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Research by Dr. Thomas Swahn

A deeper look at the ketamine molecule

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Barriers to Using Ketamine for the Treatment of Depression

Mark Beebe, Sara Maestas, and Thomas K. Swahn

Depressive disorders are prevalent in the United States. Current treatment paradigms take weeks to reach clinical efficacy and may leave patients at risk for suicide during the initial weeks of treatment. Intravenous (IV) ketamine infusions have shown promise in the rapid relief of depression symptoms, including efficacy in treatment-resistant depression and relief of suicidal ideation. Initial research has shown ketamine therapy to be safe and effective. Despite a plethora of information in support of the safety and efficacy of ketamine, there is reluctance of both patient and provider in utilizing ketamine’s unique potential. We used a grounded-theory approach to perform a meta-analysis literature review exploring the barriers preventing widespread acceptance of ketamine therapy. We found fear or moral objection to psychoactive effects, potential side effects, and history of abuse as a street drug to be inhibiting factors among patients. Among healthcare providers, barriers included lack of accessibility, addictiveness, abuse potential, and refusal of insurance policies to cover treatment. We present arguments to challenge objections and question concerns as the vast benefit of ketamine therapy far outweighs potential harms. We give recommendations for further research and call for a more rational approach to U.S. drug policy with a focus on objective evidence and an elimination of unwarranted restriction of personal freedoms.

Books We Recommend

Ketamine Therapy Educational Presentation (Length: 9:44)
April 18, 2022

Videos

What Ketamine Actually Does To Your Brain

"Ketamine, once known for its "club enhancing" effects, is now an FDA approved anti-depressant. Over four million Americans suffer from treatment-resistant depression. The new drug is a glimmer of hope for many."

Ketamine - From Street Drug to Life Saver

Watch on YouTube

This short video focuses on the anti-depressant and anti-suicidal properties of ketamine. It features of the work of Dr. Raquel Bennett from KRIYA Institute.

The Experimental Ketamine Cure for Depression

Watch on YouTube

Could the club drug, ketamine, be the best hope for curing chronic depression?

Hamilton’s Pharmacopeia, S2E5, Ketamine: Realms and Realities

Watch on ViceTV

Hamilton heads to India to see industrial Ketamine synthesis, and speak with therapists and luminaries in an attempt to understand the role of dissociative anesthetics in society.

Working with Difficult Psychedelic Experiences

Watch on maps.org

This 20-minute educational video teaches psychedelic drug users how to minimize psychological risks and explore the therapeutic applications of psychedelics.

Stutz

Watch on Netflix

In candid conversations with actor Jonah Hill, leading psychiatrist Phil Stutz explores his early life experiences and unique, visual model of therapy.

NOVA: Can Psychedelics Cure?

Watch on PBS

Hallucinogenic drugs—popularly called psychedelics—have been used by human societies for thousands of years. Today, scientists are taking a second look at many of these mind-altering substances – both natural and synthetic – and discovering that they can have profoundly positive clinical impacts, helping patients struggling with a range of afflictions from addiction to depression and PTSD.

Ketamine: Benefits and Risks for Depression, PTSD & Neuroplasticity | Huberman Labs

Watch on YouTube

"In this episode, I explain how ketamine causes rewiring of brain circuits and dissociative states to relieve symptoms of depression and post-traumatic stress disorder (PTSD). I explain how ketamine impacts both the brain’s glutamate and its endogenous opioid pathways, which together regulate mood and well-being."

Academic Literature

Comparative efficacy of racemic ketamine and esketamine for depression: A systematic review and meta-analysis.

Bahji, A., Vazquez, G. H., & Zarate, C. A. (2021). Comparative efficacy of racemic ketamine and esketamine for depression: A systematic review and meta-analysis. Journal of Affective Disorders, 278, 542–555

Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy

Dore, J., Turnipseed, B., Dwyer, S., Turnipseed, A., Andries, J., Ascani, G., Monnette, C., Huidekoper, A., Strauss, N., & Wolfson, P. (2019). Ketamine assisted psychotherapy (KAP): Patient demographics, clinical data and outcomes in three large practices administering ketamine with psychotherapy. Journal of Psychoactive Drugs, 51(2), 189-198.

Efficacy of Intravenous Ketamine in Adolescent Treatment-Resistant Depression: A Randomized Midazolam-Controlled Trial

Dwyer, J. B., Landeros-Weisenberger, A., Johnson, J. A., Londono Tobon, A., Flores, J. M., Nasir, M., Couloures, K., Sanacora, G., & Bloch, M. H. (2021). Efficacy of intravenous ketamine in adolescent treatment-resistant depression: A randomized midazolam-controlled trial. The American Journal of Psychiatry, 178(4), 352–362.

A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder

Feder, A., Costi, S., Rutter, S. B., Collins, A. B., Govindarajulu, U., Jha, M. K., Horn, S. R., Kautz, M., Corniquel, M., Collins, K. A., Bevilacqua, L., Glasgow, A. M., Brallier, J., Pietrzak, R. H., Murrough, J. W., & Charney, D. S. (2021). A randomized controlled trial of repeated ketamine administration for chronic posttraumatic stress disorder. The American Journal of Psychiatry, 178(2), 193–202.

Safety of Repeated Administration of Parenteral Ketamine for Depression

Feifel D, Dadiomov D, C. Lee K. (2020). Safety of repeated administration of parenteral ketamine for depression. Pharmaceuticals, 13(7),151.

Integrating psychotherapy and psychopharmacology: psychedelic-assisted psychotherapy and other combined treatments

Greenway, K. T., Garel, N., Jerome, L., & Feduccia, A. A. (2020). Integrating psychotherapy and psychopharmacology: Psychedelic-assisted psychotherapy and other combined treatments. Expert Review of Clinical Pharmacology, 13(6), 655–670.

A systematic review of therapeutic ketamine use in children and adolescents with treatment-resistant mood disorders

Kim, S., Rush, B.S. & Rice, T.R. (2020). A systematic review of therapeutic ketamine use in children and adolescents with treatment-resistant mood disorders. European Journal of Child & Adolescent Psychiatry.

Efficacy of Ketamine in the Treatment of Substance Use Disorders: A Systematic Review

Mathai, D., Mathew, S. J., Storch, E. A., & Kosten, T. R. (2018). Revisiting the hallucinogenic potential of ketamine. Psychiatric Times, 35(6).

A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders

Sanacora, G., Frye, M. A., McDonald, W., Mathew, S. J., Turner, M. S., Schatzberg, A. F., Summergrad, P., & Nemeroff, C. B. (2017). A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA Psychiatry, 74(4), 399-405. 

Cognitive Behavior Therapy May Sustain Antidepressant Effects of Intravenous Ketamine in Treatment-Resistant Depression

Wilkinson, S. T., Wright, D., Fasula, M. K., Fenton, L., Griepp, M., Ostroff, R. B., & Sanacora, G. (2017). Cognitive behavior therapy may sustain antidepressant effects of intravenous ketamine in treatment-resistant depression. Psychotherapy and Psychosomatics, 86(3), 162–167.

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