Are you exploring ketamine as a potential relief for your anxiety? This guide thoughtfully explores ketamine Anxiety treatments, detailing its effectiveness and important safety considerations. Discover if ketamine could be your next step toward managing anxiety.

Key Takeaways

  • Anxiety disorders affect up to 20% of adults annually. They can lead to significant impairments like depression and social isolation. Yet, treatment adequacy is low, particularly in low- and middle-income countries.¹
  • Traditional anxiety treatments, including selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT), often come with limitations like side effects and limited access, leading to inadequate relief for many, particularly those with treatment-resistant conditions.
  • Ketamine therapy presents a promising alternative for a spectrum of anxiety disorders, rapidly acting on NMDA receptors and modulating glutamate, thus alleviating symptoms more swiftly than traditional treatments. Always consider the potential side effects and the need for medical supervision before starting ketamine treatment.²

Understanding Anxiety Disorders and Their Impact

Anxiety disorders are much more than just occasional worry or fear; they are severe medical conditions that affect up to 20% of adults each year. Generalized anxiety disorder is one of the most common types, affecting women approximately twice as much as men.³ Children are not exempt from the adverse effects of anxiety; the lifetime prevalence of severe anxiety disorder reaches about 5.9% in those aged 13 to 18, with the onset of childhood anxiety disorders typically occurring around age 11.⁴

Mental health conditions, including mood disorders, can lead to significant impairments. For instance, generalized anxiety disorder can lead to substance abuse, depression, and a greater likelihood of facing social isolation and economic struggles due to the cost and side effects of psychiatric treatment.

Sadly, despite their prevalence, only 27.6% of individuals with anxiety disorders receive treatment⁵, and just 9.8% receive what is considered adequate care.⁶ These numbers are even lower in low- and middle-income countries due to structural barriers to mental health resources. The current state of anxiety treatment and lack of optimal outcomes highlight the urgent need for better and more accessible options to address mental health disorders effectively.

Anxiety disorders are diverse, not a monolith. They encompass a range of conditions, including:

  • Generalized anxiety disorder
  • Social anxiety disorder

Each condition has its unique set of symptoms and challenges. Regardless of the type of disorder, the impact on an individual’s life can be profound, affecting everything from personal relationships to professional achievements.

Traditional Anxiety Treatments and Their LimitationsAn anxious woman stares off into the distance with her hand placed on her mouth.

Traditional treatments for anxiety disorders often involve a combination of medication and psychotherapy. Doctors commonly prescribe selective serotonin reuptake inhibitors (SSRIs) as medications. However, despite being safer than older antidepressants, SSRIs still come with side effects like sexual dysfunction, weight gain, sleep disturbance, and the risk of serotonin syndrome.

Psychotherapy, particularly cognitive-behavioral therapy (CBT), is another cornerstone of anxiety treatment. The shortage of trained therapists, the high costs of individualized sessions, and societal stigma can limit access to effective psychotherapy treatments. Even when these treatments are available and accessible, they aren’t always practical.

Moreover, traditional treatments often take weeks or even months to take effect, leaving individuals to grapple with debilitating anxiety symptoms in the meantime. This delay can be particularly challenging for those with severe anxiety or those at risk of self-harm or suicide. Treatment-resistant depression is also common among individuals with anxiety disorders. 

While traditional treatments can and do provide relief for some, numerous individuals with anxiety disorders still struggle without adequate relief. Innovative therapies must address the imperative need for rapid and effective relief, particularly for individuals who struggle with treatment-resistant or treatment-refractory anxiety disorders. The limitations of conventional therapies emphasizes the need for novel therapeutic approaches.

Ketamine Therapy: A Novel Approach to Treating Anxiety

Enter ketamine therapy. This innovative treatment targets NMDA receptors and modulates glutamate – a crucial neurotransmitter for regulating brain function and anxiety symptoms – offering a unique approach to anxiety treatment. The interaction between ketamine and glutamate neurotransmission in the brain can help treatanxiety through the formation and repair of new neural connections.

Ketamine activates glutamate immediately upon administration, leading to faster symptom relief in individuals with anxiety, which offers a significant advantage over conventional treatments that may take weeks to take effect.

Intravenous Ketamine Infusions

Intravenous (IV) ketamine infusions involve a slow, constant drip of ketamine delivered directly into the bloodstream in a hospital or clinic setting. Medical professionals administer the infusions and provide close monitoring. To continuously evaluate the drug’s dissociative impact and potential side effects, such as increased blood pressure and heart rate. The standard course of treatment for intravenous ketamine infusion in treating anxiety disorders, on average, typically includes six infusions over a span of 21 days.

