Ketamine for Suicidal Thoughts

Ketamine has recently been featured on CNN. This gives the story of Mr. Ferguson, a man who dealt with depression and suicidality for years. He gives a candid and powerful account of his positive experience with ketamine. You can read the full story HERE but we’ve included a preview below as well:

“A few months ago, Alan Ferguson decided he was ready to die — for the third time. In 2014, he attempted suicide twice, and the persistent thoughts of “I need to be dead” were echoing in his brain once again.

Now 54 years old, Ferguson was diagnosed with clinical depression when he was 18. Since then, he estimates, he’s been prescribed more than a dozen medications — SSRIs, SNRIs, tricyclic antidepressants — all to little or no avail.
“I never got to the point that I thought, ‘OK, I’m feeling good,’ ” he said. “It was always, ‘OK, this is tolerable.’ But yet those thoughts [of wanting to die] were still there.”
In early May, Ferguson abruptly stopped taking all of his medications, quit his job and gave away his dog, Zeke. That evening, he called his sister, Linda.
“It was a very good conversation,” he said. “Linda and I disagree on a lot of stuff, and that night I avoided the hot-button topics because I did not want her to have bad memories or bad thoughts of what I thought was going to end up being our last conversation.”
As luck or fate or professional intuition would have it, on a prescheduled call the very next day, Ferguson’s psychiatrist offered to refer him to a ketamine clinic in Milwaukee, about an hour and a half from his home.
Ketamine is a powerful medication used in hospitals primarily as an anesthetic, but recent scientific studieshave shown significant promise with treatment-resistant depression and suicidal ideation.
Ketamine is also used recreationally, and illegally, as a club drug known as “Special K.” It generates an intense high and dissociative effects.
“I knew of the drug from having been a police officer, so I knew of its street use — illicit use — but I’m a pretty open-minded person too, and after all the traditional medications I’ve been on with no success, I thought, ‘Well, maybe they’re on to something here with this,’ ” Ferguson said. “I wasn’t worried about trying something I had never tried before. I was worried about trying something else that wasn’t going to work.”
Continue reading the full article on CNN.

So how does ketamine work?

The summary is that it revs up neurons in at least 3 parts of the brain (that we know of) to (1) change their firing pattern back to normal and (2) increase the neurons’ output. The best part is, ketamine works like starting up an engine. This effect is called “long term potentiation.” Once you start the engine, it keeps on working. In the same way, even after ketamine treatment stops, your brain keeps working healthily as well (but, like an engine, you still have to clean it [psychotherapy] and add oil [medications]).

More Ketamine Updates to Come…

I will be posting more about ketamine soon, including some evidence-based research about the details of how it works on the brain. I’ll also soon talk about how TMS and TBS work.

-Sincerely, Dr. Hernandez MD