes the evidence from a growing field of research into the potential benefits of ketamine for conditions for which there are limited effective treatments. The review included 33 systematic reviews, 29 randomized control trials, and 21 observational studies.
Ketamine’s effects on depressive symptoms and suicidal thoughts are supported by numerous systematic reviews and meta-analyses, which provide an exhaustive overview of research in a given topic. These are considered to have the highest strength of evidence compared to other types of studies, increasing confidence in the evidence for ketamine’s antidepressant and anti-suicidal effects.
However, ketamine’s therapeutic effects for psychiatric conditions other than depression and suicidal thoughts are based on small number of studies that did not randomize people into different treatment arms. These effects require replication in larger randomized placebo-controlled trials, which are considered as gold standard.
The authors noted a number of difficulties in the research field, which they recommend that future studies should seek to address. One factor is the bias created because participants realize they have been given ketamine, rather than a saline solution. Senior author Professor Celia Morgan, of the University of Exeter, said: “We’re finding that ketamine may have promising benefits for conditions that are notoriously hard to treat in clinic. We now need bigger and better-designed trials to test these benefits. For example, due to ketamine’s unique subjective effects participants may be able to tell whether they have been given ketamine or a saline solution as the placebo, potentially creating an expectation about the effects of the drug. This effect may be better controlled by having active placebo-controlled trials, where the control group receives another drug with psychoactive properties.”
A number of questions remain unanswered in the research field, including the optimal dose, route of administration and number of doses of ketamine treatment. There is also a need for further research on the added and interactive benefit of psychotherapy alongside ketamine treatment.
Additionally, the importance of ketamine’s acute subjective effects in its therapeutic benefits has not been fully explored. More research is also needed on how to optimize participants’ preparation for ketamine treatment and the setting in which ketamine treatment is delivered.
The research involved collaboration with the University of British Columbia, and received support from the Society for the Study of Addiction. The paper is entitled “Ketamine for the treatment of mental health and substance use disorders: a comprehensive systematic review,” and is published in the British Journal of Psychiatry Open.
From GOOD MORNING HEALTHCARE NEWSLETTER
People with chronic pain isolated to specific area can find great relief from trigger point injection. Tension headaches, myofascial pain syndrome, and pain from past muscular injury are just some of the common conditions treated. Find your symptoms here.
https://www.relievus.com/tests-and-treatments/trigger-point-injections/
Trigger point injections can help you find relief from chronic pain conditions.
Sciatica refers to back pain caused by a problem with the sciatic nerve. This is a large nerve that runs from the lower back down the back of each leg. When something injures or puts pressure on the sciatic nerve, it can cause pain in the lower back that spreads to the hip, buttocks, and leg. Up to 90% of people recover from sciatica without surgery.
Relievus can offer relief for your sciatica with special treatments. Learn more on our site!
Finally, a nondrug treatment approved for painful diabetic neuropathy(PDN).
Relievus offers this new, effective treatment for patients struggling with PDN.
Compared to conventional medical management, HFX™ for PDN is proven to provide significant, durable pain relief without debilitating side effects. In a large RCT, patients experienced an average of 76% pain relief.
HFX for PDN is the only spinal cord stimulation(SCS) system approved by the FDA with a specific indication to treat PDN.
The discs in your back function as rubbery cushions between the bones, which make up the spine. These discs act as natural shock absorbers. When a disc becomes damaged, it can cause compression of the spinal nerves. This is what we call a disc herniation.
Relievus has various treatment options available to help this condition including but not limited to: stem cell / prp injections, spinal cord stimulation, and Percutaneous Lumbar Discectomy.
Having back pain is difficult, as even minimal pain can be unbearable at times. It may interfere with your ability to work and function in daily living. At Relievus, we are here to help you alleviate pain as well as make it easier to tolerate.
Back pain can be characterized by aching sensation in the back, shark pain down the leg, constant pain standing up, and the loss of flexible back. Additionally, back pain may indicate more serious problems such as bowel or bladder control, numbness, intensifying pain, abdomen pain, fever, and other unusual pain.
Relievus offers services to help relieve pain, including: stem cell injections, PRP therapy, ketamine infusions, and electro-nerve therapy.
Learn more: https://www.relievus.com/tests-and-treatments-2/
Arthritis refers to around 200 rheumatic diseases and conditions that affect joints, including lupus and rheumatoid arthritis. It involves pain, aching, stiffness, and swelling in and around one or more joints.
Relievus has locations across New Jersey and Pennsylvania and has many treatments that can alleviate chronic pain from arthritis.
These include Facet Joint Injections, Electro Nerve Regeneration (ENR), Stem Cell / PRP injections, Trigger Point Injections, Acupuncture, and more.
We also offer patient exercises that can help alleviate some of the chronic pain caused by complications from arthritis.
Relievus can help you. Learn more: https://www.relievus.com/tests-and-treatments-2/
Need a doctor that cares? At Relievus, we do more than care, we invest in your future. We offer multiple treatment options and our board-certified physicians create a custom treatment plan for you based on your situation. Here, your care is in the hands of not just a single pain specialist, but an entire multi-disciplinary team, with today’s most advanced technology at their fingertips.
