Evidence from Clinical Studies
While studies looking specifically at ketamine and anxiety are rarer than those concerned with depression, there has been some clinical research. A 2022 review of existing studies looking at either ketamine for refractory (treatment-resistant) anxiety disorders and anxiety with depression, for example, considered 18 separate studies.
The individual studies had mixed methods and results, with some involving small sample sizes. Overall however, the review concluded that ‘single‐dose infusions of ketamine showed significant positive treatment outcomes for patients with refractory anxiety disorders’. It added that hgher doses of ketamine such as weekly infusions ‘have greater effects on anxiety reduction across studies’.
It also noted that: ‘Anxiety is often comorbid with depression and clinical therapies typically treat both conditions concurrently…therefore examining the utility of ketamine treatment in patient groups with both refractory anxiety and TRD [treatment-resistant depression] would enhance clinical intervention.’
A 2023 study looked at the efficacy of ketamine intravenous therapy (KIT) for co-existing therapy and depression and found the treatment significantly reduced anxiety symptoms compared to other forms of medication. The noted improvement stayed stable over a year of follow-up monitoring.
Risks, Challenges, and What Is Unknown
As noted, research is ongoing into using ketamine as a treatment for both depression and anxiety. Ketamine is not currently licenced for use for treating mental health conditions in the UK – but that doesn’t necessarily mean that it is unsafe or inappropriate. As mentioned previously, The Christie uses ketamine for treating pain in cancer patients, even though that is another off-label use – meaning using a medication in a way that it is not licenced for.
The government says that there are clinical situations when the use of unlicensed or off-label medicines ‘may be judged by the prescriber to be in the best interest of the patient on the basis of available evidence’.
Clinicians must take extra care when using medications off-label though and there are potential side effects associated with ketamine.
These include but are not limited to:
- Feeling of dissociation
- Feeling ‘drunk’ or lightheaded
- Dizziness
- Tiredness after treatment
- Nausea
- Vivid dreams
- Tinnitus – a ringing in the ears that usually resolves when the ketamine is stopped.
Rarer side effects may also be experienced that can be more serious and indicate that treatment should be stopped.
These could include hallucinations and mania.
Patient Expectations and Candidacy
Ketamine treatment is not the right choice for everybody but it might be suitable for people who are experiencing severe anxiety that has not responded to other forms of treatment. It might also be suitable for those with co-existing treatment-resistant depression and anxiety, especially of they are already undergoing or considering ketamine therapy for the depression part of the equation.
Some pre-existing or historic conditions such as psychosis or unstable cardiac conditions might exclude a potential patient from ketamine treatment. In any case, an in-depth discussion with a clinician is needed to explore the potential risks and benefits.
How Eulas Clinics Approaches Ketamine for Anxiety
Eulas Clinics’ ketamine therapy for anxiety combines the pharmacological benefits of ketamine with structured psychotherapy. It requires informed consent and also involves constant monitoring and follow-ups. Safety is just as important as potential success in treating anxiety that has proven resistant to other approaches.
The ketamine is delivered in a controlled, therapeutic environment and is used in an intensive, dual approach alongside evidence-based psychotherapy techniques. This provides temporary relief from symptoms via the ketamine and also provides you with psychological tools to sustain progress and combat anxiety over the longer term.
