Ketamine for Anxiety

The use of ketamine for a variety of mood disorders is becoming more widespread, thanks to its demonstrated efficacy in cases where more traditional methods have failed. In particular, there is a growing evidence base to support the use of ketamine in treatment-resistant anxiety disorders, including Social Anxiety Disorder (SAD), Generalized Anxiety Disorder (GAD), Obsessive Compulsive Disorder (OCD) and PTSD. 

What is Anxiety and How Can Ketamine Help?

Anxiety might be described as a feeling of worry, tension, or fear. Occasional anxiety is something we all experience at one time or another. In some cases, however, these feelings of worry or fear become persistent, greatly interfering with the ability to function in life.  When an individual is unable to stop feeling anxious, he or she may be diagnosed with an anxiety disorder. Anxiety disorders fall into one of five categories:

Generalized Anxiety Disorder (GAD)

As the name suggests, GAD is a general feeling of unease and fear that persists from day to day and without rational provocation. Constant worry can have a negative impact on relationships, physical health, and overall quality of life.

Social Anxiety Disorder (SAD)

SAD is sometimes known as Social Phobia. Individuals with this disorder experience extreme anxiety in social settings. They are often concerned with saying or doing something embarrassing in front of other people, and may avoid triggering social situations whenever possible.  A 2020 study found that patients with refractory GAD and SAD displayed a marked reduction in symptoms after one dose of ketamine. Symptom relief was rapid (within one hour) and persisted for one week after treatment.

Obsessive Compulsive Disorder (OCD)

Individuals with OCD are often plagued by repetitive, unwanted thoughts. In an effort to suppress these thoughts, OCD patients often perform “rituals.” These are repetitive tasks meant to soothe and distract, such as handwashing and counting. People with OCD may experience a dramatic increase in anxiety if they are unable to perform their rituals.  Studies for the treatment of OCD using ketamine are in the early stages. However, they have shown promising results, with one study reporting “rapid, sustained therapeutic effects in OCD patients.” 

Post Traumatic Stress Disorder (PTSD)

PTSD is an anxiety disorder that often presents after a particularly terrifying experience that resulted in severe harm or the very real threat of harm. Victims of assault, war, and natural disasters are among those who may suffer from PTSD. Nightmares, troubling memories, avoidance, depression, nervousness, and fear of the triggering event recurring may all be present.  Recent studies support the use of low-dose ketamine for the treatment of PTSD. One study found that 67% of PTSD patients who received repeated doses of ketamine experienced rapid symptom reduction, compared to only 20% of patients given the benzodiazepine midazolam. 

Panic Disorder

Panic disorder may accompany any of the above anxiety disorders. Those with panic disorder experience frequent “attacks,” during which they may have such acute feelings of fear and despair that they feel they are dying. They may also experience physical symptoms during these episodes, such as chest pain, palpitations, rapid breathing, and even nausea and vomiting.  Studies are lacking to demonstrate the use of ketamine specifically for panic disorder. However, the demonstrated efficacy in symptom reduction for other anxiety disorders suggests that this symptom relief may extend to panic attacks, since they are often an offshoot of these other disorders. 

How Ketamine Helps Anxiety

The approach to treating anxiety disorders has traditionally involved an antidepressant, either an SSRI or an SNRI. It can take several weeks to see a response, and sometimes the chosen medication may have no appreciable effect at all. Some individuals will go through several cycles of medication trials, only to still experience refractory anxiety. In other cases, the medication may help with anxiety symptoms, but side effects are not tolerated.  By contrast, the effect of Ketamine on some anxiety symptoms can be appreciated in mere hours. Ongoing side effects are generally  minimal and usually do not include the bothersome adverse events associated with many traditional antidepressants (sleep disturbances, weight gain, fatigue, constipation, diarrhea, and others). Additionally, Ketamine is not physically addicting, so there is no need to wean off the medication when it is used appropriately. The exact mechanism of action that allows ketamine to work so quickly is still under investigation. However, it appears to produce anti-anxiety effects by acting on the brain’s NMDA receptor. This receptor is in the family of L-glutamate receptors. Glutamate is thought to be crucial in mediating the stress response and the formation of traumatic memories. 

Ketamine Clinic in Destin FL

The Crane Center offers ketamine assisted psychotherapy to qualifying patients. If you have been suffering from treatment-resistant anxiety, this may be a good option for you. Call or go online today to schedule your first appointment and start the path to healing.