Anxiety disorders are one of the most prevailing mental health problems in the United States. About 40 million adults in the United States suffer from anxiety disorders each year, making up 18.1% of the population. Only 37.9% of them receive treatment for anxiety. Among patients who receive treatment, 30-40% are unable to get relief from symptoms of anxiety through standard therapeutic approaches. As treatment of mental health issues evolved, some new drugs showed promising effects, and Ketamine is one of these medications. Ketamine is an FDA-approved medication and anesthetic agent in origin. More and more clinicians use ketamine for major depression, general anxiety disorder, and other various mental health conditions.
Ketamine was first synthesized in1960 and was approved as an anesthetic in 1970 by FDA. Its main mechanism of action is NMDA receptor antagonism. NMDA receptor is one of the receptors that glutamate binds to.
Traditional treatment for depression is based on the monoamine hypothesis for depression which predicts that the underlying pathophysiologic basis of depression is a depletion in the levels of serotonin, norepinephrine, and/or dopamine in the central nervous system. Although this approach worked for some patients, many patients remained depressed despite the treatment with medications based on this hypothesis.
The new paradigm is the glutamatergic hypothesis of depression, based on the research findings suggesting the involvement of the glutamatergic neurotransmission system in the pathophysiology of MDD or bipolar depression, which includes disruptions in glutamatergic substrate concentrations and NMDAR alterations.
As a potent NMDA receptor antagonist, ketamine has been studied extensively as a treatment for depression as well as other closely related conditions such as anxiety, PTSD, and suicidality. It has been proven to be effective for major depression, particularly treatment-resistant depression, general anxiety disorder, and other mental health conditions.
Jerome H Taylor et al. conducted a randomized, placebo-controlled crossover trial to assess the efficacy of ketamine for social anxiety disorder. Eighteen individuals with DSM-5 SAD were given IV Ketamine infusions (0.5 mg/kg over 40 min) compared to the control group who received a placebo (saline infusion). Ratings of anxiety symptoms were assessed after 3 hours of infusion, followed for 14 days on the Liebowitz Social Anxiety Scale (LSAS) and self-reported anxiety on a visual analog scale (VAS-Anxiety). After two weeks of ketamine administration, patients exhibited a significant response to ketamine infusion as compared to placebo. On LSAS, response to ketamine infusion was 33.3%, and in contrast, placebo response was 0%. The VAS response was 88.89% and 52.94% to ketamine infusion and placebo, respectively. This response provided evidence of the efficacy of ketamine in reducing social anxiety.
Paul Glue et al. studied an exploratory double-blind psychoactive-controlled replication study to determine the effects of ketamine in patients with treatment-refractory generalized anxiety and social anxiety disorders in 12 patients who were not currently depressed. IV ketamine was administered in ascending doses (0.25, 0.5, and 1 mg/kg) at an interval of 7 days, and the control group was given midazolam 0.01 mg/kg. Ratings, dissociation, tolerability, and safety were detected for ketamine infusion. The rating of anxiety improved after one hour of ketamine infusion, which persisted for 7 days (1 week). In contrast, midazolam had a minor effect on the improvement of anxiety symptoms. Ketamine infusions were safe and well-tolerated. This study indicates ketamine acts as a potential therapeutic agent for reducing symptoms of treatment-refractory generalized anxiety and social anxiety disorders.
A continuation of the above-mentioned study detected the effect of the maintenance dose of ketamine in 20 patients with generalized anxiety disorders (GAD) and social anxiety disorder (SAD). In this study, patients received weekly dosing of subcutaneous ketamine at 1mg/kg for 3 months. At the end of the study, patients showed significant improvement in social functioning with minimal side effects. The researchers of this study concluded that ketamine might be a safe alternative treatment for patients with treatment-refractory GAD or SAD.
Several clinical studies indicate ketamine is effective in the treatment of patients with social anxiety disorder (SAD), and generalized anxiety disorder (GAD). Research shows that ketamine is an effective treatment for those conditions and patients tolerate maintenance treatment well with minimal side effects. Ketamine can be taken via oral, sublingual, intranasal, intravenous, intramuscular or subcutaneous routes.
Suffering from Anxiety Disorder? Isha Health has a Solution!
If you suffer form social anxiety disorder, or generalized anxiety disorder despite treatments, Ketamine therapy can be helpful for you. We provide personalized online low dose ketamine therapy in the comfort of your home. The dedicated team at Isha health helps you go through this treatment safely and effectively.