Frequently Asked Questions about Ketamine
January 03, 2022
Frequently Asked Questions about Ketamine and Antidepressants
- Can you discontinue the use of antidepressants if you’re using ketamine?
We do not recommend that anyone discontinue the use of antidepressants while in the induction phase of treatment. In fact, we very much advise against it. It is possible that you may be able to titrate down on the doses of antidepressants, or even get off of them completely after receiving several months of ketamine treatment BUT this is something that must be done under the guidance of the prescribing physician.The majority of our clients remain on antidepressants even during their maintenance phase.
- Can you use antidepressants while undergoing ketamine therapy?
Most antidepressants are compatible with ketamine. However, some less typical treatments for depression like lamotrigine (Lamictal) have been found to interfere with ketamine’s effectiveness. Your medications will be reviewed prior to ketamine treatment and your provider will discuss any potential interactions.
- What’s the difference between antidepressants and ketamine therapy?
Antidepressants modulate different neurotransmitters than ketamine does (e.g. SSRIs increase the levels of serotonin). Ketamine’s effects likely derive from its action at the NMDA receptors to increase glutamate, the most prevalent excitatory neurotransmitter in the brain, as well as by increasing levels of BDNF (brain derived neurotrophic factor). Traditional antidepressants, such as SSRIs, can take months to be effective. Ketamine has been shown to have a much more rapid antidepressant effect. A client may feel some relief from their depressive symptoms after a single dose of ketamine though these effects will not last more than a few days which is why an induction series is given - to help solidify the effects and achieve more long-lasting results.
- Which is more effective?
This is a difficult question to answer for many reasons. First, let’s look at SSRIs as these are probably the most commonly prescribed antidepressants. Studies have shown that they can be 40-60% effective. However, because they can often cause significant side effects and take weeks or even months to work, people stop taking them. Second, it really depends on the antidepressant. Some are much more effective than others. The studies that have been done on IV ketamine and the anecdotal evidence from those who administer it report relief of depressive symptoms in approximately 70-85% of clients.
At Imagine, our success rate for treating those with moderate to severe depression is 76% for clients who have undergone 6 induction infusions with us (i.e. 76% have shown clinically meaningful improvement on well-established assessment tools by the end of their induction series). Our success rate is similar for those with moderate to severe anxiety.
- What prescription medications interact with ketamine?
Most of what we know regarding medication interactions with low-dose ketamine is from reports from ketamine clients around the country. However, a recently published review offers additional scientific data on some potential mitigators of ketamine - “Pharmacodynamic interactions between ketamine and psychiatric medications used in the treatment of depression: a systematic review”Do antibiotics interfere with ketamine treatment?
In addition, some antibiotics particularly those in the penicillin class may interfere with ketamine treatment. It is important to always update your provider about your prescription medications and any other drugs that you use while undergoing ketamine treatment.
Do you have more questions about ketamine therapy? Refer to our resources page or contact us for more information.