Frequently Asked Questions

Ketamine is an anesthetic developed in the early 1960s.  It is one of the most widely used drugs in modern medicine, and is on the World Health Organization’s List of Essential Medicines.  It has a variety of medical uses, and is FDA-approved as an anesthesic.  Ketamine has a remarkably safe track record in surgical settings, and is frequently used in pediatric surgery.  It is also commonly used to treat the extreme physical pain of a condition called CRPS/RSD.  The US military has used ketamine as a battlefield anesthetic since the Vietnam War.  Ketamine is also used in veterinary medicine.  Just like many other essential medications such as morphine or Valium, ketamine is stolen from suppliers and pharmacies to be abused recreationally, and it is a controlled substance in many countries.  In the US ketamine is listed on DEA Schedule III.

Use the Learn menu at the top of the page for detailed explanations of how ketamine is being used to treat depression, bipolar, and PTSD.

About 70% of patients with treatment-resistant depression (including bipolar patients) experience rapid relief after a low-dose ketamine infusion.  Similar success rates have been seen in returning combat veterans suffering from PTSD.  These patients’ cases are the worst of the worst, lasting years or even decades, and which have not responded to any other treatments. Many have hovered on the verge of suicide for years, many have actually attempted suicide, and all have endured a very poor quality of life. Before ketamine therapy, there was virtually no way to substantially improve the condition of patients like these. The fact that ketamine works rapidly on 70% of them is astonishing, and its discovery has profoundly changed depression research, and our understanding of the very nature of depression. It’s important to keep in mind, however, that the degree of relief can vary among patients.  Some sufferers get only partial relief, some do not get relief until a second or third infusion, and some do not respond to ketamine at all.  And some patients have additional medical conditions in addition to depression that can reduce its effectiveness.
It’s real. Ketamine treatment is an intravenous infusion procedure performed in a specially-equipped medical office by an MD, usually an anesthesiologist.

It’s not hype. The National Institutes of Health has been studying ketamine’s affect on depression for more than ten years.  There is serious scholarly research behind this treatment, which means controlled, double-blind, peer-reviewed studies at major institutions. Researchers at Yale pioneered this research nearly 20 years ago and published the first major study in 2000.  Since then, dozens more ketamine studies have been conducted at Yale and other major institutions including NIH, The VA, Harvard, Johns Hopkins, Mt. Sinai Medical School, Oxford University, and many more around the world.

No. The Ketamine Advocacy Network doesn’t sell or endorse anything or anyone. We are a nonprofit made up of actual ketamine patients whose mission is to make our fellow sufferers aware of this important new treatment.

If you are a long-time sufferer of treatment-resistant depression, you’ve probably tried dozens of meds and years of therapy with no relief. Along the way you’ve seen hundreds of commercials for antidepressant meds that promise relief. And you’ve seen plenty of scammers using informercials or websites to peddle “cures” for depression by preying on your desperation. Here, we make no claims or promises. We simply present the facts about ketamine therapy and provide you resources so you can learn more. We maintain a list of doctors who offer the treatment, but we’re not affiliated with or compensated by any of them.

This can vary a great deal between patients. Most patients who respond to ketamine find that a single infusion will provide at least several days of symptomatic relief. This means relief of the physical symptoms that make depression/bipolar/PTSD so unbearable: anxiety, anhedonia, physical fatigue, dysphoria, cognitive impairment, insomnia, etc. Patients who get a series of multiple infusions over several days often get symptomatic relief that lasts weeks.

But there’s more to it than that. When the physical symptoms are relieved, that can also trigger a dramatic improvement in mood. It can help patients feel healthy, function normally, and stop feeling negatively about themselves, sometimes for the first time in decades. Even if the physical symptoms begin to return, many patients find they can withstand them with more resilience than before, instead of retreating to the fetal position each time a new stress or obstacle arises. This improvement in mood and function can last longer than the physical symptom relief. See here for a more complete explanation.

The number of patients using ketamine long-term is still very small, and long-term treatment regimens are still being developed.

