THIRUVANANTHAPURAM: Ketamine therapy centres are gaining popularity across the state as a promising solution for treatment-resistant depression (TRD) and severe mental health conditions, including obsessive-compulsive disorder (OCD). By leveraging ketamine’s rapid-acting properties, these centres offer renewed hope to patients who have had little or no success with traditional therapies.
Originally used as an anaesthetic in both human and veterinary medicine, ketamine has found a new purpose in psychiatry over the last two decades. Its ability to rapidly repair neural connections has made it an effective emergency treatment for suicidal ideation, providing relief much faster than conventional antidepressants or therapies like electroconvulsive therapy (ECT).
“Ketamine is administered only for treatment-resistant depression, suicidality, or severe mental health conditions like OCD. It works within hours, compared to the weeks or months typically required by traditional antidepressants. We’ve been offering ketamine therapy for three years, and it is conducted in the emergency department under strict monitoring to ensure patient safety,” said Rajamohan, a psychiatrist at KMCT Hospital in Kozhikode.
The therapy involves the administration of ketamine via intravenous (IV) infusion, with each session lasting 40 to 60 minutes. Sessions are supervised by both a psychiatrist and an anaesthetist. After the infusion, patients are monitored for up to two hours to manage potential side effects, such as dissociation, dizziness, or nausea. Typically, the treatment course involves two sessions per week for three weeks.
“Vital signs such as pulse, blood pressure, oxygen saturation, and respiratory rate are closely monitored throughout the procedure. While the benefits are often noticeable within a few hours, they may last only a few weeks to months, requiring follow-up or maintenance infusions as needed,” added Rajamohan.
Ketamine therapy is generally considered for patients who have experienced two or more failed antidepressant trials and at least 16 psychotherapy sessions without significant improvement. Studies show that patients can experience dramatic improvements, sometimes as quickly as two to four hours after the first infusion. The cost of treatment typically ranges from `80 to `200 per session.
“Ketamine is generally safe, even for patients with suicidal ideation, but it is not a first-line treatment. It is used only under strict medical supervision due to potential side effects,” said Dr Arun B Nair from Thiruvananthapuram Medical College.
It is important to note that ketamine is not licensed as an antidepressant. “Ketamine is a regulated substance under the Narcotic Drugs and Psychotropic Substances Act (NDPS),” explained Arun Mohan. The main side effects include dissociation, intoxication, sedation, high blood pressure, dizziness, headache, blurred vision, anxiety, nausea, and vomiting, which are typically managed by the hospital’s emergency department or intensive care unit.
Experts warn against self-administration or purchasing ketamine illegally, as misuse can lead to severe consequences, including addiction and harmful side effects. Ketamine therapy recently made headlines following the tragic death of actor Matthew Perry, which was attributed to improper use and misuse of the drug.