A drug that was developed as an anesthetic, ketamine has recently gained much attention for its potential in psychiatric disorders, most especially anxiety. Traditionally, ketamine is medically used as a sedative and painkilling. Surprisingly, though, its effects on anxiety have turned the fortunes of many suffering from this debilitating psychiatric disorder. However, how do people know exactly how fast does ketamine work for anxiety? This post will focus on the science behind ketamine, its application and role in anxiety treatment, and finally, the time of relief onset.
What Is Ketamine, and How Does It Work?
Ketamine is a dissociative anesthetic first synthesized in the 1960s for surgery. Shortly after its creation, people realized it could be useful for treating some mental illnesses, depression, and anxiety. Ketamine’s primary action is on the glutamate system, one of the brain’s primary excitatory neurotransmitters.
Ketamine might be hypothesized to be working “by resetting” brain areas by increasing neuronal activity from stimulated NMDA (N-methyl-D-aspartate) receptors and increases in brain-derived neurotrophic factor (BDNF). That connection helps regenerate neuronal circuits related to mood control or emotional reactivity. In the case of anxiety, ketamine’s impact on glutamate and BDNF levels helps alleviate symptoms by promoting neuroplasticity and reducing the overactivity of stress pathways in the brain.
Types of Ketamine Therapy for Anxiety
The ketamine can be prescribed in a few different forms. Each form may be administered differently with a slightly varying onset time and effectiveness in treating anxiety:
- Intravenous (IV) Ketamine: Probably the most often used form of ketamine application in the clinic is intravenous. This ensures that the injection can be established in the circulatory system from an IV drip, thus affecting rapid intake and quick uptake.
- Intramuscular (IM) Ketamine: injections ketamine directly into the muscle in the arm or thigh. Although it takes effect almost immediately, it may take slightly longer to commence its effects than if injected intravenously.
- Nasal Ketamine (Spravato): This one, FDA-approved, is an adjunct for the treatment of resistant depression and is a ketamine nasal spray; it also treats anxiety. While faster than intravenous, perhaps by several days, this delivery system still presents with its lag time.
- Oral Ketamine: This is pretty rare in psychiatric medicine. Delivering the substance through oral delivery takes a long time, as the substance undergoes digestive processes first. But under exceptional circumstances, that might not be very important after all.
How Fast Does Ketamine Work for Anxiety?
The onset of action for ketamine can vary, as it is administered differently in various cases and has different responses from different individuals with varying severity of their symptoms. Generally, ketamine is a drug that works relatively fast in comparison to standard antidepressants or anti-anxiety medications.
Intravenous (IV) Ketamine
Intravenous ketamine can be effective in initiating its effects within minutes. Many patients receiving therapy report feeling changes in their level of symptoms virtually immediately, as anxiety symptoms reportedly improve within 15-30 minutes of dosing. Among the most salient features making ketamine a particularly appealing compound for the treatment of acute, severe anxiety may be its short-onset therapeutic effect from fearsome, disturbing, and possibly overwhelming emotions.
Intramuscular (IM) Ketamine
IM ketamine acts a little bit slower than IV ketamine, but it is nonetheless much faster than antidepressants. However, patients usually feel the onset of the decrease in anxiety symptoms within 20-45 minutes following an IM injection. This is not typically used for anxiety as often as IV, but it does work for many.
Nasal Ketamine (Spravato)
Spravato is the nasal spray version of ketamine and has a rapid onset but usually takes 20-40 minutes before observable effects. It is administered in patients who are poorly responsive to other treatments or medications, specifically when treatment-resistant anxiety is seen. Its onset time is slightly longer compared to IV ketamine but faster than most forms of anxiety treatment.
Oral Ketamine
Oral ketamine is the slowest-acting method, as it must first pass through the digestive system before it can take effect. It can take up to 1-2 hours for anxiety relief to set in. While not as commonly used for anxiety, oral ketamine may be prescribed in certain circumstances or for patients who prefer a more gradual onset.
