Ketamine is an effective way to treat depression—and now you may be able to do ketamine treatments from the comfort of your own home. A new study reports that quick-dissolving ketamine tablets could be an effective at-home alternative to visiting a ketamine clinic for depression. 1
This research is promising because for up to 30% of patients, depression symptoms do not respond to commonly-prescribed antidepressants. 2 In the US, that leaves about 2.8 million people without a viable treatment option.3 Continued research is crucial to uncover new treatment approaches, as major depressive disorders can be life-threatening and current models of treatment aren’t effective for everyone.
Ketamine Clinics for Treatment-resistant Depression
Ketamine clinics involve patients going to an on-site treatment facility and receiving intravenous (IV) ketamine in a clinical setting. Some clinics pair the ketamine with talk therapy or integration techniques, which may enhance its antidepressant effects.
Ketamine improves depression in a large percentage of patients—and relief can last for a month or more after a single treatment session. 4
Although ketamine clinics for mental health are becoming more widely accepted and available, access to treatment is still an issue for a portion of the population. Most ketamine clinics are in cities, which leaves them out of reach of people in more rural areas.
Now, however, ketamine could be more accessible than ever. New research shows that sublingual ketamine may be an effective home-based treatment option, opening ketamine therapy up to anyone with a mailbox and an internet connection. Sublingual ketamine is still in its early stages—but if doctors and researchers can develop at-home treatment protocols that are as safe and effective as IV ketamine infusions, it can only expand options for people who need it most.
Cost Implications for At-home Ketamine Treatment
Currently, few insurance companies cover ketamine therapy. Out-of-pocket costs for clinic-based ketamine therapy can be quite high, especially for people who have severe depression and can’t work consistently.
At-home ketamine treatments are often less expensive than clinic-based treatments. They get rid of the facility, utility, equipment, and staffing costs that come with on-site medical care. If at-home ketamine therapy turns out to be as safe and effective as clinic-based therapy, patients could save tens of thousands of dollars in out-of-pocket costs.
Some Doctors Are Against At-home Ketamine
Still, there are doctors who raise valid concerns about the dangers of at-home ketamine therapy. The most common criticisms around at-home ketamine use are that ketamine for mental health is technically off-label use of the drug, and taking ketamine at home without professional supervision could have physiological and psychological risks. Some doctors argue that you should only take ketamine under the supervision of a qualified healthcare team.
Ketamine for Mental Health Is Off-label Use
Traditionally, ketamine is a surgical anesthetic (pain blocker). However, research shows that it’s effective for treating depression, and some doctors prescribe it off-label for improving mental health.
Other healthcare providers aren’t comfortable with off-label use of the drug, and will be hesitant to refer patients to a ketamine clinic.
Some doctors also argue that a drug as potent as ketamine shouldn’t be left to a patient and a non-medical support person to manage. In a clinical setting, trained medical staff continually monitor the patient’s vitals while keeping a close eye on their behavior and mental state.
It is understandable that doctors might be cautious about using ketamine off-label and without medical supervision. Potential side effects of ketamine may include 5:
- Unstable blood pressure
- Irregular heartbeat
- Confusion, disorientation
- Dissociated state
And in extreme cases:
- Respiratory arrest
- Tonic-clonic muscle movements (which resemble grand mal seizure movements)
- Apnea (when your brain fails to signal to your breathing muscles to contract)
There is also the risk that if a patient self-administers, he or she could make a dosing error and take the wrong amount, which could be dangerous or even fatal. The same could be said about many prescriptions, but it’s still worth factoring into a decision to pursue at-home ketamine therapy.
It’s important to keep in mind that dosing ketamine for surgical procedures and for mental health applications are very different, and the lower dose of ketamine for depression and anxiety treatment may not present as many risks as the dose for surgical treatment would. That said, taking any drug has the potential for side effects, and ketamine treatment for depression is still only a few years old
Research Shows That At-home Ketamine Is Safe and Effective
A large prospective study found that overall, at-home ketamine is safe and effective for moderate to severe anxiety and depression. 6 Of the 1247 participants, only two left the study before completing it due to adverse events.
1. Hassan K, Struthers WM, Sankarabhotla A, Davis P. Safety, effectiveness and tolerability of sublingual ketamine in depression and anxiety: A retrospective study of off-label, at-home use. Front Psychiatry. 2022;13. doi:10.3389/fpsyt.2022.992624
3. Zhdanava M, Pilon D, Ghelerter I, et al. The Prevalence and National Burden of Treatment-Resistant Depression and Major Depressive Disorder in the United States. J Clin Psychiatry. 2021;82(2). doi:10.4088/JCP.20m13699
6. Hull TD, Malgaroli M, Gazzaley A, et al. At-home, sublingual ketamine telehealth is a safe and effective treatment for moderate to severe anxiety and depression: Findings from a large, prospective, open-label effectiveness trial. J Affect Disord. 2022;314:59-67. doi:10.1016/j.jad.2022.07.004