Ketamine has been used as a FDA approved anesthetic agent over 40 years.
Ketamine induces sedation and dissociative anesthesia which demonstrates out of body experience.
Ketamine reduces excitatory synaptic response of glutamate receptor known as NMDA receptor as an non competitive inhibitor and decreases calcium mediated neuronal cell death. Ketamine also works as an opioid agonist and monoamine transporter.
Ketamine increases Brain Derived Neurotropic Factor which is significantly decreses in the state of depression and stress. BDNF is responsible for the birth of new neurons known as neurogenesis. Ketamine also helps neuronal connection by increasing protein kinase known as mTOR which increases dendrite response and regeneration. Indeed ketamine helps to restore brain anatomical structure by increasing synaptic plasticity and remodeling.
Clinical studies demonstrated ketamine rapidly decreases treatment resistant major depression,bipolar depression,suicidal ideation and PTSD symptoms.
Patients reported rapid dramatic responses even after single infusion and series of 6 infusions demonstrated several weeks to months of relief from refractory depression for more than 70% of subjects.
Neuropathic pain is associated with increased glutamate release and disregulation of NMDA receptor which increases substance C at dorsal horn of spinal cord. Wind up of NMDA amplifies the nociceptive message in the spinal cord. Blocking NMDA receptor with ketamine inhibits wind up phenomenon and reduces hypersensitivity of spinal dorsal horn neurons.
NMDA receptor is also responsible for opioid tolerance and opioid induced hyperalgesia for patients taking prescription opioids.
Ketamine infusion is an exciting new paradigm of rapid treatment to relieve chronic suffering from refractory depression,PTSD,severe anxiety, chronic pain and opioid use disorder.