Ketamine treatment types
Generalized and social anxiety
In another 2022 review, researchers found that single-dose ketamine infusions reduced panic, irritability, and other anxiety symptoms in people with GAD and social anxiety disorder. Higher doses of ketamine were more effective than lower doses, and the anxiety-reducing effects lasted up to 2 weeks.
A small 2017 study found 83% of participants with GAD and social anxiety disorder reported reduced anxiety symptoms within just 1 hour of receiving subcutaneous (under the skin) ketamine treatments.
In another small 2013 study, hospice residents with depression and anxiety took oral ketamine for 28 days. All eight participants who completed the trial reported having reduced anxiety symptoms.
In a small 2017 study of people with social anxiety, participants received IV infusions containing either saline (a placebo) or ketamine. Those who received a ketamine infusion reported much greater improvements in their symptoms compared to those who received the placebo.
However, it’s worth noting the majority of participants could tell when they received the ketamine versus the placebo. This compromised the blinding of the study, meaning participants may have been biased when reporting results.
A small 2017 study found 83% of participants with GAD and social anxiety disorder reported reduced anxiety symptoms within just 1 hour of receiving subcutaneous (under the skin) ketamine treatments.
In another small 2013 study, hospice residents with depression and anxiety took oral ketamine for 28 days. All eight participants who completed the trial reported having reduced anxiety symptoms.
In a small 2017 study of people with social anxiety, participants received IV infusions containing either saline (a placebo) or ketamine. Those who received a ketamine infusion reported much greater improvements in their symptoms compared to those who received the placebo.
However, it’s worth noting the majority of participants could tell when they received the ketamine versus the placebo. This compromised the blinding of the study, meaning participants may have been biased when reporting results.
Ketamine vs. other medications
Traditional anti-anxiety medications start by boosting other brain chemicals, like serotonin, before targeting glutamate.
What sets ketamine apart is that it immediately activates glutamate. This can translate to faster results, according to Kai Lewis, a licensed marriage and family therapist in private practice. While it can take 2 to 6 weeks for anti-anxiety medications to work, Lewis notes ketamine can help to relieve anxiety in as little as 2 hours.
Bowarshi notes that ketamine has shown benefits for both GAD and social anxiety disorder.
What sets ketamine apart is that it immediately activates glutamate. This can translate to faster results, according to Kai Lewis, a licensed marriage and family therapist in private practice. While it can take 2 to 6 weeks for anti-anxiety medications to work, Lewis notes ketamine can help to relieve anxiety in as little as 2 hours.
Bowarshi notes that ketamine has shown benefits for both GAD and social anxiety disorder.
* Information gathered from: healthline.com
Ketamine can be taken in multiple ways:
- Sublingual tablets or troches: This form of ketamine is prescribed for at-home use as a stand-alone treatment. This is the route of ketamine administration that we recommend. You put a tablet under your tongue and allow it to dissolve slowly. It takes longer for your body to absorb this type of ketamine. The route has a longer absorption time and with that comes a smooth onset of ketamine. The patient slowly moves to a lucid dream like state. The oral ketamine sessions typically last 90-120 minutes. Since the patients are in the comfort of their own home, the ketamine sessions are much deeper and more meaningful. The interference of beeping medical equipment does not interfere with a session like in some clinical settings.
- Intramuscular (IM) Injections: Ketamine is injected into a large muscle, such as your thigh or arm, in a hospital or clinic setting. After sublingual tablets and troches this is the next best route of administration. Injections provide a more comfortable alternative to receiving. Unfortunately, the injections are only given in a clinical setting. Many patients find it difficult to get full dissociation in the clinical setting.
- Intravenous (IV) ketamine infusions: A slow, constant IV drip of ketamine is delivered directly into your bloodstream. This can only be done in a hospital or clinic setting. You have to have the IV in during the entire treatment. The setting is less than ideal because it is not as comfortable as being in your own home. Patients tend to have much deeper and more meaningful ketamine sessions at home. To be administered correctly you need an IV pump which is expensive. Most ketamine clinics will not spend the money on the proper IV pumps. Instead, most ketamine clinics just use gravity. The problem with gravity is that if you move the IV can become blocked and the ketamine session is interrupted. Another problem with Ketamine IVs is that you have an IV in one of your arms and you can feel it when you move. Any external stimuli can interrupt the ketamine session.
- Nasal spray: Sprovato (esketamine) or other ketamine nasal sprays can only be administered at a hospital or doctor’s office because someone will need to monitor any side effects. You’ll use the spray once or twice weekly for the first 8 weeks, and then only once every week or 2 in the maintenance phase. The nasal spray is a thick sticky liquid. The gel spray is uncomfortable in the nose. The ketamine nasal spray is sprayed in each nostril multiple times over 20 minutes. If the angle of the spray is too far forward the ketamine spray runs out of nose. If the head is too far back, all the ketamine spray drains into the throat. This makes achieving the correct dose difficult, not to mention that ketamine does not have a pleasant taste. It is difficult to get a dose high enough for dissociation.