Updated: Sep 20
May honors Mental Health Month in America. In a time of growing mental health crises worldwide, it’s crucial for us to begin acknowledging, respecting, and exploring the suffering of those with mental health disorders. To help highlight this cause, we’re covering an incredible breakthrough option for treatment-resistant depression specifically.
In a retrospective chart review published in 2022, “Clinical Effectiveness of Intravenous Racemic Ketamine Infusions in a Large Community Sample of Patients With Treatment-Resistant Depression, Suicidal Ideation, and Generalized Anxiety Symptoms,” clinicians concluded that ketamine infusion therapy can provide promising results for treatment-resistant depression.
Defining Treatment-Resistant Depression:
Treatment-resistant depression (TRD) is generally defined as not achieving significant symptom improvement after having two trials of different antidepressant medications (at an adequate dosage and duration). The term "treatment-resistant" implies that someone’s depressive symptoms persist despite attempts at treatment.
Depression is a widespread mental health condition affecting millions of people worldwide. It is estimated that around one-third of individuals with depression don’t respond adequately to initial treatment attempts. Unfortunately for the patient, this can lead to chronic suffering, impaired functioning, increased risk of suicide, decreased quality of life, and a higher likelihood of compounding medical conditions. TRD can significantly disrupt personal relationships, job performance, and someone’s overall well-being.
Causes and Contributing Factors of Treatment Resistant Depression:
The exact causes of treatment-resistant depression are not fully understood. Depression is a complex disorder. Several factors may contribute to the development of TRD, including:
Biological Factors: Genetic predisposition, neurotransmitter imbalances, changes in brain structure and function, and disruptions in neurological factors may play a role.
Psychological Factors: Co-occurring psychiatric conditions, such as anxiety disorders or personality disorders, may complicate the treatment response. Plus, lived trauma can impact treatment outcomes.
Treatment Factors: Inadequate dosing, insufficient duration of treatment, non-adherence to medications, and inadequate access to evidence-based therapies can all contribute to treatment resistance.
Medical Factors: Certain medical conditions, such as thyroid disorders, chronic pain, or substance abuse, can complicate depression treatment and contribute to treatment resistance.
Findings of The Study
The study utilized anonymized electronic health chart data from a private ketamine infusion clinic, encompassing 424 patients with TRD seen between 2017 and 2021. Ketamine infusions were administered to patients starting at a dose of 0.5 mg/kg over a duration of 40 minutes, with 6 infusions within 21 days. Maintenance infusions were offered as well. The study analyzed changes in outcome measures, specifically scores on the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), and found significant improvements in outcomes over time.
Based on self-reported data from the questionnaire, a 50% response rate and a 20% remission rate for depressive symptoms were observed within 6 weeks of initiating ketamine infusions. After 10 infusions, response and remission rates increased to 72% and 38%, respectively.
Within 6 weeks, there was a 50% reduction in self-harm/suicidal ideation (SI) symptom scores, with half of the patients who reported SI at baseline no longer experiencing it after 6 infusions. A 30% reduction in anxiety symptoms was also observed.
These results demonstrate the effectiveness of ketamine in reducing symptoms of treatment-resistant depression. The findings support what our practice wholeheartedly believes: ketamine infusion therapy is a potential breakthrough in the management of TRD.
Benefits of Ketamine Infusion Therapy:
Rapid Relief: One of the best aspects of ketamine infusion therapy is its ability to provide fast relief from depression. Unlike conventional antidepressants that can take weeks or even months to show noticeable effects, ketamine often produces a significant improvement in mood within hours. This quick response can be life-changing for those who have struggled for years without relief.
Alternative Mechanism of Action: Ketamine works through a different mechanism compared to traditional antidepressants. It targets the glutamate system in the brain, specifically the N-methyl-D-aspartate (NMDA) receptor. By modulating glutamate levels, ketamine promotes the growth of new brain connections, potentially reversing neural changes associated with the disorder.
Long-Lasting Effects: While the effects of a single ketamine infusion may be relatively short-lived, the benefits can be extended through a series of treatments. Many patients experience a cumulative effect, with longer-lasting relief and reduced depressive symptoms over time. This can provide a window of opportunity for patients to make lifestyle improvements for sustained wellbeing.
Suicidal Ideation Reduction: Ketamine infusion therapy has shown promise in rapidly reducing suicidal ideation, providing a critical intervention for individuals at risk. The alleviation of suicidal thoughts can offer immediate relief and create space for comprehensive therapeutic interventions to address underlying issues.
Mental Health Month presents an opportunity to raise awareness and promote understanding of how ketamine infusion therapy can help not only treatment resistant depression, but also anxiety, PTSD, and other mental health conditions. Mental health is an integral part of our overall well-being, deserving of our attention and care.
Freedom Ketamine Treatment Centers has six offices throughout the DMV. Our Board-Certified Physicians are committed to providing compassionate, cutting-edge ketamine infusion therapy at our locations in Bethesda, Rockville, Columbia, Vienna, Reston, and Marshall. The infusion process is safe, usually side-effect free or minimal, and has been life-changing for our patients, as evidenced by numerous patient reviews.
If you’re interested in scheduling an initial consultation with one of our Physicians, contact our office today for more information.
The image used in this article is by Humberto Chavez.