Ketamine therapy can be considered not as a primary method, but only when standard treatment methods, such as for depression, have not yielded results. This was stated to a UNN journalist by Ihor Ihorovych Dubyna, head of the structural unit of the Odesa Regional Mental Health Medical Center, who spoke about its use in modern clinical practice in Ukraine.
What is ketamine
Ketamine is a drug that was originally developed as an anesthetic for medical and veterinary purposes. However, its specific properties, such as hallucinogenic effects and the ability to induce an altered state of consciousness, have also made it popular in the illegal sphere. Discussions about ketamine continue, both in scientific circles and among the public.
Mechanism of ketamine therapy
Dubyna explained that ketamine does not act like conventional antidepressants — it does not affect serotonin or dopamine, but "resets" the work of brain networks through glutamate, the main excitatory neurotransmitter.
It blocks specific receptors (NMDA) on inhibitory neurons, resulting in a brief "surge" of glutamate in the brain. This surge activates other receptors (AMPA) and triggers internal processes that stimulate the production of growth factors (including BDNF) and proteins that form new synapses. As a result, brain cells begin to interact actively again, and the connection between areas responsible for emotions and motivation improves.
Who and when should ketamine therapy be prescribed?
Dubyna emphasized that ketamine therapy can be considered not as a first-line treatment, but only when standard treatment methods, such as for depression, have not yielded results — that is, in cases of treatment-resistant depression (TRD).
In Ukraine, its use in psychiatry is possible only in an inpatient setting, off-label, under strict medical supervision, with the patient's written informed consent, and in compliance with the rules for handling controlled substances.
Application of ketamine therapy in Ukraine
In modern clinical practice in Ukraine, the use of ketamine therapy is limited and irregular, primarily implemented within private medical institutions, experimental programs, or research initiatives, and is not included in approved standards or protocols for psychiatric care. Thus, the use of ketamine for the treatment of depressive or post-stress disorders in Ukraine should currently be considered as isolated, off-label, and experimental use in specialized clinical settings.
How appropriate is it to prescribe ketamine therapy for PTSD?
According to Dubyna, it can only be considered an experimental or auxiliary method in narrowly defined cases.
Data from some clinical studies are described where ketamine shows a temporary reduction in PTSD symptoms (in particular, hyperarousal and avoidance) during the first 1-2 weeks, but a long-term effect has not been confirmed.
Add
Self-medication is dangerous, so you should always consult a doctor for accurate diagnosis and treatment, especially for mental disorders. This publication is for informational purposes only.
Addition
The Royal College of Psychiatrists (RCPsych) approved ketamine-based drugs for the treatment of depression in clinical settings, while calling for more active research into other psychedelic drugs.
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