How Does Ketamine Treat Bipolar Disorder?

Medical providers are always searching for new ways to treat mental illnesses, including depression and bipolar disorder. If you experience symptoms of mental illness, you know they can happen suddenly, often without warning, and interfere with daily life. The challenge is always finding treatment or therapy that works. Fortunately, ketamine may be one such option.

What is Ketamine?

First introduced in 1962 as a human anesthetic, ketamine was subjected to several clinical and field trials, most notably as a treatment for wounded U.S. combat soldiers fighting in Vietnam. When dispensed in non-anesthetic doses, ketamine induces a sometimes euphoric and mildly dissociative effect. Ketamine soon became an option for treating symptoms of mental illness and chronic pain conditions. One version of ketamine received U.S. Food and Drug Administration approval in 2019 as an option for patients with treatment-resistant depression.

Ketamine for Bipolar Disorder

Bipolar disorder affects many areas of the brain, especially those critical to moods and emotions: the hippocampus, the amygdala, the ventral prefrontal cortex, the ventral striatum, and gray matter. Symptoms of the condition have been observed in each.

No one knows exactly how ketamine works to relieve symptoms of bipolar disorder and other mental health conditions. It is considered dissociative medicine. According to the U.S. National Institutes of Health, studies suggest that dissociative medicine like ketamine induces their effects by disrupting the brain chemical glutamate (a neurotransmitter) at certain kinds of receptors (N-methyl-D-aspartate) or NMDA receptors on nerve cells in the brain. Neurotransmitters play a critical role in cognitive functions like learning, memory, how emotions are perceived, and pain recognition (when pain-regulating cells outside the brain get activated).

It has long been suspected that ketamine’s ability to strengthen and repair weak or damaged neurotransmitters is one of its chief strengths, but more research is needed. In the case of treating symptoms of bipolar disorder, low-dose ketamine – normally dispensed intravenously – produces effects related to sensory perceptions (body image, perception of time, shapes, sight, and sound) and detachment from reality. Racemic ketamine, often called intravenous or IV ketamine is a mix of mirror-image molecules R and S ketamine.

While most antidepressants and related medicines target monoamine neurotransmitters like serotonin, norepinephrine, or dopamine, ketamine goes after glutamate, the brain’s number one excitative chemical messenger. These chemical messengers play a significant role in regulating cognitive function, promoting and strengthening the synaptic connections.

According to some reports, ketamine creates significant antidepressant and anti suicidal effects, especially among people with structural changes in their brains due to prolonged bipolar depression. It is believed that ketamine is effective because it influences the release of molecules in the brain, which builds new communication pathways between neurons. This is a process called synaptogenesis, critical to everyone’s ability to regulate moods.

While human trials are ongoing, and healthcare professionals continue to document the progress of patients who receive ketamine for bipolar disorder and other mental illnesses, researchers also continue to test the effects of ketamine on animals, particularly mice. In one study referenced in Chemical & Engineering News, researchers looked at neurons in living mice with chronic stress, “a condition that models depression in rodents.”

 Results indicated that a dose of ketamine helped reestablish electrical activity and then repaired physical connections severed during stress. This suggests ketamine offers immediate and sustained positive outcomes on neuron function in the brain.

Diagnosis & Treatment

According to the U.S. National Institute of Mental Health, bipolar disorder affects nearly 3% of all U.S. adults. If you think you have bipolar disorder, the first step to regaining control of your life is to see a healthcare professional for diagnosis. Diagnosing bipolar disorder involves:

• A medical examination to determine if your medical history or an underlying condition triggers symptoms.
• A psychiatric assessment to understand how your thoughts, emotions, and behavior may influence your symptoms and whether you or a family member has a history of mental illness.
• Keeping a mood journal. Tracking your moods, including duration, intensity, and triggers can help inform diagnosis and treatment options.
• Comparing symptoms to criteria in the Diagnostic and Statistical Manual of Mental Disorders.

If you receive a diagnosis of bipolar disorder, your clinician may recommend an integrated treatment approach. This could include psychiatric counseling, antidepressants or other medicine, self-help strategies, or ketamine therapy.

With time and care, symptoms of bipolar disorder can be managed, allowing you to regain control of your life.