SSRI and ketamine targeting a serotonin synapse and a glutamate synapse

Ketamine vs. SSRIs to Treat Depression

Depression can be treated in a number of ways. The traditional SSRI treatment is effective for some, but not for everyone. Studies on ketamine have shown that it is very helpful with depression, especially when other treatments have not been able to help as much.

How Does Ketamine Help to Treat Depression?

Scientists still have a lot to learn about the mechanisms of our brain and depression itself. Thus, it’s difficult to pinpoint exactly how ketamine helps a depressed patient, but theories are being researched. Here is a popular one:

Stress causes damage to neurons and ketamine helps to repair those neurons.

Scientists have found that when people are exposed to repeated stress, it wears away at their brain cells. These cells are in the hippocampus and the prefrontal cortex of your brain. The hippocampus is associated with memory, and the prefrontal cortex is associated with personality and planning.

There are two ways ketamine may help alleviate depression by improving neuron health:

  • By boosting the body’s levels of BDNF (brain-derived neurotrophic factor). BDNF is a protein in the brain that helps to make connections between the neurons.
  • By promoting the release of glutamate. Ketamine restores the health of neurons in the prefrontal cortex by promoting the release of glutamate. Ketamine can reverse synaptic dysfunction and may help treatment-resistant individuals recover.

Ketamine is intended to occasion breakthrough experiences, or moments of ego dissolution. Ego dissolution is a state in which the patient temporarily loses their sense of self.

With proper preparation and integration, tremendous healing can occur in this state. The patient may dissolve old narratives about the self and may gain greater insight about who they truly are.  

How SSRIs Work

SSRIs are the most common form of antidepressant. Since the introduction of Prozac in 1987, SSRIs have been prescribed to patients to combat depression.

Selective serotonin reuptake inhibitors (SSRIs) are the most widely prescribed antidepressants in the United States. They include popular medications such as Prozac, Zoloft and Lexapro.

This class of drugs was once thought to work by increasing the brain’s serotonin levels. Neurons use neurotransmitters like serotonin to send and receive messages. After carrying a message, serotonin is typically reabsorbed by the neurons.

SSRIs supposedly “inhibit” this “reuptake”, thereby increasing the levels of available serotonin. This was believed to correct a chemical imbalance in the brain that was thought to be the cause of depression (although mounting evidence is starting to challenge this concept).

SSRIs do work for many people, but they can also present issues. Despite increasing serotonin levels immediately, it can take patients about a month or more to start seeing results. SSRIs also require the patient to stick to a daily pharmaceutical regime of taking pills that can have negative side effects.

 

Is Ketamine Safe to Take with Antidepressants?

Patients that seek out ketamine therapy may currently be taking an antidepressant medication. They may be resistant to stopping the medication before starting therapy for fear that their symptoms will get worse. It is only natural to wonder if ketamine is safe to take with antidepressants.

The simple answer is yes. Unlike other psychedelics such as psilocybin and MDMA, antidepressants are routinely administered alongside ketamine. For the nasal spray esketamine, FDA-approved use even requires it.

 

Are these medications safe to take with ketamine?

  • SSRIs

Most people taking antidepressants are perfectly safe to continue use while undergoing ketamine therapy. This includes the most commonly prescribed classes of antidepressants, SSRIs (Lexapro, Prozac, Zoloft).

  • MAOIs

Using ketamine with MAOIs (an older class of antidepressants), should be done with more caution. MAOIs (monoamine oxidase inhibitors) were introduced in the 1950s. They are now prescribed as a last resort as they come with a whole host of side effects.

Patients prescribed MAOIs alone must take special care of their diet or can risk a possibly fatal hypertensive crisis. Administering ketamine at the same time can increase heart rate and blood pressure.

  • SNRIs

It is generally safe to take SNRIs (Cymbalta, Effexor), Wellburtin and lithium with ketamine. This class of antidepressants can also increase blood pressure, but is usually minimal.

  • Antipsychotics

Antipsychotics—while not antidepressants—are sometimes prescribed for patients with bipolar depression. These drugs can blunt the positive effects of ketamine in some patients.

 

What is the Best Option for Treating Depression? 

Ketamine seems promising as an alternative to current antidepressants. Most SSRIs can take weeks to kick in and may involve unpleasant side effects like agitation and weight gain. A study done in 2006 showed that ketamine can relieve symptoms of depression after only a few hours, with minimal, bothersome side effects. However, duration of relief from symptoms varies greatly, and most long lasting results happen when ketamine treatments are paired with integration techniques such as therapy, community, and daily practice. 

There are a number of options for treating depression but ketamine is showing promise as a new alternative which can potentially serve as a more effective adjunct to someone’s existing healing process. 

 

Safety at Nushama

In order to ensure the safety of patients at Nushama, a full medical history is taken before treatment. Secondly, clinicians perform a thorough screening on all new patients. If the patient is found to have high blood pressure, then treatment will not proceed. Patients who qualify for treatment will have their heart rate and blood pressure monitored throughout the entire infusion by trained professionals.

Discover what psychedelic medicine can do for you.

Our mission is to help people achieve mental wellness safely… so they can transcend their emotional pain, and live a free and fulfilling life. Book an appointment.

More Blog Posts