Ketamine Therapy, Depression, Mental Health, Recovery

Ketamine is a dissociative anesthetic that has been used for decades in medical settings, primarily for anesthesia during surgery. However, in recent years, there has been growing interest in the potential therapeutic effects of ketamine, particularly in the treatment of mental illnesses such as depression, anxiety disorders, and post-traumatic stress disorder (PTSD). We started hearing a lot about ketamine and had already noticed that when B had been under anesthesia a couple of times, the few days after were surprisingly pleasant. I was intrigued. I spent some time reading and researching and found it is another good fit for those NMDA receptors that are not working as they should – and as we had already had some success with amantadine, a trial of ketamine therapy seemed a logical step.

We had a long discussion about depression and while we don’t necessarily see the “sadness” of depression, it seems possible some of the anger and frustration is related to the feelings of being alone, sad, isolated, etc. leading to depression. The knowledge from previous trials of amantadine and Namenda, also played into the decision to try ketamine. We hoped this might be a positive response rather than paradoxical like so many others have been.

Ultimately this wasn’t a quick decision, I was terrified of the infamous bladder stiffness side effect, and while that is linked to ketamine abuse it still terrifies me. I can’t fathom that if one takes it recreationally the side effect is there but if it’s RX’d it isn’t, that doesn’t make sense to me, so that remains a source of concern. His neurologist explained that the use of ketamine for this purpose typically involves low-dose intravenous infusions or nasal spray administration under medical supervision. With that in mind, instead of infusions, we decided on a trial of nasal ketamine which seemed a good place to start. His neurologist sourced the ketamine from a reputable compounding pharmacy and it arrived within about 5 days after ordering. We were really hoping this was going to have a positive impact on the symptoms that were assumed to be depression.

Mayo Clinic lists some of the depression signs that may indicate a problem in teens and adolescents and for us, these were definite checks on a page of symptoms:

• Feelings of sadness, which can include crying spells for no apparent reason
• Frustration or feelings of anger, even over small matters
• Feeling hopeless or empty
• Irritable or annoyed mood
• Loss of interest or pleasure in usual activities
• Loss of interest in, or conflict with, family and friends
• Low self-esteem
• Feelings of worthlessness or guilt
• Fixation on past failures or exaggerated self-blame or self-criticism
• Extreme sensitivity to rejection or failure, and the need for excessive reassurance
• Trouble thinking, concentrating, making decisions and remembering things
• Ongoing sense that life and the future are grim and bleak
• Frequent thoughts of death, dying or suicide

In fact, all these symptoms have been pervasive throughout the past 10 years. Nothing seems to work, nothing makes it better, and it seems everything can make it worse. In the spirit of always hoping for better, we decided to try ketamine therapy. After all, there is a lot of research showing that ketamine may have rapid-acting antidepressant effects, providing relief for individuals who have not responded to traditional antidepressant medications.

I think it’s important to note that while ketamine is showing great promise as a treatment for symptoms of mental illness, it is not a first-line treatment and is only typically considered when other standard treatments have been unsuccessful. As the effects of ketamine are relatively short-lived, we combined the nasal spray with CBT therapy and other forms of treatment.

Ketamine’s mechanism of action in mental illness treatment is not yet fully understood, but it is believed to involve the modulation of glutamate, a neurotransmitter involved in learning and memory processes. Ketamine may also have neuroprotective and anti-inflammatory effects, which could contribute to its therapeutic potential. Ketamine does have some other pesky potential side effects and risks, including dissociative experiences, elevated blood pressure, and in rare cases, hallucinations or other psychological disturbances, again pretty terrified to get started.

He started out at 2 sprays once a day before bed, then we went to 3 sprays twice a day if needed. He actually did do well on this medication. It was fairly instant because of the delivery and he was happier for about 2-3 hours after he did the sprays. Ultimately, after 2 or so months, he started to refuse to take the medication. He started feeling crystals in his nose from the sprays and he began to really hate the feeling in his throat as it trickled down. A few days after the complaining and refusal started, we were done. Overall, I do think it helped. Thankfully, I don’t think he experienced too many side effects from the nasal spray and I do think we had a quality product. It was expensive, about $79 per small bottle which lasted about a month, so wasn’t terrible but not the best either. While that trial has ended, I continue to think somehow the NMDA pathway is part of whatever this is that’s going on. I spend a bunch of time rabbit hole-ing in the middle of the night and have found articles like this one (linked below), which makes me think there is a connection and not just our anecdotal history.

Oligodendroglial NMDA Receptors Regulate Glucose Import and Axonal Energy Metabolism

Highlights:

• Oligodendroglial NMDA receptors regulate GLUT1 trafficking and glucose import

• Mice lacking oligodendroglial NMDA receptors develop late-onset axonopathy and neuroinflammation

Click below to read why GLUT1 is so important to everything our bodies need to do.

Anyway, it may be that in the future he chooses to try ketamine again, maybe via infusion, to see if it really can lift him out of whatever this quicksand is that’s dragging him down constantly. All I know is, no child should have to live this way, with this much pain and internal angst, certainly, no child should be blamed for the way this manifests and the symptoms exhibited because of feeling just so low and worthless all the time. It has to be exhausting.

As with any medical treatment, it’s essential to consult with a healthcare provider to determine the potential benefits and risks of ketamine treatment for a specific individual’s circumstances. Mental health professionals can help assess whether ketamine treatment is appropriate and guide patients through the process, ensuring comprehensive care and monitoring throughout the treatment.