Professor Nutt says therapeutic doses are typically higher than those used by many people who experiment with ketamine recreationally. Ketamine is sold on the street as a white powder and is usually inhaled.
“Recreational doses typically start low and then get higher and higher due to tolerance,” he says. “Doses used medically are higher than recreational doses for beginners, but lower than recreational trips for addicts.”
He believes the main difference has to do with the mindset and intent of the individual receiving ketamine therapeutically.
“In both cases, ketamine disrupts brain processes, but when you use ketamine just to slow things down or to get out of a night on MDMA, ketamine does a different job. “The treatment is not effective because of the lack of treatment,” he says. “Using it to break through your resistance to facing problems or reliving trauma with a therapist can take you in a completely different direction.”
How long does it take for ketamine to work for depression?
The acute effects are very quick, with some people noticing a difference within a few hours. One study found that 71 percent of depressed patients had some response to ketamine administration within 24 hours.
But while Stühl and other patients began to experience significant changes in their symptoms within days, about 50 percent of patients with treatment-resistant depression still show no response at all.
Professor Young said more needs to be understood about why ketamine appears to work for some patients and not for others, and why there is so much variation from patient to patient. states.
“Some patients may respond very quickly; others take several weeks to build up,” he says. “There's a big question about how long you should continue it before you decide it's not working. There's no clear answer to this, but he's better off doing it twice a week for four weeks before you say it's not working.” That’s fine.”
What does the future hold for ketamine treatment?
Currently, to receive a ketamine injection on the NHS, people with depression must be referred to one of a handful of specialist centers across the UK.
At present, many patients seeking ketamine therapy in the UK are forced to receive treatment privately. Professor Nutt works with a clinic called Awakn Life Sciences which runs a center in London, but a full course of ketamine therapy costs more than £7,000 and is out of reach for many patients.
In 2019, U.S. Food and Drug Administration regulators made headlines when they approved a new ketamine-related drug called Supravat to treat depression. However, although the drug is available on the NHS in Scotland, the National Institute for Healthcare Excellence (NICE), the watchdog that decides which medicines are approved for use on the NHS in England, has yet to give it the green light. Not yet.
Professor Nutt is frustrated that ketamine is not widely available as a treatment for depression in the UK, despite its proven effectiveness. He feels the decision is related to misperceptions about drug prices.
Ketamine therapy is certainly much more expensive than Prozac, but is probably only used as a last resort and is much more cost-effective than admitting someone to a psychiatric ward.
