How Effective Is Ketamine for Anxiety?

Anxiety disorders are among the most prevalent mental health conditions in the United States, affecting approximately 40 million adults each year—around 18.1% of the population. Despite the high prevalence, only 37.9% of those affected receive treatment, and for those who do, 30-40% experience little to no relief from traditional therapies. As mental health treatment evolves, ketamine has emerged as a promising alternative, offering relief where conventional treatments fall short.

Dr. Fred, a provider of ketamine-assisted psychotherapy, helps individuals struggling with generalized anxiety disorder (GAD), social anxiety disorder (SAD), PTSD, and depression explore the benefits of this innovative treatment.

What is Ketamine?

First synthesized in the 1960s and approved as an anesthetic by the FDA in 1970, ketamine works primarily as an NMDA receptor antagonist—meaning it interacts with glutamate, a key neurotransmitter involved in learning, memory, and mood regulation.

Unlike traditional antidepressants, which are based on the monoamine hypothesis—focusing on serotonin, dopamine, and norepinephrine—ketamine operates under the glutamatergic hypothesis. Research suggests that disruptions in the glutamate system may play a significant role in mood disorders, making ketamine a powerful and fast-acting alternative to conventional treatments (Duman et al., 2012).

Studies show that ketamine is effective for major depression, treatment-resistant depression, and various anxiety disorders, providing rapid symptom relief that can last days or weeks after a single treatment (Murrough et al., 2013).

Ketamine for Social Anxiety Disorder (SAD)

A randomized, placebo-controlled crossover trial by Jerome H. Taylor et al. examined the efficacy of IV ketamine infusions (0.5 mg/kg over 40 minutes) in individuals with social anxiety disorder (SAD). Results showed that after just three hours, patients experienced significant reductions in anxiety, with benefits lasting up to 14 days (Taylor et al., 2018).

Key Findings:

• 33.3% of participants responded positively to ketamine, compared to 0% in the placebo group, according to the Liebowitz Social Anxiety Scale (LSAS).
• On a Visual Analog Scale (VAS-Anxiety), 88.89% of ketamine participants showed improvement, compared to 52.94% for placebo.
• These findings suggest that ketamine rapidly alleviates symptoms of SAD, offering a viable alternative for individuals resistant to traditional treatments.

Ketamine for Generalized Anxiety Disorder (GAD)

A study by Paul Glue et al. examined 12 patients with treatment-resistant GAD and SAD, administering IV ketamine infusions in increasing doses (0.25, 0.5, and 1 mg/kg). The control group received midazolam (0.01 mg/kg), a common anti-anxiety medication.

Key Findings:

• Ketamine significantly reduced anxiety symptoms within one hour of administration, with effects lasting for up to a week (Glue et al., 2018).
• Midazolam had only minor effects, reinforcing ketamine’s superior efficacy.
• Ketamine was well-tolerated, with minimal side effects, making it a safe and effective treatment for GAD.

Ketamine as a Long-Term Maintenance Therapy

In a follow-up study, 20 patients with treatment-resistant GAD and SAD received weekly subcutaneous ketamine infusions (1 mg/kg) for three months. The results were promising:

• Patients demonstrated significant improvements in social and occupational functioning.
• Minimal side effects were reported, showing that ketamine may be a safe, long-term alternative for chronic anxiety sufferers (Glue et al., 2020).

How is Ketamine Administered?

Ketamine can be delivered through various methods, including:

• Intravenous (IV) infusion – The most common method in clinical settings.
• Intramuscular (IM) injection – A fast-acting alternative.
• Sublingual tablets or troches – Used for at-home therapy under supervision.
• Intranasal spray – Available as Spravato (esketamine), an FDA-approved ketamine-based medication.
• Subcutaneous injection – A lower-dose option sometimes used in maintenance therapy.

The best administration route depends on individual patient needs, response to treatment, and guidance from healthcare professionals.

Conclusion: Is Ketamine Right for You?

If you struggle with social anxiety disorder (SAD), generalized anxiety disorder (GAD), or treatment-resistant depression, ketamine-assisted therapy could offer the relief you’ve been searching for.

Dr. Fred provides personalized ketamine-assisted psychotherapy, ensuring a safe, supportive, and transformative experience. He works with trusted providers like ISHA Health to offer low-dose at-home ketamine therapy, helping clients navigate their ketamine journeys in a professional and therapeutic environment.

For those who feel stuck in chronic anxiety cycles, ketamine is an exciting new avenue, offering hope, relief, and a path forward. If you’re interested in exploring ketamine therapy, reach out today to learn more about how it can help you regain control and improve your quality of life.

References

• Duman, R. S., et al. (2012). A neurotrophic model for stress-related mood disorders. Biological Psychiatry, 73(7), 111-120.
• Glue, P., et al. (2018). The effects of ketamine in patients with treatment-refractory generalized anxiety and social anxiety disorders. Journal of Psychopharmacology, 32(4), 395-402.
• Glue, P., et al. (2020). Maintenance ketamine therapy for treatment-resistant generalized anxiety and social anxiety disorders: A follow-up study. Journal of Affective Disorders, 276, 597-603.
• Murrough, J. W., et al. (2013). Rapid and sustained antidepressant effect of ketamine in major depression: A randomized controlled trial. American Journal of Psychiatry, 170(10), 1134-1142.
• Taylor, J. H., et al. (2018). Ketamine for social anxiety disorder: A randomized, placebo-controlled crossover trial. Neuropsychopharmacology, 43(2), 325-333.