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How Long Does Ketamine Work to Treat my Depression?



Many people wonder how long they can expect the therapeutic benefits of ketamine to last. Although the answer to this question is patient-specific and still under investigation, we can look at current research to help us establish a rough estimate. A 2021 meta-analysis published in the Journal of Psychopharmacology pooled data from multiple studies to assess the overall effect size of ketamine treatment at two, four-, and six weeks post-treatment. This meta-analysis showed that people receiving ketamine treatment for depression can continue to expect significant relief at the two-week mark, with diminishing but still substantial effects at four- and six weeks post-treatment.


According to current evidence, the best way to prolong the antidepressant effects of ketamine is to receive a series of initial treatments followed by maintenance or "booster" treatments scheduled at regular intervals. These booster treatments can help extend the duration of relief and maintain treatment gains over time. Many patients who respond to Ketamine treatment will find they feel best if they receive a "maintenance" ketamine treatment every 1-3 months. Some patients find that their depressive symptoms respond well to the 6 initial treatments and do not require additional treatments. The exact schedule varies depending on patient preference, degree of symptom relief, and many other patient-specific indications.


The exact duration of relief from depression following ketamine treatment can vary depending on the number of sessions, individual response, and severity of the depression. Ketamine's rapid onset can provide much-needed relief for someone during a major depressive episode, reducing the risk of self-harm and improving quality of life. Perhaps even more importantly, ketamine treatments can buy time to allow for other interventions to take effect, such as antidepressants, therapy, and lifestyle changes.


A 2016 randomized trial illustrated ketamine's ability to hasten the response time to antidepressant treatment, which typically takes 6 to 12 weeks. Twenty-seven patients with depression, including treatment-resistant cases, were given either a single infusion of ketamine or a placebo alongside newly initiated Lexapro. Results showed that 92% of patients treated with ketamine in conjunction with Lexapro responded well to treatment, compared to 57% with placebo, with an average response time of 6 days versus 27 days, respectively. The findings of this study demonstrate ketamine's ability to provide swift relief, granting additional treatments the necessary time to take effect.


Reach out to Wellness Psychiatry for questions about ketamine treatment or if you want to set up a consult:



References:

Chen, M.-H., Wu, H.-J., Li, C.-T., Lin, W.-C., Tsai, S.-J., Hong, C.-J., Tu, P.-C., Bai, Y.-M., Mao, W.-C., & Su, T.-P. (2021). Is one or two infusions better in the first week of low-dose ketamine treatment for medication-resistant depression? A post hoc pooled analysis of randomized placebo-controlled and open-label trials. Journal of Psychiatric Research, 144, 448–454. https://doi-org.frontier.idm.oclc.org/10.1016/j.jpsychires.2021.11.006

Conley, A. A., Norwood, A. E. Q., Hatvany, T. C., Griffith, J. D., & Barber, K. E. (2021). Efficacy of ketamine for major depressive episodes at 2, 4, and 6-weeks post-treatment: A meta-analysis. Psychopharmacology, 238(7), 1737–1752. https://doi-org.frontier.idm.oclc.org/10.1007/s00213-021-05825-8

Hu, Y.-D., Xiang, Y.-T., Fang, J.-X., Zu, S., Sha, S., Shi, H., Ungvari, G. S., Correll, C. U., Chiu, H. F. K., Xue, Y., Tian, T.-F., Wu, A.-S., Ma, X., & Wang, G. (2016). Single i.v. ketamine augmentation of newly initiated escitalopram for major depression: results from a randomized, placebo-controlled 4-week study. Psychological Medicine, 46(3), 623–635. https://doi-org.frontier.idm.oclc.org/10.1017/S0033291715002159

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