Ketamine for Depression: How It Works

When at least two trials of a standard anti-depression medication fail to alleviate symptoms, ketamine treatment may be an option.

When someone has depression, there are changes in the brain’s circuitry, including how neurons communicate with one another. Ketamine seems to allow for a regrowth of synapses (connections between neurons), explains John Krystal, MD, chair of the Yale School of Medicine Department of Psychiatry.

The drug targets a different system in the brain than typical antidepressants, and that may be why ketamine works so well, even for patients who have not had success with different standard antidepressants, says Yale’s Rachel Katz, PA-C, MS.

There's evidence that ketamine can have a very rapid onset of effects in neuroplasticity, says Gerard Sanacora, MD, PhD, director of the Yale Depression Research Center.

“We think that this may open a critical period in which the brain is more plastic, both at the cellular level and possibly even at the functional level, where we can start to work to change people's reference of thinking or their ability to respond and adapt to new social or environmental stimuli,” Dr. Sanacora says.

In the video above, Yale experts talk more about ketamine and how it can work with a comprehensive treatment plan that includes psychotherapy, such as cognitive behavioral therapy (CBT).