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Introduction to Ketamine Treatment for Depression
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In recent years, the landscape of treating depression has undergone a transformative shift with
the exploration of Ketamine—a medication traditionally known for its anesthetic properties
Beyond its established use in surgical settings, Ketamine has emerged as a promising breakthrough in the realm of mental health, particularly in the treatment of depression.
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The conventional pharmacological approaches for depression often involve medications that act on neurotransmitters like serotonin and norepinephrine. However, a significant subset of individuals with depression may not achieve adequate relief from these conventional treatments, leading researchers to explore alternative options.
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Ketamine's unique ability to induce rapid and robust antidepressant effects, sometimes within hours to days rather than weeks as seen with standard antidepressants, has garnered substantial attention from the psychiatric and scientific communities. Its distinct mechanism of action, working on the glutamate system in the brain, sets it apart from traditional antidepressants, offering a potential breakthrough for individuals with treatment-resistant depression.
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The use of Ketamine, particularly its S(+) enantiomer esketamine, in clinical settings has shown promising results in alleviating symptoms of depression, especially in cases where other treatments have been ineffective. This innovative approach not only marks a paradigm shift in depression treatment but also underscores the potential for novel interventions targeting different pathways in the brain to address mental health conditions.
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​In 2019, the FDA and European Commission approved an esketamine nasal spray named Spravato for depression treatment. Presently, ketamine is categorized as a Schedule III medication in the United States, denoting substances with a moderate potential for psychological and physical dependence according to the Drug Enforcement Administration (DEA). While Schedule III drugs can still lead to abuse or addiction if misused, they are considered less hazardous or addictive than substances in Schedules I and II. They are exclusively available through a prescription.
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HOW KETAMINE WORKS
Conventional antidepressants function by impeding the reuptake of crucial brain chemicals—such as serotonin, norepinephrine, and dopamine—to enhance intercellular communication within the brain. In contrast, the mechanism of ketamine involves elevating glutamate, an excitatory neurotransmitter, by inhibiting NMDA receptors. The antagonism of NMDA receptors initiates a subsequent series of events leading to an augmented production of essential brain proteins like Brain Derived Neurotrophic Factor (BDNF) and rapamycin (mTor). These proteins play a pivotal role in fostering the formation of robust and healthier synaptic connections between brain cells, effectively reversing the detrimental impact inflicted upon synapses by chronic stress and depression.
Jacques-Cartier National Park Canada Summer 2023
CONTRAINDICATIONS:
Every medication carries potential risks, and these risks fluctuate based on a patient's existing medical conditions and concurrent medications. Among the primary risks associated with ketamine are temporary spikes in blood pressure and the possibility of exacerbating pre-existing symptoms of psychosis or bipolar mania. However, ketamine might not be suitable for individuals with specific medical and psychiatric conditions, including pregnancy, cardiovascular disease, uncontrolled hypertension, schizophrenia, schizoaffective disorder, active use of illicit drugs, ongoing psychosis, and active mania.
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