In March of 2019, the U.S. Food and Drug Administration (FDA) approved Spravato, a nasal spray comprised of ketamine to help treat depression. This psychedelic prescription is unique because a single dose can have beneficial effects in a few hours and can continue to help for weeks.
The cause of depression at the neuro level is still unknown because each person has unique variables such as environment and behavior. Most of the information that scientists have gathered are from behavioral observations. Studies have found depression causes decreased mood, tiredness, mental fog, and suicidal thoughts.
In the 1960s researchers discovered some drugs that change serotonin in the brain result in mood related side effects. They found drugs that elevated serotonin levels resulted in less depressive behavior.
SSRIs (Selective Serotonin Reuptake Inhibitors) were developed to treat depression by increasing serotonin activities. While originally a good option, it doesn’t fully treat depression. Patients with depression have other neurotransmitters that are altered need assistance. Solely raising serotonin levels isn’t always enough.
Ketamine is an attractive option for patients who don’t respond well to SSRIs because it interferes with glutamate receptors. This is critical because glutamate is in half of all the connections in the brain and it’s the neurotransmitter that makes neurons more active.
The antidepressant effects can kick in within hours of taking ketamine and could last for weeks. This is much different compared to SSRIs because they can take months to take full effect.
The scientific explanation of ketamine and depression is still a bit of a mystery. What we currently know is it causes the brain to produce more chemicals which helps neurons grow new connections. The combination of cognitive behavioral therapy and Spravato is the could be the best way to help patients with depression.
Ketamine represents a whole new way of fighting depression by interacting with glutamate. As research continues this could lead us to a whole new family of psychedelic drugs to help treat mental health.