Close monitoring during intravenous ketamine infusions encourages patient safety, allowing for immediate response to potential adverse effects. As such, this form of ketamine therapy provides a controlled and medically supervised environment for patients undergoing treatment.

Nasal Spray and Oral Ketamine

Not all ketamine treatments require an IV line or a hospital setting. A doctor’s office may administer nasal spray esketamine (Spravato). Doctors may prescribe esketamine in conjunction with traditional anti-anxiety medication while monitoring closely for side effects. Esketamine, a form of ketamine, has been researched for its quick action in alleviating symptoms of anxiety and depression, serving as an alternative to the intravenous administration method.⁷

Oral ketamine offers yet another route of administration. In a study involving hospice residents with depression and anxiety, participants reported reduced anxiety symptoms after taking oral ketamine for 28 days. Although less common and less researched than intravenous ketamine infusions, oral ketamine has shown promise in reducing symptoms of anxiety and depression.⁸ However, the bioavailability of oral ketamine is estimated to be approximately 20% to 25%,⁹ which may impact its efficacy compared to other routes of administration, like intravenous or intranasal ketamine.

Research Findings on Ketamine for Anxiety DisordersKetamine Anxiety Treatments

The promising results of ketamine therapy aren’t just anecdotal; scientific research shows the efficacy of ketamine in treating various anxiety disorders. Studies show that ketamine intravenous therapy (KIT) leads to a significant reduction in anxiety and depression symptoms, indicating its effectiveness as a treatment for symptoms of depression and anxiety when administered in a series of infusions.¹⁰

When compared to control groups not receiving ketamine, the group treated with KIT consistently demonstrated a more significant improvement in anxiety symptoms, with patients achieving considerable improvement and a more substantial reduction in depression symptoms over eight weeks. Side effects for KIT treatment remained stable across induction and maintenance phases.

One study showed the following results after ten infusions of ketamine¹¹:

  • High response rates
  • 38% remission rate in depressive symptoms
  • Half of the patients with suicidal ideation were in remission after six weeks
  • 50% response rate and 20% remission rate in depressive symptoms after six weeks
  • Suicidal ideation and major depression symptoms showed significant reduction post-ketamine infusion.

In another study involving patients with social anxiety disorder (SAD), single doses of intravenous ketamine led to reduced anxiety on the Liebowitz Social Anxiety Scale (LSAS), with some cases showing persistent reduced anxiety symptoms for up to 14 days. Ketamine demonstrated significant benefit over placebo in multiple sub-scales of the LSAS related to fear, avoidance, and social anxiety.

Collectively, these research findings underscore the potential of ketamine therapy as a novel and effective treatment for various anxiety disorders. However, similar to all treatments, ketamine may not be a fit for everyone, and patients and providers must consider the potential risks and side effects.

Safety and Side Effects of Ketamine Therapy

While ketamine therapy brings a new ray of hope for many individuals with anxiety disorders, gaining an awareness of the potential side effects and risks before starting treatment is crucial. Ketamine therapy can cause side effects, including:

  • Nausea
  • Vomiting
  • Dissociation
  • Double vision
  • Dream-like states
  • Uncontrolled eye movements
  • Warm skin sensation
  • Increased blood pressure

Serious side effects may include hallucinations, confusion, and irregular heartbeat. Medical supervision during ketamine therapy can help manage potential side effects, ensure proper dosing, and protect patient safety.

Other rare side effects, such as weight loss, are linked to oral ketamine, while transient dissociative side effects are common post-infusion, usually resolving within 30 to 60 minutes.Supervised administration of ketamine therapy by trained healthcare professionals is vital. Individuals considering ketamine therapy should discuss the potential risks and benefits with their healthcare provider to make an informed decision.

When to Consider Ketamine Therapy for Anxiety

When is it appropriate to consider ketamine therapy for anxiety? Ketamine therapy is suitable for individuals with:

  • Generalized anxiety disorder (GAD)
  • Social anxiety disorder
  • Treatment-resistant anxiety
  • Other anxiety-related conditions, like specific phobias, that have not responded adequately to conventional treatments

Ketamine  quickly enhances glutamate activity in the brain, offering faster relief from anxiety symptoms compared to traditional anti-anxiety medications.

Please remember that ketamine therapy is not suitable for everyone. Medical professionals do not recommend ketamine for individuals who:

  • Are you pregnant or breastfeeding
  • Have schizophrenia
  • Have unmanaged high blood pressure
  • Have a history of substance use disorder
  • Have psychosis
  • Have heart disease
  • Have increased intracranial pressure

Patients exploring ketamine therapy should consult with healthcare professionals who are familiar with their anxiety treatment history to determine suitability before receiving a referral to a ketamine therapy specialist.

