Persistent anxiety disorders like generalized anxiety disorder (GAD) are characterized by excessive, uncontrollable worry about everyday things [1]. Common symptoms include [2]:
- Restlessness and feeling on edge
- Fatigue
- Irritability
- Muscle tension
- Sleep disturbances
- Difficulty concentrating
- Racing thoughts
Physical symptoms like nausea, headaches, and sweating may also occur. Symptoms persist for over 6 months and impair daily function.
Ketamine has shown promise for rapidly reducing anxiety symptoms by altering glutamate signaling and increasing synaptic connections in areas linked to emotion regulation, like the prefrontal cortex [3].
In people with treatment-resistant GAD, a single ketamine infusion significantly reduced anxiety scores for up to 7 days compared to placebo [4]. Repeated doses may extend benefits further.
One study found that 6 ketamine infusions over 2 weeks allowed >50% of people with chronic anxiety to achieve remission for over 3 months [5]. Ongoing therapy can help maintain gains long-term.
While more research is needed, ketamine appears uniquely effective at providing rapid and sustained anxiety relief compared to standard treatments like SSRIs or benzodiazepines. This makes it an exciting therapeutic option.
References:
[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
[2] Mayo Clinic. (2018). Generalized anxiety disorder. https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/symptoms-causes/syc-20360803
[3] Abdallah CG, Sanacora G, Duman RS, Krystal JH. Ketamine and rapid-acting antidepressants: a window into a new neurobiology for mood disorder therapeutics. Annu Rev Med. 2015;66:509-523. doi: 10.1146/annurev-med-053013-062946.
[4] Glue P, Gulati A, Le Nedelec M, Duffull S. Dose- and exposure-response to ketamine in depression. J Pharmacokinet Pharmacodyn. 2018;45(2):291-302. doi:10.1007/s10928-017-9561-9
[5] Phillips JL, Norris S, Talbot J, et al. Single, Repeated, and Maintenance Ketamine Infusions for Treatment-Resistant Depression: A Randomized Controlled Trial. Am J Psychiatry. 2019;176(5):401-409. doi:10.1176/appi.ajp.2018.18070834