The ketamine must be administered in a very precise way in order to achieve the antidepressant effect.  Virtually all of the research studies have used intravenous infusion (aka, an IV drip) to ensure it goes directly into the bloodstream at a carefully controlled rate and straight to your brain without first being metabolized by the body.  The IV drip rate will be set very precisely and fine-tuned throughout the procedure so that the optimal rate is maintained.  A small number of doctors use intranasal application (sprayed into the nose) or intramuscular injections (with a syringe, like how a flu shot is given).  Patients who have experienced multiple methods of administration often report significant differences in effectiveness from one method to another.  The initial dose is based on your weight, and your doctor may adjust it in later infusions to improve your results.  During the treatment, you may experience something called a dissociative effect.  Most patients describe the experience with words like relaxing, floating, pleasant.  If you ever received gas for a dental procedure, the effect is similar but stronger.
Partly because the pharmaceutical industry can’t make money from using ketamine on depression.  Ketamine is an old drug whose patent expired decades ago, and is cheap to manufacture generically, which means it will never produce blockbuster profits.  In addition, some of the most prominent ketamine researchers discourage doctors from using it outside of research settings, arguing that the benefits of using ketamine widely are outweighed by the need to conduct more studies on long-term safety and efficacy.  Some also feel that the brief dissociative effect some patients experience during treatment is reason enough not to use it in clinical practice. Finally, many psychiatrists oppose ketamine therapy. All of these reasons are discussed at length here.
Probably not.  Ketamine is most often used by anesthesiologists during surgery, and other types of doctors rarely have first-hand experience with it.  Ketamine is FDA-approved only for anesthesia, not depression, so it must be used off-label.  This is a very common practice with a wide variety of medications, but your doctor may not be familiar with this new use for ketamine and might not be comfortable using it off-label.  For depression it is most often administered by IV over roughly an hour, during which time you must be constantly monitored – not the kind of procedure typically performed in a GP’s office.
As of 2015, there are a small number of US clinics that focus on ketamine therapy for depression, bipolar, PTSD, and other mood disorders.  See our directory of ketamine providers.  Beyond those, anesthesiologists and pain management specialists (“pdocs”) have the most experience with ketamine, and are the most likely to be willing to perform infusions.  Psychiatrists are interested in treating depression, of course, but most have not performed physical procedures or laid hands on patients since medical school, and their offices are rarely equipped to perform an infusion, so few if any actually perform the procedure themselves, or they team with other medical professionals who do.  Any psychiatrist who endorses ketamine treatment can write an order for the infusion and send the patient to a third party (like a pain management specialist) who has the procedure room, equipment, and training to actually perform it.  A very small number of psychiatrists will personally administer ketamine to the patient, using a nasal spray or simple injection.
Ketamine is completely different from SSRIs, tricyclics, MOAI inhibitors, benzos, or any other antidepressant or anti-anxiety medication.  The exact mechanism that causes ketamine to relieve depression is still under study, and is quite complex.  In short, when ketamine is administered in a very precise way it triggers a cascading sequence of events in the brain, which ultimately results in the re-growth of neurons that previously died off.  It is thought by some researchers that prolonged exposure to stress causes these neurons die off in the first place, resulting in depression, but ketamine causes them to rapidly re-grow within hours, relieving the depressive symptoms.  This is an oversimplification of a very complex topic, and the latest research hints there may be several other mechanisms involved that also play important roles.  Elsewhere on this site you’ll find more in-depth discussion, as well as a research database.
When ketamine is administered in a controlled medical setting by a properly trained physician using established methods, it is very safe.  Ketamine is the only anesthetic that does not suppress the body’s cardiovascular and respiratory systems.  It does have the potential to elevate heart rate and blood pressure, so the patient’s vitals must be monitored during treatment.

Using illegally-obtained ketamine on your own, without a doctor’s supervision, is a different matter.  There’s no assurance the substance you’re taking is actually ketamine at all, or that it hasn’t been mixed with other substances.  And since ketamine is an anesthetic capable of sedating patients during major surgery, you can seriously injure yourself while under its influence if you are not in a controlled medical setting.  If you are contemplating taking “street” ketamine in hopes of relieving your depression, keep in mind that the antidepressant effect depends on it being administered in a very precise, controlled way that you cannot achieve in a recreational setting.

No, not yet.  This is sadly one of the biggest obstacles to patients who are badly in need of relief.  See here, here, and the forums for longer discussions.
Ketamine was originally developed for human use, and it has been safely used on humans for more than 50 years.  Many human medications are also useful in veterinary medicine, and ketamine is one of them.  Vets use it as a surgical anesthetic for certain warm-blooded animals.  The term “horse tranquilizer” is a slang term coined by recreational abusers, and it is inaccurate since ketamine is an anesthetic, not a tranquilizer. This term is also used as a smear by those who oppose ketamine therapy for depression. They seek to discredit the treatment by making ketamine sound like something suited only for animals. Calling ketamine a “horse tranquilizer” is akin to calling a plastic bag a “human suffocator”. It is intentionally misleading.

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