Ketamine is a drug in a class called dissociative anesthetics, medications that can make you feel detached from your surroundings and from sensations. This is the same class as nitrous oxide and PCP. Ketamine has been used traditionally as an anesthetic and pain reliever, having some properties that make it well-suited in some situations.
However, it’s also seen a dark side as a recreational street drug, and ketamine has a range of side effects that, despite its advantages, limited its use outside of anesthesia except under specific, well-observed medical care. Surprising and promising off-label uses of ketamine are emerging as a treatment for depression and fibromyalgia.
Off-label medical use
“Off-label” refers to using a medication for something other than why it was approved by the federal Food and Drug Administration. In fact, while this does sounds ominous, it is a common and legal practice. Drugs approved to target certain types of cancer, for example, frequently prove useful in treating other types as well. Off-label use frequently leads to future FDA approval for that purpose.
Treatment of depression
As a treatment for depression, ketamine shows tremendously fast results. Clinical trials indicate that ketamine lessens the symptoms of depression in hours. Traditional antidepressants may take weeks to have an effect. Since ketamine has an immediate effect on neuron bursts in the brain’s lateral habenula, the balance of reward/anti-reward systems can be restored quickly.
Though ketamine has been used for decades as a human and veterinary anesthetic, research into its value as an antidepressant is a recent development. This research is particularly exciting, since it may offer insight into the mechanisms behind depression, as well as providing a therapeutic treatment for symptoms.
While its antidepressant effects generate excitement, low-dose ketamine treatment proves effective for many fibromyalgia patients. Ketamine injections or infusions often reduce the overactive nerve activity thought to be at the heart of fibromyalgia in many people. The drug has a slightly suppressive effect on the central nervous system, reducing neurotransmitter activity and the excessive pain that often accompanies fibromyalgia.
The association between ketamine and fibromyalgia emerged after people with the condition underwent unrelated surgery that involved ketamine in their anesthetic protocol. The ketamine infusion seems to reset the pain perception systems in fibromyalgia patients, long after the temporary anesthetic effects are gone. Ketamine activates opiate receptors and increases levels of serotonin and dopamine, naturally occurring substances with pain relief properties.
Ketamine’s effectiveness for fibromyalgia pain is unparalleled. Studies show that ketamine reduces pain symptoms more effectively than both lidocaine and morphine. This supports the idea that NMDA receptors are the most likely suspects behind the excessive nervous system activity thought to cause fibromyalgia pain.
Due to the off-label use of ketamine for fibromyalgia and depression, treatments are classed as experimental, and they might not be covered under many health plans. The drug may be administered as an intravenous infusion, a local injection, or through topical creams. While ketamine can be given in pill form, effectiveness is limited due to the digestive process.