Grandpa Bill continues talking today in our series of Ask The Doc. Dr. prescribed and Patient talk :Ketamine- which was first synthesized in the 1960s as an anesthetic, a sedative. It was useful in the rescue mission. Then in the 1980s, it became a popular club drug. It had nicknames like Special K and Cat Valium. Now, a form of ketamine, esketamine was approved by the FDA for antidepressant augmentation. So how does a drug that is so multipurpose actually work? Ketamine is what scientists call a dirty drug. It doesn’t just target one system in the brain, but dozens. It has a weak effect on opiate receptors and one study actually showed that when patients took naltrexone (which blocks opioid receptors), they did not experience the anti-depressive effects of ketamine. These same receptors are targeted also by drugs like heroine and cocaine. Most importantly, ketamine affects the glutamate system. Glutamate is used in the brain for neurons to communicate. At high doses, ketamine seems to block glutamate, making it an effective anesthetic. But at low doses, glutamate production is enhanced. This can have a variety of effects, some individuals hallucinate or feel they are losing touch with reality. It may also help build new connections or synapses between neurons. Now, when people are under stress for a long time or depressed for a long time, they can start to lose the connections. When ketamine is administered, some of those effects seem to start to reverse. It is believed that ketamine may help regenerate neuronal connections. One of the appeals of ketamine is the rapid onset of action and unique mechanism of action versus other antidepressants or even augmenting agents. Cited New Frontier https://anchor.fm/bhsales
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