Ketamine Therapy vs Traditional Antidepressants

While it was first developed as an anesthetic, doctors have discovered that off-label use of ketamine may help treat conditions such as treatment-resistant depression. This article explores the differences between how ketamine and traditional antidepressants work on the brain. It also discusses why ketamine relieves depression faster and how this helps treat people with mental health conditions. But which treatment is right for you, and can you take ket while on antidepressants? We have the answers below.

How Ketamine Works in the Brain Compared to SSRIs and SNRIs

Ketamine and traditional antidepressants like selective serotonin reuptake inhibitors (SSRIs) all target receptors and neurotransmitters in the brain. In this way, they positively increase the brain’s neuroplasticity and help it form new neural pathways. These changes can alleviate symptoms of depression and other mental health conditions.

Ketamine and the Brain

Ketamine is a fast-acting N-methyl-D-aspartate receptor (NMDA) antagonist. The drug acts on the glutamatergic system, one of the main excitatory neurotransmitter systems in the brain. It boosts glutamatergic activity and helps improve brain function. Ketamine also increases serotonin, but not to the same extent as SSRIs.

The Pharmacological Action of SSRIs and SNRIs

SSRIs and serotonin and norepinephrine reuptake inhibitors (SNRIs) target serotonin levels by slowing the reuptake, or reabsorption, of serotonin by brain cells. This means there’s more serotonin available to transmit messages between neurons. Increased levels of serotonin help reduce depression and other mental illnesses.

Onset of Relief: Rapid vs. Gradual Effects

Important considerations are how quickly the different therapies work, the duration of symptom relief and whether these treatments on their own are sufficient.

• How Quickly Does Each Treatment Work?
  Ketamine therapy is fast-acting, and patients normally notice a significant reduction in symptoms within 24 hours. SSRIs and SNRIs are slower-acting, and it may take up to 6 weeks to feel the benefits of these drugs.
• How Long Do the Benefits Last?
  The mental health benefits of ketamine vs. SSRIs last for a relatively short length of time, and repeat treatments are necessary before medium- to long-term relief is achieved. Conversely, people taking SSRIs and SNRIs may need to take these drugs indefinitely.
• Do These Treatments Work in Isolation?
  While continued treatment with ketamine or antidepressants can lift mood, neither deals with underlying mental health issues. Most patients still need psychotherapy to deal with emotional issues and negative thought patterns.

Who Can Benefit From Ketamine Therapy?

Ketamine therapy is recommended for people who’ve unsuccessfully tried other forms of mental health treatment. Candidates are psychiatrically screened to assess the severity of their symptoms and medically screened for preexisting health conditions that may preclude this treatment. Medically indicated exclusions include pregnancy, heart disease, schizophrenia and active psychosis.

Conditions that can be treated by ketamine therapy include:

• Unipolar depression and MDD. IV ketamine is effective for treating serious depression.
• Bipolar disorders. Intravenous ketamine or esketamine nasal spray can reduce manic symptoms for extended periods.
• Suicidal thoughts. The drug reduces suicidal thoughts.
• Social anxiety and generalized anxiety disorders. Ketamine therapy reduces anxiety and significantly improves anxiety scores.
• Obsessive–compulsive disorders. Trials show ketamine reduces symptoms of OCD.
• Post-traumatic stress disorder. A study by the University of Florida showed that PTSD symptoms are reduced by ketamine.
• Substance use disorders. Ketamine reduces cravings and withdrawal symptoms and improves abstinence from drug and alcohol addiction.
• Eating disorders. Ketamine-assisted therapy appears to help people with eating disorders process negative emotions and eat normally.

Side Effects of These Treatments and Safety Considerations

Treatment with ketamine and SSRIs should always be conducted under medical supervision. Both treatments have side effects that must be considered.

Can You Take Ket on Antidepressants?

Yes, you can take ketamine while on antidepressants. Clinical trials show that using ketamine together with prescription antidepressants like SSRIs and SNRIs is safe. It’s generally recommended that people receiving ketamine IV treatment stay on their antidepressant medication. However, there’s a risk of a potentially fatal serotonin syndrome when taking monoamine oxidase inhibitors (MAOIs). Always inform your physician of all medications you’re taking before ketamine therapy.

Cost, Access and Administration Differences

The treatment costs are significantly different, as are how to access these treatments and the ways the drugs are administered.

Treatment Costs

Antidepressants, including SSRIs and SNRIs, are usually covered by insurance. Ketamine IV therapy isn’t, but esketamine nasal spray is FDA-approved and would normally be covered by insurance. The costs for generic versions of antidepressant medications vary from $4 to $200 per month, while brand-name drug costs are higher.

Ketamine IV therapy is relatively more expensive and not covered by insurance. The cost for a ketamine infusion could be between $400 and $1,000, so for a typical course of six therapies, you can expect to pay between $2,400 and $6,000, depending on the treatment provider and your geographical region.

In both instances, you need to allow for consultation and psychotherapy costs.

Access to Therapies

While antidepressants are readily available from qualified doctors and psychiatrists, ketamine IV therapy access is restricted to those clinics and specialists offering this form of off-label treatment, such as the IV ketamine therapy at Sun Health Center.

Administration Differences

Treatment for mental health conditions should always be under a qualified medical specialist. If you’re on antidepressants, you take them at home and have periodic follow-up consultations.

IV ketamine therapy must be done in a safe place under qualified medical supervision. An IV ketamine session may last for up to an hour, and during that period, you’re monitored by medical staff and a therapist. You may experience intense emotions during the therapy. You won’t be able to drive after the session is complete, and it’s recommended you take it easy for the rest of the day.

Choosing the Right Treatment With Your Provider

If you’re struggling with depression, anxiety or another mental health condition, contact us at Sun Health Center. Our licensed therapists can assess your condition and advise whether you’re a candidate for ketamine IV treatment or whether we recommend traditional antidepressants together with therapy. At Sun Health, we offer a wide range of therapies and treatments for mental health and substance abuse disorders.