Duration of Ketamine’s Effects on Anxiety
Although ketamine starts working fast, the duration might not be too long. The anxiety relief sometimes lasts for hours or even until the next day after treatment. It is usually given during treatments to maintain the effects of therapy. Patients might have 6 to 12 sessions over a couple of weeks. This builds up the positive effects over time, and the relief from anxiety can be sustained with more use.
For some patients, ketamine provides significant anxiety relief that lasts for several days, while for others, ketamine must be given more frequently to maintain its benefits. Additionally, relief may last longer in individuals with milder anxiety, depending on the route of ketamine administration as well as the body’s response to such treatment.
Combining ketamine with other therapies
The best results are typically achieved when ketamine treatment for anxiety is used in combination with other therapies. Cognitive behavioural therapy is the most commonly recommended therapy to be used in conjunction with ketamine. CBT helps patients realize and change any negative thought patterns and behaviours which lead to their anxiety. The combination of rapid symptom relief from ketamine and the long-term coping strategies learned in CBT may help individuals manage their anxiety more sustainably.
In addition, some healthcare providers recommend pairing ketamine with other lifestyle modifications, such as regular exercise, better sleep hygiene, or meditation/yoga. These practices reduce an overall stress level that can improve response to ketamine and induce long-term management of anxiety.
Future of Ketamine Therapy for Anxiety
The use of ketamine to treat anxiety was not so widely applied until some years ago. Nevertheless, researchers are already experimenting with how to relate ketamine to other neurotransmitters and using it in treatments of other forms of mental disease. With continuous clinical trials underway, this might give room for a good understanding of how the long-term effect of using ketamine relates to optimal doses and perhaps to its suitability as part of a larger treatment for anxiety and more severe mood disturbances.
Hence, the advent of ketamine home treatment, in particular, its form of nasal spray, branded as Spravato, gives many patients additional possibilities for treatment. Although at-home ketamine treatment is convenient, there needs to be a cautionary approach, and proper medical supervision would be highly recommended to ensure safe usage.
The Role of PGx Testing in Optimizing Ketamine Treatment for Anxiety
Pharmacogenomic testing of PGx performs a very fundamental role in managing and diagnosing anxiety by enlightening individuals and their physicians personally about how any genetic makeup influences the response given to medications, as in the present case, treatment with ketamine. Such testing helps identify genetic variations likely to impact treatment metabolism, efficacy, and side effects so that treatment can be tailored to the unique needs of each individual under care. When combined with treatments such as ketamine, which work rapidly to alleviate anxiety symptoms within minutes to hours, PGx testing can make care much more precise. This means that the right drug is used at the right dose, improving success in overall treatment outcomes.
Conclusion: Is Ketamine the Right Solution for You?
Ketamine can offer rapid relief of anxiety. This is important for people who are seeking fast relief from the heavy burden of anxiety. In that respect, while other drugs might take weeks before they can have their effects seen, ketamine is a cure that offers close to instant relief. However, this does not mean it is a remedy for everyone; it requires careful consideration and medical guidance.
To those suffering from treatment-resistant anxiety, ketamine may be the hope other treatments could not deliver. This could be for the simple reason that even if other treatments along with lifestyle modification are there, ketamine offers long-term remission regarding anxiety and recovery of mental control.
With the decision to use ketamine for anxiety, a professional in the area of ketamine therapy must be consulted for the evaluation and development of a treatment plan that best serves your needs for the best possible outcome.
Despite potential risks and side effects, ketamine’s ability to decrease anxiety symptomatology is quite a breakthrough. As this research continues to grow, it is becoming more vibrant by the day, and this ketamine shall revolutionize how anxiety is to be treated in the future. As a first-line treatment or an adjunct, ketamine is the solution for you—that’s going to help you feel better sooner.
References
https://pmc.ncbi.nlm.nih.gov/articles/PMC9556663/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3696246/
Leave a Reply