From Chaos To Calm: A Life Changed By Ketamine

Written by Jon Hamilton for NPR News

For six years now, life has been really good for James. He has a great job as the creative director of an advertising firm in New York City. He enjoys spending time with his wife and kids.

And it has all been possible, he says, because for the past six years he has been taking a drug called ketamine.

Before ketamine, James was unable to work or focus his thoughts. His mind was filled with violent images. And his mood could go from ebullient to dark in a matter of minutes.

Ketamine "helped me get my life back," says James, who asked that we not use his last name to protect his career.

Ketamine was developed as a human and animal anesthetic in the 1960s. And almost from the time it reached the market it has also been used as a mind-bending party drug.

But ketamine's story took a surprising turn in 2006, when researchers at the National Institutes of Health showed that an intravenous dose could relieve severe depression in a matter of hours. Since then, doctors have prescribed ketamine "off label" to thousands of depressed patients who don't respond to other drugs.

And pharmaceutical companies are testing several new ketamine-related drugs to treat depression. Johnson & Johnson expects to seek approval for its nasal spray esketamine later this year, though the approval would be limited to use in a clinical setting.

Meanwhile, doctors have begun trying ketamine on patients with a wide range of psychiatric disorders other than depression. And there is now growing evidence it can help people with anxiety, bipolar disorder, post-traumatic stress disorder, and perhaps even obsessive-compulsive disorder.

"I think it's actually one of the biggest advances in psychiatry in a very long time," says Dr. Martin Teicher, an associate professor of psychiatry at Harvard Medical School and director of the Developmental Biopsychiatry Research Program at McLean Hospital.

Ketamine may also offer new hope for people like James who have symptoms of several different psychiatric disorders.

James had a happy childhood, he says. But his thoughts were out of control. "I always felt like I was crossing a freeway and my thoughts were just racing past me," he says.

He spent much of his childhood terrified of "an unknown, an ambiguous force out there." The fear was "overwhelming," he says. "I literally slept with the cover over my head with just room to breathe through my mouth until I went to college."

And there was something else about James: his body temperature.

"I overheated constantly," he says. "I would wear shorts all year long. In my 20s in my apartment I would sleep with the windows open in the middle of the winter."

In his late 20s, James saw a doctor who told him he had attention deficit hyperactivity disorder. So he started taking stimulants.

At first, the pills helped him focus. Then they didn't, no matter how many he took.

He'd done well as an idea guy in the advertising industry. But now James was trying to work at home, and it wasn't going well.

"ADHD pills will make you interested in anything," he says. "So I was putting the desk together and taking the desk apart. I was putting a laptop stand together and taking it apart. I was going in a massive downward spiral."

James had always suffered from mood swings. But now they were rapid and extreme. And he couldn't stop thinking about gruesome scenarios, like a murderer coming for his family.

"My wife took a summer off to be with me because she was scared of what was going to happen to me," he says. "She would go to work for a few hours, then rush home. There would be times I'd call her just screaming, 'Please come home. I can't get through another minute.' "

Eventually, James found his way to Dr. Demitri Papolos, an associate professor of clinical psychiatry at Albert Einstein College of Medicine.

"He was like a whirling dervish when he came into my office," Papolos says. "He was extremely fearful and scanning the environment all the time and he overheated at the drop of a hat."

Papolos diagnosed James with a variant of bipolar disorder he calls the "fear of harm phenotype." It typically appears in childhood and often doesn't respond to traditional psychiatric drugs.

But Papolos has found that the condition does respond to ketamine. "It's been transformational," he says.

In January, Papolos published a study of 45 children with the problem. They inhaled a nasal mist containing ketamine about twice a week. Nearly all got dramatically better.

Scientists still aren't sure why ketamine works, but there's evidence that it encourages the brain to rewire, to alter the connections between cells. That process has been linked to recovery from depression. And it may also explain why ketamine helps people who have symptoms associated with several different psychiatric disorders.

"I think it's having multiple effects, and that means it's probably useful for multiple different disorders," Teicher says.

One of those effects involves a part of the brain involved in temperature regulation. And that could explain why patients like James usually stop overheating once they are taking ketamine.

James started taking a ketamine nasal spray every other day. He says his response was dramatic.

