The Evolution and Expanding Role of Ketamine in Modern Medicine
Ketamine was first synthesized in 1962 by Dr. Calvin Stevens at Wayne State University while working with Parke-Davis Laboratories. At the time, he was seeking a safer alternative to phencyclidine (PCP)—one that would maintain anesthetic effectiveness without the heightened risk of seizures or neurotoxicity. His research led to the discovery of ketamine, a dissociative anesthetic known for producing a unique combination of effects: analgesia, sedation, amnesia, hallucination, and catalepsy. Initially adopted for surgical anesthesia, ketamine gained prominence in the 1970s for battlefield and burn care due to its safety profile and ability to maintain cardiovascular stability. In the peri-operative setting, it continues to serve vital roles, such as: Induction agent for trauma and burn patients, Sedation during awake fiber-optic intubation, and Pre-spinal anesthetic pain relief in orthopedic procedures.
Over the last five decades, ketamine has proven to be a safe, reliable anesthetic with powerful analgesic effects. But perhaps even more significant is its expanding role in the field of mental health and chronic pain management. Clinical research and real-world application have demonstrated ketamine’s remarkable effectiveness in treating conditions that have proven resistant to conventional therapies, including:
Treatment-Resistant Depression (TRD), Anxiety Disorders, Post-Traumatic Stress Disorder (PTSD), Postpartum Depression, Chronic Pain Syndromes, Fibromyalgia, Migraine Headaches, Neuropathy, and Psoriatic Arthritis.
By modulating glutamate transmission and activating the brain’s neuroplasticity pathways, ketamine offers rapid and lasting relief—often within hours—making it a groundbreaking option for patients who have exhausted other forms of treatment.
KETAMINE + WELLNESS = SUSTAINABILITY
How Does Ketamine Treat Depression?
Basic and clinical studies demonstrate that depression is associated with a reduction in the size of brain regions that regulate mood and cognition, including the prefrontal cortex (PFT) and the hippocampus, as well as decreased neuronal synapses in these areas. Antidepressants can block or reverse these neuronal deficits, although typical antidepressants have limited efficacy and delayed response times of weeks to months. Ketamine, an N-methyl-D-aspartate receptor antagonist, produces rapid antidepressant responses, even within a few hours, in patients who are resistant to typical antidepressants. Ketamine rapidly induces synaptogenesis and reverses the synaptic deficits caused by chronic stress.
How Does Ketamine Treat Chronic Pain?
Over the past several decades, there have been a growing number of patients who are being diagnosed with some form of chronic pain[1]. The treatment of chronic pain is based on a trial and error approach with antidepressants, anti-epileptics, and opioids as drugs of first choice. Irrespective of treatment, efficacy is limited, with just 30-40% of patients showing adequate to good pain relief. Anesthesiologists and other pain physicians started using ketamine, at sub-anesthetic doses, to treat therapy-resistant chronic pain syndromes. Low dose ketamine produces strong analgesia by inhibition of the N-methyl-D-aspartate receptor. Other mechanisms by which ketamine inhibits pain include enhancement of descending inhibition and anti-inflammatory effects in the brain.
At KHWCT, we practice a multimodal approach to treating patients with treatment-resistant depression and chronic pain. We collaborate with psychiatrists, neurologists, mental health providers, physical therapists, family medicine physicians, pain specialists, and obstetricians/gynecologists to help coordinate and develop the best treatment plan for each patient. Scientific research supports the assertion that exercise, diet, and proper rest are integral components to health and wellness. We treat patients on a referral basis and are happy to assist you.
Reading Materials
How Ketamine Acts As A 'Switch' In The Brain