Plus by APN: Comprehensive Mental Health Care

At Plus by APN, we believe in a comprehensive, personalized approach to mental health care. We tailor treatments based on individual stories and needs, focusing mainly on mood instability and depressive disorders and anxiety, including bipolar depression. We utilize interventional psychiatry along with a variety of modern healthcare techniques for a comprehensive and fully customized approach

We pledge to utilize the most recent research to support our mental health services for both safety and efficacy, rooting our approach in peer-reviewed science and the latest regulatory guidelines. Our medical board regularly reviews and incorporates cutting-edge treatments into our service offerings, ensuring that our patients have access to the most advanced care available.

Summary

In conclusion, anxiety disorders are a prevalent and severe issue that can significantly impact individuals’ lives. The limitations of traditional treatments and the prevalence of treatment-resistant anxiety highlight the need for new approaches. Enter ketamine therapy: a novel treatment that offers rapid relief from anxiety symptoms, providing a new ray of hope for individuals struggling with anxiety disorders.

While ketamine therapy shows promise, it’s important to remember that it’s not a one-size-fits-all solution. Each person’s experience with anxiety is unique, and what works for one person may not work for another. It’s important to always consult with a healthcare professional before embarking on any new treatment. 

At Plus by APN, we’re here to help you navigate your mental health journey and find the treatment that works best for you.

Frequently Asked Questions

What are the benefits of ketamine?

Ketamine therapy under medical supervision can help regulate brain activity and form new neural connections, aiding in overcoming negative thoughts and depression.

What is ketamine used to treat?

Ketamine is used to treat depression, with the FDA approval indicated for treatment-resistant depression in the form of esketamine nasal spray. Ketamine also has accepted medical uses for short-term sedation and anesthesia.

What is the strongest anxiety treatment?

Cognitive behavioral therapy (CBT) is considered the strongest anxiety treatment, and shows higher efficacy in managing anxiety disorders in the long term compared to medications or benzodiazepines. CBT focuses on teaching specific skills to improve symptoms with the ultimate goal of supporting a gradual return to avoided activities.

What is the best medication for high-functioning anxiety?

The best medication for high-functioning anxiety is usually antidepressants like SSRIs and anti-anxiety medications such as benzodiazepines or beta blockers. However, SSRIs may take a few weeks to begin working and may have some side effects.

The best medication for anxiety depends on the individual and treatment goals. Ketamine offers faster relief than SSRIs or other traditional anti-anxiety medications.

How is ketamine administered?

Healthcare providers can administer ketamine through various methods, including intravenous infusions, nasal sprays, or in pill form, taken orally. Ketamine administration should depend on an individual’s needs and overall treatment goals.

Reference

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  3. “Anxiety Disorders – Facts & Statistics.” Anxiety & Depression Association of America, 28 Oct. 2022, adaa.org/understanding-anxiety/facts-statistics. 
  4. Wang Z, Whiteside S, Sim L, et al. Anxiety in Children [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2017 Aug. (Comparative Effectiveness Reviews, No. 192.) Introduction. Available from: https://www.ncbi.nlm.nih.gov/books/NBK476265/
  5. “Anxiety Disorders.” World Health Organization, 27 Sept. 2023, www.who.int/news-room/fact-sheets/detail/anxiety-disorders.
  6. Alonso, Jordi et al. “Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries.” Depression and anxiety vol. 35,3 (2018): 195-208. doi:10.1002/da.22711
  7. Salahudeen, Mohammed S et al. “Esketamine: new hope for the treatment of treatment-resistant depression? A narrative review.” Therapeutic advances in drug safety vol. 11 2042098620937899. 23 Jul. 2020, doi:10.1177/2042098620937899
  8. Irwin, Scott A et al. “Daily oral ketamine for the treatment of depression and anxiety in patients receiving hospice care: a 28-day open-label proof-of-concept trial.” Journal of palliative medicine vol. 16,8 (2013): 958-65. doi:10.1089/jpm.2012.0617
  9. Andrade, Chittaranjan. “Oral Ketamine for Depression, 1: Pharmacologic Considerations and Clinical Evidence.” The Journal of clinical psychiatry vol. 80,2 19f12820. 2 Apr. 2019, doi:10.4088/JCP.19f12820
  10. Hietamies, Tuuli M et al. “The effects of ketamine on symptoms of depression and anxiety in real-world care settings: A retrospective controlled analysis.” Journal of affective disorders vol. 335 (2023): 484-492. doi:10.1016/j.jad.2023.04.141

Zhan, Yanni et al. “A preliminary study of anti-suicidal efficacy of repeated ketamine infusions in depression with suicidal ideation.” Journal of affective disorders vol. 251 (2019): 205-212. doi:10.1016/j.jad.2019.03.071