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Can ketamine be used for major depressive disorder?
Yes, ketamine can be used to treat major depressive disorder in some cases, but it is not usually a first-line treatment. In the UK, it is generally considered for people with depression that has not improved with standard treatments such as antidepressants and talking therapies.
Ketamine may be given in specialist services under close medical supervision. It is not suitable for everyone, and a clinician must decide whether the potential benefits outweigh the risks.
How ketamine works
Ketamine works differently from traditional antidepressants. It affects the brain’s glutamate system, which is involved in mood, learning and memory.
Some people notice an improvement in depressive symptoms much faster than with standard medicines. In certain cases, effects can begin within hours or days rather than weeks.
Who might be offered it?
Ketamine is usually considered for adults with treatment-resistant depression. This means depression that has not responded well to several other treatments.
It may also be considered when symptoms are severe or when rapid improvement is needed. A psychiatrist or specialist team will assess whether it is appropriate.
How it is given in the UK
Ketamine for depression is typically given in a clinic, not bought or used casually. It may be administered as an intravenous infusion, or in some settings as a nasal spray called esketamine.
Treatment is usually delivered over a series of appointments. Patients are monitored during and after each dose because ketamine can affect blood pressure, perception and coordination.
Possible benefits and limits
Some people experience a meaningful reduction in low mood, hopelessness and suicidal thoughts. For those who have tried several treatments without success, this can be an important option.
However, ketamine does not work for everyone, and the benefits may not last forever. Ongoing treatment or a broader care plan may be needed to maintain improvement.
Risks and side effects
Common side effects can include dizziness, nausea, drowsiness, raised blood pressure and feeling detached or “spaced out”. These effects are usually temporary, but they can be unpleasant.
There are also concerns about misuse, dependency and long-term effects if ketamine is used improperly. This is why treatment should only happen under expert supervision in a licensed setting.
What to discuss with a clinician
If you are considering ketamine, speak to your GP or mental health specialist. They can explain whether it is available locally, what the referral process is, and whether you meet the criteria.
It is also important to ask about alternative treatments. A full treatment plan may include medication, therapy, lifestyle support and crisis planning alongside or instead of ketamine.
Frequently Asked Questions
Ketamine treatment for major depressive disorder is a medical treatment that uses ketamine, usually in low doses and under supervision, to help reduce depressive symptoms, especially when standard treatments have not worked well.
Ketamine treatment for major depressive disorder is thought to work by affecting glutamate signaling in the brain and promoting rapid changes in neural connections, which may help improve mood and reduce depressive symptoms more quickly than traditional antidepressants.
People with major depressive disorder who have not responded adequately to other treatments, or who need a rapidly acting option, may be considered for ketamine treatment for major depressive disorder after a thorough medical and psychiatric evaluation.
Ketamine treatment for major depressive disorder may not be appropriate for people with uncontrolled high blood pressure, certain heart conditions, active psychosis, or some substance use disorders, but eligibility depends on an individualized medical assessment.
Ketamine treatment for major depressive disorder can sometimes improve symptoms within hours to days, which is faster than many standard antidepressants, though the duration and degree of benefit vary from person to person.
Ketamine treatment for major depressive disorder is commonly given as an intravenous infusion, though some clinics may use intranasal esketamine or other supervised methods depending on the treatment plan and local regulations.
The number of sessions for ketamine treatment for major depressive disorder varies, but many treatment plans include an initial series of sessions followed by maintenance treatments if benefits are seen and the clinician recommends continued care.
Common side effects of ketamine treatment for major depressive disorder can include dizziness, nausea, sleepiness, elevated blood pressure, dissociation, and feeling disconnected from surroundings during or shortly after treatment.
Serious risks of ketamine treatment for major depressive disorder are uncommon but can include significant blood pressure changes, breathing problems in rare cases, worsening of certain psychiatric symptoms, and misuse or dependence if not carefully monitored.
Intranasal esketamine, a form related to ketamine treatment for major depressive disorder, is FDA approved for specific cases of depression, while racemic ketamine itself is used off-label for depression in many settings.
Ketamine treatment for major depressive disorder is not exactly the same as esketamine treatment; ketamine is the original medication used off-label, while esketamine is a specific related drug approved for certain depressive disorders.
Ketamine treatment for major depressive disorder is often used alongside other treatments, including antidepressants, but the combination should be reviewed by a clinician to avoid interactions and to coordinate a safe treatment plan.
Before ketamine treatment for major depressive disorder, a patient should have a medical evaluation, review current medications, follow fasting or driving instructions if given, and arrange for someone to accompany them home if needed.
During ketamine treatment for major depressive disorder, the patient is monitored by medical staff while the medication is administered, and the patient may feel changes in perception, relaxation, or dissociation that usually fade after the session.
The benefits of ketamine treatment for major depressive disorder may last days to weeks after a dose, but some people need repeat treatments to maintain improvement, and the duration of response varies widely.
Ketamine treatment for major depressive disorder has potential for misuse and dependence, especially outside supervised medical care, which is why treatment should only be provided with careful screening and monitoring.
Ketamine treatment for major depressive disorder can sometimes temporarily increase anxiety, cause unsettling dissociation, or worsen psychotic symptoms in susceptible individuals, so clinicians screen carefully before treatment.
The cost of ketamine treatment for major depressive disorder varies depending on the type of treatment, clinic, location, and insurance coverage, and many plans do not fully cover off-label ketamine infusions.
Ketamine treatment for major depressive disorder is generally not first-line during pregnancy or breastfeeding because safety data are limited, so the risks and benefits must be reviewed carefully with a clinician.
A person should seek emergency help during ketamine treatment for major depressive disorder if they have chest pain, trouble breathing, severe confusion, fainting, dangerous agitation, or suicidal thoughts that feel immediate or unmanageable.
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