Ketamine is a medication approved for use as an anesthetic. Although scientists are still researching ketamine for anxiety, some studies show it may be an effective treatment.

Ketamine is an anesthetic medication. It relieves pain and changes their perception of reality. Healthcare professionals may use approved forms of ketamine as an anesthetic, as a sedative, or to treat depression.

Healthcare professionals may currently also use ketamine “off-label” to treat anxiety. Off-label refers to the use of a medication for something other than its approved uses.

Recent scientific trials have investigated the effectiveness of ketamine for depression and anxiety. Scientists are also continuing to research new ketamine treatments.

This article discusses how ketamine works, types of ketamine treatment, and how effective ketamine is. It also discusses ketamine side effects.

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Ketamine is a dissociative anesthetic that can make a person feel calm and relaxed.

It can also make people feel detached from their surroundings and pain and produce some hallucinogenic effects. These changes a person’s perceptions, as well as make them feel disconnected and not in control.

Ketamine can act as a pain relief or a sedative at higher doses. Researchers are still investigating exactly how ketamine works on the brain. However, it appears to affect multiple brain pathways, chemical messengers, and receptors.

Scientists believe ketamine blocks several types of receptors and pathways in the brain. One type, N-methyl-D-aspartate (NMDA) receptors, regulates how connections in a person’s brain change over time. Ketamine has a blocking effect on NMDA receptors.

Ketamine can also affect the levels of glutamate in the brain. Glutamate is a chemical messenger. It has important roles in a person’s memory, thinking, and mood regulation.

Both these effects may rapidly increase synaptic plasticity in the brain, or its ability to adapt and change with new experiences. Researchers believe this effect can help the brain form new pathways and disrupt older, more harmful ones. These changes may help with depression or anxiety symptoms.

Scientists continue to investigate how effective ketamine is for several conditions, including anxiety disorders. Healthcare professionals may prescribe ketamine for anxiety “off-label.” This is called ketamine intravenous therapy (KIT).

Ketamine is not yet FDA-approved for the treatment of any psychiatric disorder, including anxiety. The FDA has not yet established dosages or investigated its benefits and safe usage.

However, in a 2023 analysis, scientists investigated the effect of KIT on symptoms of depression and anxiety. They analyzed data on people treated with KIT from 2017 to 2020. They found that KIT significantly reduced anxiety symptoms compared to other forms of medication. This improvement stayed stable over a year of follow-up monitoring.

The scientists noted their study used historical data rather than firsthand observations. It also used data from a group of people that may not accurately reflect real-world effects. Nonetheless, they concluded that the study showed KIT can be an effective anxiety treatment when given as a series of infusions.

Generalized and social anxiety

Scientists evaluated the safety and effectiveness of weekly ketamine treatments for generalized anxiety disorder (GAD) and social anxiety disorder in 2017. They found that people rapidly reported reduced anxiety after treatments, which lasted for up to 7 days.

Phobias

Researchers who investigated ketamine for several mental health conditions in 2021 found it may be effective for treating certain phobias. They found ketamine injections could help reduce the effects of:

  • Agoraphobia: Agoraphobia is the fear of being in open or crowded spaces, leaving one’s home, or of being in places that are difficult to escape.
  • Social phobia: Social phobia is now known as social anxiety disorder. It is a fear of being watched or judged by others in a social situation.
  • Blood injury phobia: Blood injury phobia, or blood injury-injection-phobia, is the fear of the sight of blood, injury, or mutilation.

Obsessive-compulsive disorder

Ketamine IV treatment can rapidly reduce symptoms of obsessive-compulsive disorder (OCD). However, these effects are not generally long lasting.

Scientists have investigated combining ketamine IV therapy with psychotherapy to produce longer-lasting OCD symptom reduction. However, more research is necessary.

Ketamine therapy is not a first-line treatment for anxiety disorders. It is essential to work with a healthcare professional to explore other options first.

However, if other medications and therapies have proven ineffective, people can discuss the potential of progressing to ketamine therapies. They will not be suitable in all cases, and a medical professional can best assess a person’s physical and mental suitability for the treatment.

What to look for in a clinic

Before choosing a clinic for ketamine therapy, the American Society of Ketamine Physicians, Psychotherapists, and Practitioners recommends investigating:

  • What other mental health services do they offer?
  • Are mental health staff licensed with the state medical board?
  • Is it a reputable establishment with positive reviews and a strong track record of performance?
  • Do they practice thorough safety screenings?

Ketamine is currently a Food and Drug Administration (FDA)-approved anesthetic. The FDA has also approved a form of ketamine called esketamine as a prescription treatment for treatment-resistant depression (TRD). Esktamine may be effective for people with TRD and with anxiety.

Healthcare professionals usually administer ketamine to a person in a healthcare setting with:

  • Intravenous (IV) infusions: using an IV drip of ketamine to deliver it directly into the bloodstream
  • Intramuscular (IM) shots: injecting ketamine into the muscles
  • Nasal sprays: used to administer esketamine, sometimes with other anti-anxiety medication

They may also prescribe treatments for a person to use at home or between IM or IV treatments. This type of treatment involves sublingual tablets, which are placed under the tongue to dissolve.

The most common side effects of ketamine can include:

Other side effects of ketamine may include:

  • agitation
  • memory loss
  • cognitive difficulties
  • depression
  • unconsciousness

Some people may experience a ketamine emergence phenomenon (EP), also called emergence delirium (ED). EP is a state of confusion as a person recovers from an anesthetic, including:

  • euphoria
  • vivid dreams
  • illusions
  • severe confusion and disorientation
  • hallucinations

Ketamine is an anesthetic medication that can produce several sedative and other effects. Ketamine also has several potential side effects. Healthcare professionals may prescribe it for anxiety off-label.

Although ketamine is not yet an approved FDA anxiety treatment, scientific trials have shown it may be effective in reducing anxiety. Scientists continue to investigate ketamine treatments for anxiety disorders and several other mental health conditions.