Ketamine Therapy as a New Treatment for Anxiety: Benefits, Risks, Routes

Using Ketamine as a Treatment for Anxiety

Ketamine is emerging as a promising therapy for many mental health conditions, including anxiety disorders. Traditionally used as an anesthetic, ketamine is now being studied and utilized for its ability to rapidly reduce symptoms of anxiety, depression, OCD, PTSD and more. Understanding its effects, administration methods, potential benefits and risks allows for informed decisions about ketamine therapy for anxiety.

How Ketamine Works for Anxiety

Ketamine is a dissociative anesthetic that works on glutamate, one of the brains neurotransmitters. Research shows it helps 'reset' abnormal brain circuits and pathways that may contribute to mood and anxiety disorders. Effects may include:

• Increasing brain-derived neurotrophic factor (BDNF)
• Stimulating nerve growth and synaptogenesis
• Altering cortisol levels
• Reducing inflammation
• Activating opioid receptors

This leads to rapid suppression of anxiety symptoms in many cases. Effects can occur within hours, rather than weeks or months as with traditional antidepressants.

Types of Anxiety Treated with Ketamine

Ketamine therapy can potentially help reduce symptoms of many different anxiety disorder types, including:

• Generalized anxiety disorder (GAD)
• Social anxiety disorder (SAD)
• Panic disorder
• Agoraphobia
• Specific phobias
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)

It appears most beneficial for anxiety that is resistant to first-line treatments like SSRIs, SNRIs, psychotherapy and lifestyle changes.

Effectiveness of Ketamine for Anxiety

Clinical research on using ketamine for anxiety disorders shows promising results:

• A 2016 study found a single ketamine infusion had rapid anti-anxiety effects in patients with generalized anxiety disorder.
• Repeated low doses of intravenous ketamine reduced social anxiety symptoms in a 2018 trial.
• Intranasal ketamine improved anxiety in PTSD patients according to a 2020 study.
• Reviews show over 70% of OCD patients respond to ketamine therapy.

More research is still needed on optimal protocols and long-term benefits. But current evidence supports ketamine as a potentially rapid-acting anti-anxiety treatment option.

Benefits of Ketamine Treatment

There are several advantages that make ketamine a unique and appealing treatment option for anxiety:

• Rapid effects Symptom relief can occur within hours/days, unlike traditional antidepressants.
• Fewer side effects Well-tolerated with minimal effects at proper dosing.
• Non-habit forming Very low potential for abuse or addiction.
• Different mechanism Works differently than current anxiety medications.
• Multiple routes Can be given intravenously, as a nasal spray, or orally.
• Short treatment times Effects seen after a single infusion in some cases.

For those with treatment-resistant anxiety, ketamine provides a promising option without the need for long-term medication use.

Risks and Side Effects

Ketamine therapy is considered safe when administered and monitored properly. However, there are some potential side effects to be aware of:

• Dissociation - Feeling 'out of body' during the infusion.
• Dizziness - Or feeling 'wavy' for a short period.
• Nausea and vomiting - Rare but can occur.
• Headaches - Usually resolve quickly.
• Blood pressure changes - Can increase blood pressure short-term.
• Bladder problems - Very rare with short-term use.

Side effects are generally mild and dissipate within hours after treatment. Your provider will take steps to minimize any risks or discomforts.

Ketamine Administration Methods

There are several ways ketamine can be administered for anxiety treatment:

• Intravenous infusion - Given slowly through an IV over 40-60 minutes.
• Intramuscular injection - Single injection into a large muscle.
• Sublingual tabs/liquids - Dissolving under the tongue.
• Nasal spray - Self-administered via a nasal spray device.
• Oral lozenge - Allowed to dissolve in the mouth.
• Rectal gel - Applied rectally in a small dose.

The route chosen depends on factors like cost, convenience, and provider/patient preference. Nasal spray ketamine allows for home administration after the initial doses.

What to Expect During Treatment

Prior to your first ketamine infusion, your provider will obtain your medical history and conduct an examination. They will also explain the treatment process:

• An IV is inserted into your arm.
• You recline comfortably as the infusion is administered slowly.
• Vital signs like blood pressure are monitored.
• You may experience dissociative effects during the infusion.
• The entire process takes about 1-2 hours.
• Someone will need to drive you home afterwards.

Nasal spray or oral ketamine can be administered in the provider's office as well. Effects are felt within about 15-30 minutes after dosing.

Length of Ketamine Treatment

For long-term anxiety relief, an induction phase followed by maintenance phase is often recommended:

• Induction: Several infusions within a week or two to rapidly reduce symptoms.
• Maintenance: Less frequent 'booster' treatments to sustain the benefits.

This allows for an initial anti-anxiety effect, followed by an individualized schedule to prevent relapse. The right duration is personalized based on your response.

At-home Ketamine Treatment

For convenience and affordability, at-home ketamine treatment may be an option once you are stabilized on the medication. This may involve:

• Nasal spray administration
• Sublingual ketamine tablets/drops
• Close provider monitoring
• Short check-in visits for medication refills

Your mental health provider will determine if at-home treatment is appropriate for your individual case.

Ketamine Therapy Costs

Overall, ketamine therapy is relatively expensive, with costs typically ranging from:

• Intravenous infusion: $350 - $900 per treatment
• Intranasal ketamine: $250 - $850 per month
• Oral/sublingual: $100 - $500 per month

Many providers offer discounted packages for a set number of infusions. Some health insurance companies may cover a portion of ketamine therapy depending on your policy.

Finding a Qualified Provider

It is important to find an experienced medical professional trained in ketamine therapy. Options may include:

• Psychiatrists
• Anesthesiologists
• Nurse practitioners
• Dedicated ketamine clinics

Confirm they are properly licensed and credentialed. You can also research their experience, read reviews, and schedule a consultation.

Using Ketamine Safely and Effectively

When administered properly by a qualified professional, ketamine therapy offers a promising option for rapidly reducing anxiety symptoms. Like any treatment, there are both potential benefits and risks to consider. Discuss with your psychiatrist or doctor to see if ketamine is appropriate for your individual case.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.