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Annelise - I was drawn to your post as I myself have heard of the antidepressant properties of Ketamine Infusions. It is incredibly exciting to hear the results of Abbar et. al's study, as you highlighted above - not only does this sound promising, but also fairly novel. That being said, I am concerned regarding the extension of such findings to the general public, who may take this information and run with it. I think as research within Ketamine therapies further progresses, it is crucial to highlight the importance of proper surveillance and administration of the drug for these purposes. Reading up on Ketamine therapy myself, I found that an enantiomer of ketamine, Esketamine, has begun to be implemented via nasal spray as it has better pharmacodynamic selectivity, and its higher cost makes it relatively difficult to abuse outside of a clinical setting (Janovska et. al, 2021). Additionally, the nasal route of Esketamine also reduces the dangers of oral ketamine ingestion, which includes formation of a genotoxic derivative in the stomach (LI et. al, 2011). Perhaps the greatest concern for recreational Ketamine use versus clinical use lays within a lack of correct dosing, and or combination with other drugs. Ketamine toxicity due to either may present with serious side effects - sedation, respiratory depression, and extreme stupor (Orhurhu et. al, 2022).
ReplyDeleteAll of that is not to diminish how exciting this treatment avenue is - with correct monitoring and administration, Ketamine therapy is proving to be very promising. That being said, I wonder how we may move forward with sharing this information in a way that fully highlights the importance of clinical use versus recreational, and the potential risks of taking Ketamine into one's own hands.
References:
Jonovska, S. Sugnet, T., Sendula-Jengic, V. Ketamine - Undrawn Lines between Medical and Recreational Use - Implications for Clinical Practice. Psychiatria Danubina, 2021 Spring - Summer; 33(Suppl 4): 1113-1117.
Li, H., Vicknasingam, B., Cheung, Y., Zhou, W., Nurhidayat, A., Jalais, D., Schottenfeld, R. (2011). To Use or Not To Use: An Update on Licit and Illicit Ketamine Use. Substance aAbuse and Rehabilitation, 2, 11-20. https://doi.org/10.2147/SAR,S15458
Orhurhu, V., Vashisht, R., Claus, L., Cohen, S. Ketamine Toxicity. (2022). StatPearls. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541087
Hi Annelise. I thought your post was very interesting and something new that I had not heard of before! I was not aware that ketamine is used as a therapeutic treatment option. After reading your post, I wondered how Ketamine actually effects your body, and how it works similarly to an antidepressant. I found some interesting insight on the receptors it binds to/affects. One of the reasons they believe ketamine to be so successful is due to its target to multiple pathways. The neurotransmitter systems it targets are the opioidergic, monoaminergic, glutamatergic, and muscarinic systems. In regards to the glutamatergic system, this is associated with a NMDA receptor, and this receptor is associated with cellular processes important for synaptogenesis and neuroplasticity. A recent study showed that when this system is blocked, it can show an antidepressent like response. Due to Ketamines similar structure to the NMDA receptor antagonist, they believe this is one of the ways that Ketamine acts as an antidepressant! From this it can cause an increase in glutamate release which can in turn promote neuroplasticity. Another unique quality of ketamine is its anti-inflammatory properties. Inflammation is commonly seen in MDD (major depressive disorder), and Ketamines role as an anti-inflammatory could also be connected to its antidepressant-like effects. I also think there should be additional research done in this area to gain more insight on its longterm effects, just assure the benefits outweigh its side affects.
ReplyDeleteYavi, M., Lee, H., Henter, I.D. et al. Ketamine treatment for depression: a review. Discov Ment Health 2, 9 (2022). https://doi.org/10.1007/s44192-022-00012-3