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Ketamine for treatment-resistant depression and anxiety: What to know


MDW is proud to feature Caitlin Strebing, AGACNP, Nurse Practitioner, Lead Provider, SPRAVATO®, and IV Ketamine at Relief Mental Health on the MDW blog about alternative treatments for depression, anxiety, and bipolar disorder.


Ketamine is a medication first created in a laboratory in the early 1960s and approved by the Food and Drug Administration (FDA) as a general anesthetic in 1970. In the mid-1970s, researchers recognized its potential use as an antidepressant medication. However, research into ketamine for its mental health benefits didn’t begin until more than 20 years later, with the first peer-reviewed research paper on the antidepressant effects of ketamine appearing early in the year 2000.


Since then, research has shown that ketamine – in various forms, including the nasal spray SPRAVATO® and intramuscular injections – can help people with a variety of mental health diagnoses. 


Another effective delivery method for ketamine is through an intravenous drip, called an IV ketamine infusion. The off-label use of IV ketamine can help people with:


  • Treatment-resistant depression

  • Major depressive disorder

  • Bipolar depression

  • Post-traumatic stress disorder

Over the past two and a half decades, peer-reviewed research on ketamine has shown the following:


  • It’s fast-acting; many patients experience a reduction in depressive symptoms in under an hour

  • Ongoing symptom reduction after initial infusion:

  • Six studies reported symptom reduction for three weeks

  • Three studies reported symptom reduction for one month 

  • Three studies reported symptom reduction for six weeks

  • Significant symptom reduction in 70% of patients with depression

That’s why IV ketamine for mental health treatment is becoming increasingly common. It’s effective and can offer symptom relief for diagnoses such as treatment-resistant depression (TRD), which is defined as depression that doesn’t respond well to at least two attempts at traditional treatment with a standard antidepressant and psychotherapy.


Mental Health in the U.S.



Mental health is in the news far more often than it was just five years ago. Several factors account for this. 


First, the COVID-19 pandemic increased awareness of mental health, as treatment professionals overwhelmingly agreed that the consequences of public safety measures like self-isolation, social distancing, remote work, and virtual school could exacerbate existing mental health diagnoses and lead to an increase in the overall prevalence of diagnoses such as anxiety and depression.


Second, two advisories from the Surgeon General of the United States got everyone’s attention: one about a growing mental health crisis among youth and adolescents, and another about an epidemic of loneliness and isolation among U.S. adults.


Finally, the obvious: the past few years have been more stressful than usual in the U.S. From the uncertainty and fear around COVID-19, to contentious social and political debates that have persisted much longer than anyone expected, to increasing suicide rates – particularly among young people – the need for effective, accessible mental health treatment is more important now than ever.


Evidence shows mental health treatment with ketamine infusions can help reduce symptoms significantly. This fact alone can bring hope to millions of people in the U.S. with treatment-resistant mental health diagnoses. The presence of this new and effective treatment is also important in light of data in the 2022 National Survey on Drug Use and Health (2022 NSDUH) that show that only 50-75 percent of people diagnosed with a mental health disorder receive professional care, leaving millions of people untreated, living with symptoms that cause serious disruption in their daily lives.


Treatment With IV Ketamine: How it Works


Traditional mental health treatment most often involves an evaluation by a licensed clinician, a diagnosis of mental health disorder, if present, and then a treatment plan by a psychiatric provider (mainly for prescription medication such as antidepressants) or therapist.


Treatment with IV ketamine starts the same way: assessment, diagnosis, and treatment plan. While traditional treatment might include a combination of psychotherapy, medication, and lifestyle changes that support optimal health, treatment with IV Ketamine most often follows this protocol, or one very similar.


IV Ketamine: Treatment Session Details


First, the patient and the provider – often a nurse practitioner, but always a qualified and skilled clinician – prepare for the session. At Relief Mental Health, patients relax in a comfortable chair in a private treatment room. The clinician initiates the infusion, which lasts around 45 minutes. After the infusion, the clinician monitors the patient for at least 30 minutes. A treatment session typically lasts about 90 minutes. Since one possible side-effect of IV ketamine is drowsiness, patients arrange transportation to and from sessions.


IV Ketamine: A Typical Treatment Plan 


A full course of treatment with IV ketamine may vary by patient needs and provider preference. At Relief, an effective treatment protocol includes six treatment sessions over a period of 2-3 weeks. Some patients may require booster sessions, depending on their response to the initial treatment protocol. In some cases, patients don’t need any booster sessions at all. Patients who receive boosters may return for sessions monthly, every six months, or at a schedule determined by the individual needs and provider input.


Summing It Up: IV Ketamine for Mental Health



We’re fortunate to live in a time when – finally – the stigma around mental health diagnoses and treatment is fading. In the past, many people struggling with their mental health were wary of treatment, for various reasons: the stigma, the effectiveness, the side effects of medication, and a general lack of knowledge and awareness of the most important facts surrounding mental health disorders and treatment options.


What are those facts?


I’ll offer three:


  1. Mental health diagnoses are treatable medical conditions. They’re not character flaws or personal failings, and the disruptive symptoms – e.g. withdrawal from friends and family, avoiding triggering situations – are not choices made by the individual, but rather features of the disorders themselves.

  2. With professional support and care, it’s possible to manage the symptoms of a mental health diagnosis and live a full and fulfilling life.

  3. With the advent of new and innovative treatments – including IV ketamine – patients have a greater chance of treatment success than ever before. 

There’s now every reason to hope that anyone with a mental health diagnosis can find effective treatment – and change their lives for the better.

If you or someone you know is struggling with depression, anxiety, OCD, or other mental health diagnoses, reach out today at 855.205.4764, info@reliefmh.com, or reliefmh.com.


IV ketamine is available at Relief’s clinics in Oak Brook, Orland Park, Chicago (West Loop), Northbrook, and St. Charles. If you've been considering ketamine infusions, take advantage of Relief’s March 2024 Spring Break Special: $2,750 for 6 infusions (when paid in full upfront), valid through March 31, 2024. Call (844) 731-7543 for more information.

 

About the Author:


Caitlin Strebing, AGACNP (Adult -gerontology acute care nurse practitioner) is a dedicated healthcare professional with a passion for helping individuals facing treatment-resistant depression, anxiety, and various mental health diagnoses. With a wealth of experience and expertise in psychedelic treatment modalities, she specializes in the administration of intranasal ketamine (SPRAVATO®) and IV ketamine.


Caitlin holds an Acute Care Board Certification and has received clinical training under anesthesiologists, solidifying her status as an expert in ketamine therapies. Her primary objective is to facilitate transformative experiences for patients, aiming for them to leave treatment feeling significantly improved compared to their initial arrival.


With an impressive 12 years of experience in intensive care units (ICUs) at Northwestern Memorial Hospital in Chicago, Caitlin brings a strong foundation in acute care to her practice. Building on this foundation, she has accumulated more than two years of specific expertise in ketamine administration, encompassing both intranasal and IV methods. Currently serving as the lead provider of SPRAVATO® and IV ketamine at Relief, Caitlin plays a pivotal role in advancing innovative and effective mental health treatments.


Caitlin works in close coordination with our team of providers throughout the Chicagoland area to guarantee that our patients have seamless access to a range of treatment services, including transcranial magnetic stimulation (TMS), psychiatric medication management, and psychotherapy, as needed.


Learn more about Caitlin and Relief Mental Health at reliefmh.com



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