Ketamine for Anxiety: Could ‘Special K’ Ease a Stressed Out Mind?
- By Lara McGlashan, CPT
- Fact-checked by Denise Maher
- November 2, 2023
30 Second Takeaway
- Research suggests that ketamine therapy is an effective (and safe) way to treat symptoms of anxiety.
- You can get IV ketamine therapy at a clinic or tablets to take at home. A nasal spray spray version of ketamine is also available.
- While many people report relief from anxiety with ketamine therapy, you should work with your healthcare provider to discuss whether it’s a good option for you.
If you seriously sweat social situations, or even just the future, you might have an anxiety disorder: about one in every 10 guys are affected (1). The good news is anxiety is highly treatable with therapy and medication. The latter has traditionally included selective serotonin uptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and benzodiazepines. But some doctors are exploring a new option: ketamine.
How Ketamine Helps Anxiety
Ketamine was developed in the 1960s as an anesthetic, but 40 years later, researchers found that, at a lower dose, ketamine was helpful in treating mental health conditions (2). Dozens of subsequent studies not only confirmed those results, but also revealed ketamine to be effective at treating both general and social anxiety disorders.
“Ketamine causes an increase in the production of a chemical called brain-derived neurotrophic factor (BDNF), which makes the brain more malleable and open to change,” explains psychiatrist Leonardo Vando, M.D., the medical director at Mindbloom, a mental health and wellness platform in the field of psychedelic telemedicine.
According to Vando, this malleability means your brain is able to build new neural connections that can help give you perspective and develop new, more positive ways of thinking.
“We all have depressive or anxious thoughts, but we don’t get caught in that repeating loop,” he says. But for those with anxiety, this loop can be a pattern that’s pretty tough to escape.
“Ketamine disrupts this negative loop circuitry and flushes the brain with BDNF, allowing for new thoughts, and making it more likely to create a positive loop pattern,” Vando continues. “Ketamine helps people separate from their normal thoughts and feelings, allowing them to break out of negative patterns and form healthier ways of thinking.”
Ketamine Works Quickly
One of the best things about ketamine is that it acts quickly. Patients may experience relief of their anxious symptoms within hours or days of receiving treatment, according to Vando.
Research concurs: A 2023 article published in the Journal of Affective Disorders found that in comparison to those receiving standard anxiety and depression treatment, those who underwent ketamine intravenous therapy for eight weeks experienced a significantly greater reduction in symptoms.
Even better: Ketamine treatment “elicited robust symptomatic relief that remained stable up to one year after follow-up.”
In other words, not only did the treatments work for the study participants in the short term, but many patients experienced relief from symptoms for an entire year (3). Common anti-anxiety medications can take weeks—if not months—to be fully effective, and even then, people may not respond favorably.
“Traditional [anxiety] medications can also cause side effects like sexual dysfunction,” Vando says. “You have to take them every day, and if you miss a dose, you can have terrible side effects. With ketamine, there are minimal side effects.”
Some potential side effects include blood pressure and heart rate changes, and as with any medication, it’s important to check with your healthcare provider before starting.
MORE PSYCHEDELICS FOR YOUR PSYCHE
Ketamine for Anxiety
You actually may have been administered ketamine without realizing it. For example, have you ever had a root canal where you were still conscious, but also completely relaxed and feeling no pain? Those feelings may have been thanks to ketamine, which is still used today in the emergency room and dental offices, and which is now available through ketamine clinics as a treatment for anxiety (4, 5, 6).
Ketamine clinics offer different methods of delivery such as IV infusions or in-office dosing, and are often combined with therapy sessions. And other online platforms—like Mindbloom and Joyous—provide an at-home, sublingual dosing option combined with plenty of medical, therapeutic, and technical support. There’s also Spravato, which is ketamine in the form of a nasal spray, and currently the only form of the drug FDA-approved for treating mental health conditions.
Ketamine via IV
An in-office setting is the only place you are able to receive an IV treatment, which is delivered directly into a vein. According to the American Society of Ketamine Physicians, dosing intravenously delivers the most bioavailable ketamine and is fast acting (7). An IV dose is also quite strong, which is why you need to be medically supervised during the session.
The downside to an IV treatment is that it might actually cause some people more anxiety, due to a fear of needles or medical offices, according to Vando..
Ketamine at home
Some research supports taking ketamine in the comfort of your own home (8). A 2022 review found that at-home sublingual (tablets that you put under the tongue) ketamine was a safe and effective option for treatment-resistant anxiety and depression, and that after just three sessions, 50 percent of people reported a significant improvement.
Clients interested in taking ketamine at home are typically paired with a licensed clinician who conducts a psychiatric evaluation and, if appropriate, clears them for treatment. “Some people are not candidates for at-home ketamine therapy, including those with a history of substance abuse, those with severe psychiatric disorders, and those who are cardiovascularly compromised,” Vando says.
Once cleared, however, clients receive their medication in the mail, and a personal guide—a licensed clinician—helps facilitate their at-home sessions. You take the specified dose, and may be advised to put on an eye mask to block the world while you lay on your couch for an house as the medication does its thing.
“[I recommend] people to prepare for the at-home experience by working with their guide and laying out their intentions beforehand,” Vando says. “It’s also important to honor the medicine, so don’t schedule anything else after a treatment. Because in the hours following, your brain is primed for change. The last thing you want to do is go back to a stressful job, which can put you back into that negative loop pattern. Instead, do something positive that makes you happy, and that drives positive feelings.”
How Much Does Ketamine Therapy Cost?
Most insurance providers currently don’t cover the cost of ketamine therapy, however Vando has hope treatments will be covered in the future. “Mental health and substance abuse are major healthcare issues; some insurance plans are starting to cover this, and we expect coverage to increase in the near future,” he says.
When it comes to dollars, IV treatments can run from $300 to more than $1,000 per infusion. At-home sublingual ketamine versions are less costly, but many clinics have a monthly fee (or subscription) that accompanies the cost of the medication in order to offer clients medical and technical support. (At publication Joyous runs $129 per month, for example, and Mindbloom is $193/session.)
How Long Does Ketamine Treatment Last?
Whether you do IV therapy or opt for at-home treatment, a typical course of treatment runs about four to six weeks, according to Vando. “After the initial course, your physician will reassess your progress and put you on a maintenance dose, once a month or so,” he says.
Considering the costs of therapy and typical antidepressants, ketamine could be a game changer. “Ketamine works, and more people should have access to this amazing tool,” Vando says.
References
1. Anxiety & Depression Association of America Website. “Men’s Health.”
2. Berman, R., et al. (2000). “Antidepressant effects of ketamine in depressed patients.”
3. Hietamies, T., et al. (2023). “The effects of ketamine on symptoms of depression and anxiety in real-world care settings: A retrospective controlled analysis.”
4. Whittaker, E, et al. (2021). “Systematic Review and meta-analysis of randomized controlled trials of ketamine in the treatment of refractory anxiety spectrum disorders.”
5. Derakhshanian, S., et al. (2021). “Role of Ketamine in the Treatment of Psychiatric Disorders.”
6. Mion, Georges. “History of Anesthesia: The ketamine story—past, present and future.”
7. American Society of Ketamine Physicians, Psychotherapists, and Practitioners. “Routes of Administration.”
8. Hassan, K., et al. (2022). “Safety, effectiveness and tolerability of sublingual ketamine in depression and anxiety: A retrospective study of off-label, at-home use”
