Comparing Treatments for Depression: SSRIs vs. Ketamine

Comparing Treatments for Depression: SSRIs vs. Ketamine

October 15, 2021

SSRIs are the most common form of antidepressant. Since the introduction of Prozac in 1987, SSRIs have been prescribed to patients to combat depression.

With the rise of ketamine as an alternative treatment, it’s worth taking a look at how the two compare.

How SSRIs Work

Selective serotonin reuptake inhibitors (SSRIs) are the most widely prescribed antidepressants in the United States. They include popular medications such as Prozac, Zoloft and Lexapro.

This class of drugs was once thought to work by increasing the brain’s serotonin levels. Neurons use neurotransmitters like serotonin to send and receive messages. After carrying a message, serotonin is typically reabsorbed by the neurons.

SSRIs “inhibit” this “reuptake”, thereby increasing the levels of available serotonin. This supposedly corrects a chemical imbalance in the brain.

SSRIs do work for many people, but they can also present issues. Despite increasing serotonin levels immediately, it can take patients about a month or more to start seeing results. SSRIs also require the patient to stick to a daily pharmaceutical regime of taking pills that can have negative side effects.

How Ketamine Works

Ketamine treatments offer months of lasting relief in single or packaged sessions.

It rapidly reduces the symptoms of depression, and does so by targeting a different neurotransmitter: glutamate.

By increasing the secretion of glutamate, and simultaneously boosting levels of BDNF (brain-derived neurotrophic factor), ketamine helps promote neuroplasticity.

Ketamine is administered at far higher doses than an SSRI. It is intended to occasion breakthrough experiences, or moments of ego dissolution. Ego dissolution is a state in which the patient temporarily loses a sense of self.

With proper preparation and integration, tremendous healing can occur in this state. The patient may dissolve old narratives about the self and may gain greater insight about who they truly are. This state can give distance to fear and transcendence from trauma.

Unlike SSRIs, ketamine provides instant relief. It is effective for more people, and lasts for far longer.

About a third of people prescribed SSRIs and other antidepressants see no improvement. Ketamine therapy works on two thirds of patients with treatment-resistant depression.

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