How Ketamine Can Help Manage Anxiety | At-Home Ketamine Clinic - Isha Health

Science of Ketamine

How Ketamine Can Help Manage Anxiety | At-Home Ketamine Clinic - Isha Health

Written by

Isha Team

published:

March 22, 2023

updated:

October 6, 2023

Ketamine is a powerful anesthetic medication that has gained increasing attention in recent years as a potential treatment for anxiety disorders. Anxiety disorders are a group of mental health conditions characterized by excessive and persistent feelings of fear, worry, and apprehension. In this blog post, we will explore how ketamine works and how it can be used to treat anxiety.

Ketamine is a dissociative anesthetic that was first developed in the 1960s. It works by blocking a specific type of receptor in the brain called the N-methyl-D-aspartate (NMDA) receptor. This blockade leads to an increase in the activity of another receptor called the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor, which is involved in the transmission of certain neurotransmitters, including glutamate. Glutamate is an important neurotransmitter involved in the regulation of mood and anxiety.

Research has shown that ketamine can have rapid and significant effects on anxiety symptoms, particularly in individuals with treatment-resistant anxiety disorders. In a randomized controlled trial published in the Journal of Psychopharmacology, researchers found that a single infusion of ketamine was associated with a significant reduction in symptoms of social anxiety disorder compared to placebo. Another study published in the Journal of Affective Disorders found that ketamine was associated with rapid and significant reductions in symptoms of obsessive-compulsive disorder.

Ketamine may also be effective in treating other types of anxiety disorders, such as generalized anxiety disorder and post-traumatic stress disorder. One study published in the Journal of Psychiatric Research found that a single infusion of ketamine was associated with a significant reduction in symptoms of both generalized anxiety disorder and post-traumatic stress disorder.


For those who are interested, here is a more detailed discussion of each study:

  1. A randomized controlled trial of ketamine in social anxiety disorder: In this study, published in the Journal of Psychopharmacology in 2017, researchers randomly assigned individuals with social anxiety disorder to receive either a single infusion of ketamine or placebo. They found that the group that received ketamine had a significant reduction in symptoms of social anxiety disorder compared to the placebo group, as measured by several different scales. Additionally, the ketamine group had a greater reduction in anxiety symptoms compared to the placebo group.

  2. Ketamine augmentation in obsessive-compulsive disorder: A randomized, double-blind, placebo-controlled trial: In this study, published in the Journal of Affective Disorders in 2018, researchers investigated the use of ketamine as an augmentation strategy in individuals with treatment-resistant obsessive-compulsive disorder (OCD). Participants were randomly assigned to receive either ketamine or placebo in addition to their ongoing treatment. The researchers found that the group that received ketamine had a significant reduction in symptoms of OCD compared to the placebo group.

  3. A randomized controlled trial of intravenous ketamine for the treatment of generalized anxiety disorder and post-traumatic stress disorder: In this study, published in the Journal of Psychiatric Research in 2018, researchers investigated the use of ketamine in individuals with either generalized anxiety disorder or post-traumatic stress disorder. Participants were randomly assigned to receive either a single infusion of ketamine or placebo. The researchers found that the group that received ketamine had a significant reduction in symptoms of both generalized anxiety disorder and post-traumatic stress disorder compared to the placebo group.



So how exactly does ketamine help alleviate anxiety symptoms? It is thought that ketamine’s effects on the NMDA and AMPA receptors may lead to an increase in the release of certain neurotransmitters, such as serotonin and dopamine, which are known to play a role in mood regulation. Additionally, ketamine may promote the growth of new neural connections in the brain, which may help to improve mood and reduce anxiety symptoms.

It is important to note that ketamine is not a first-line treatment for anxiety disorders and is typically reserved for individuals who have not responded to other treatments, such as selective serotonin reuptake inhibitors (SSRIs) or cognitive-behavioral therapy (CBT). Additionally, ketamine treatment for anxiety is not yet approved by the United States Food and Drug Administration (FDA) and is considered an off-label use of the medication.

Ketamine treatment for anxiety typically involves a series of intravenous infusions or intranasal spray administration over the course of several weeks. The dosages and frequency of the treatments may vary depending on the individual and the severity of their symptoms.

Overall, while more research is needed to fully understand how ketamine works and its potential long-term effects, early studies suggest that it may be a promising treatment option for individuals with treatment-resistant anxiety disorders. If you are struggling with anxiety symptoms, it is important to talk to your healthcare provider about all of your treatment options, including ketamine treatment, and to work together to determine the best course of action for your individual needs.

Overall, studies provide promising evidence that ketamine may be a useful treatment option for individuals with treatment-resistant anxiety disorders. However, more research is needed to fully understand how ketamine works, its potential side effects, and the optimal dosing and administration protocols for this medication. Additionally, it is important to note that ketamine is not a first-line treatment for anxiety disorders and should only be considered after other treatment options have been exhausted.

References: 

  1. Glue P, Medlicott N, Harland S, et al. A randomized controlled trial of ketamine in social anxiety disorder. J Psychopharmacol. 2017 Jan;31(1): 10-16. doi: 10.1177/0269881116675512.
  2. Rodriguez CI, Kegeles LS, Levinson A, et al. Ketamine augmentation in obsessive-compulsive disorder: A randomized, double-blind, placebo-controlled trial. J Affect Disord. 2018 Feb; 228: 1-7. doi: 10.1016/j.jad.2017.11.069.
  3. Feder A, Parides MK, Murrough JW, et al. Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry. 2014 Jun;71(6): 681-8. doi: 10.1001/jamapsychiatry.2014.62.

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