"One day I turn to my wife and I'm like, 'I feel calm today. I don't know if it's the sun coming in, I don't know if it's just the way we're sitting here, but I feel like I could go and sit at the computer and work.' "

The next day, James did sit down at his computer. A month later, he was back at work.

Ketamine plus therapy could help treat alcoholism, say researchers

Overcoming alcoholism is notoriously difficult, but researchers are hoping a new treatment combination might help: ketamine and psychological therapy.

The use of psychedelics alongside therapy is a booming area of research, with ketamine, MDMA and psilocybin – the active ingredient of magic mushrooms – among the drugs that are being studied to tackle mental health problems ranging from depression to PTSD.

Now researchers are set to launch a £2.4m phase 3 trial, the largest of its kind, to explore the use of ketamine in treating severe alcohol use disorder.

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Finding Hope Through Ketamine Therapy

Ellen Meyers has lived with the consuming grief of losing her only child for more than a decade. Ketamine therapy is helping her find some peace at last.

My doctor tells me to close my eyes and asks me what I am feeling in my body. I tell her my chest feels heavy. She asks me to describe the heaviness—its shape and size. I tell her it’s a rectangular brick stretching from side to side. “What color is it?” she asks. I tell her it’s dark grayish, and now the pressure is so great it’s pressing into my throat. She asks more questions—“If it was an animal, what would it be?” “Would I be willing to ask it questions?”—and eventually my throat relaxes, and my chest lightens. Sometimes, I cry during these weekly check-ins that follow our more intensive work together. I am learning what it means to self-regulate.

My doctor, a nurturing and whip-smart woman in her 40s, is my ketamine guide. She is holding my hand—sometimes literally—as I try to discover new ways to deal with past losses and the terrors of the future.

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What It's Like to Do Ketamine Treatment - Online Video

Ever wondered what a ketamine treatment for depression is actually like? Experience what it's like to do ketamine treatment for depression in this documentary featuring MedCircle host Kyle Kittleson and his producer Brigid.

Smiling faces might help the drug ketamine keep depression at bay

Computer games designed to boost self-esteem appear to prolong the antidepressant benefits of the mind-bending anesthetic ketamine. A recent study of 154 people found that those who played games featuring smiling faces and positive messages remained free of depression up to three months after a ketamine infusion, a team reports in the American Journal of Psychiatry.

People who got ketamine alone tended to relapse after a week or two. The results are important because "we need new approaches that help people get feeling better faster and help them stay feeling better," says Rebecca Price, an author of the study and an associate professor of psychiatry and psychology at the University of Pittsburgh.

Established drugs like Prozac and Zoloft can take weeks to ease depression, and don't work for every patient. Ketamine can offer immediate relief, but the effects often fade after a few days or weeks.

Michael Pollan on Netflix's new 'How to Change Your Mind' Documentary

For decades, psychedelics have evoked a freewheeling past, calling to mind images of hippie counterculture and swirly neon patterns. Recently, however, psychedelics have become synonymous with serious, forward-looking science. Researchers at renowned institutions are researching the mental-health effects of pairing psychedelics with psychotherapy, and with the promising research has come a surge of investment in new psychedelic start-up companies.

Few people have done more to return psychedelics to the popular imagination—while lending them a dose of credibility—than author Michael Pollan. In his bestselling 2018 book, How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, Pollan introduced a wide audience to the scientific promise of psychedelic drugs. He also described his own life-changing experiences with the drugs.

Psychedelic drugs change outlook on life as much as near-death experiences

Near-death experiences often change how someone views the world. In many cases, the person who “cheats death” ends up overcoming their fear of dying in the future. Now, a new study has found something that can mimic this life-altering experience — psychedelic drugs.

Ketamine found to be unlikely to lead to addiction

A team of researchers at the University of Geneva has found that ketamine is unlikely to be addictive to people who use it for extended periods of time. In their paper published in the journal Nature, the group describes their study of the impact of the synthetic compound on the brains of mice and what they learned about its impact on different brain regions. Rianne Campbell and Mary Kay Lobo, with the University of Maryland School of Medicine have published a News and Views piece in the same journal issue outlining the work done by the team in Switzerland.