Ketamine treatment for bipolar disorder is gaining attention as a promising option for individuals who haven’t found relief with traditional medications. Characterized by extreme mood swings, bipolar disorder can severely impact daily life. This article explores how ketamine may offer fast and effective relief, particularly for treatment-resistant cases, as well as what to expect from treatment at McLean Neuropsychiatric Treatment Centre (NTC).
Why Traditional Treatments Fall Short — And How Ketamine Treatment for Bipolar Disorder Can Help
Bipolar disorder affects an estimated 0.5% of the global population, though the actual number may be higher due to frequent misdiagnosis. The manic and depressive episodes that define the condition can create major challenges in all areas of an individual’s life. Those with bipolar disorder often struggle with relationships, school, and daily functioning and face a much higher unemployment rate compared to the general population.
Treatment for bipolar disorder typically consists of medications and psychological therapies, but these approaches don’t work for everyone. It’s estimated that about one-quarter of people with bipolar disorder are treatment-resistant, meaning there’s no significant improvement in symptoms despite trying multiple therapies.
Medications like mood stabilizers and antipsychotics are not only ineffective for some people but often come with unpleasant side effects such as weight gain, drowsiness, and difficulties with thinking clearly. These challenges may make people hesitant to use these medications, even when they effectively help relieve symptoms. Psychological therapies, like cognitive-behavioral therapy (CBT) and interpersonal therapy, can help people manage their mood episodes and relationships and improve coping strategies for a more balanced life. However, they require time, effort, and commitment to see results.
As such, there’s an unmet need for effective bipolar treatment. This is especially the case for those experiencing suicidal ideation, who urgently need rapid relief. Researchers estimate that between 25% and 60% of individuals with bipolar disorder will attempt suicide at least once in their lives.
Ketamine Treatment for Bipolar Disorder
What is Ketamine Treatment?
Ketamine was initially developed as an anesthetic and later became recognized for its powerful, rapid-acting antidepressant effects.
Ketamine treatment can come in many forms to suit the different needs of patients. Administration methods include intravenous (IV) infusions, intramuscular (IM) injections, oral tablets, and nasal sprays. Spravato (esketamine) is also a nasal spray form of ketamine but is approved only for treatment-resistant depression (TRD) and major depressive disorder with suicidality (MDSI).
While ketamine is FDA-approved for anesthesia and certain types of depression (e.g., treatment-resistant depression with esketamine/Spravato), its use for bipolar disorder remains off-label. This means it is not officially approved by the FDA for this condition, though some clinicians use it based on emerging research and clinical judgment. Patients should discuss the experimental nature of this treatment with their healthcare provider.
At McLean NTC, we provide both Spravato and IM ketamine treatment to help provide relief for patients suffering from treatment-resistant symptoms from severe mental health disorders. Some studies suggest that intramuscular (IM) ketamine can work quickly and may help relieve symptoms of mood disorders, including bipolar disorder. That said, research specifically on IM ketamine for bipolar depression is still growing. While early results are encouraging for short-term relief, more studies are needed to better understand long-term effects, especially given the risk of triggering mania in some people.
Mechanisms of Ketamine and Bipolar Disorder
Bipolar disorder is a complex condition with no single cause, likely resulting from a combination of genetic, biological, and environmental factors. Research shows that people with bipolar disorder often share certain neurological traits, including distinct patterns of nerve cell communication in brain regions responsible for mood regulation and stress. Bipolar patients also show a loss of gray matter (brain tissue) in areas associated with mood and cognition. These neurological factors may play a key role in the development of bipolar symptoms.
Ketamine appears to help the brain form new neural connections, a process known as neuroplasticity. By enhancing communication between brain regions involved in mood regulation, ketamine may help interrupt the cycles that keep people stuck in depressive patterns. Additionally, ketamine boosts the production of brain-derived neurotrophic factor (BDNF), a protein that supports the growth and survival of nerve cells. Increased BDNF levels may help reverse some of the grey matter loss linked to bipolar disorder.
As well as neurological factors, ketamine can also support counseling and psychotherapy. Its neuroplastic effects can make it easier for people to build coping skills and implement positive lifestyle habits. Additionally, ketamine can induce an altered state of consciousness in which someone may have valuable insights that help them process any trauma contributing to their condition.
Benefits of Ketamine Treatment for Bipolar
Rapid-Acting Effects
Unlike traditional antidepressants, which can take weeks to show effects, ketamine begins to alleviate depressive symptoms within hours to days. This quick relief can be particularly beneficial for individuals experiencing acute depressive episodes or those struggling with suicidal thoughts. A single dose of ketamine has been shown to relieve suicidal thoughts for up to 72 hours post-injection.
Sustained Decrease in Symptoms
Ketamine treatment can offer sustained mood improvements, unlike conventional medications, which need to be taken every day.
A study examining the mood benefits of intramuscular (IM) ketamine involved 41 individuals with bipolar disorder and demonstrated sustained mood improvements. Depression scores dropped by 38% and anxiety scores by 50% after four treatments, and these benefits lasted for over seven months with period maintenance treatments.
Effective When Other Treatments Have Failed
Ketamine treatment is particularly beneficial for those treatment-resistant mental health disorders, including bipolar, as well as anxiety, depression, and post-traumatic stress disorder.
In a study involving 39 treatment-resistant bipolar patients who had not found relief from traditional medications, IV ketamine or Spravato was administered twice weekly for up to four weeks. By the end of the study, 39% of participants experienced a clinical response, and 13% achieved full remission.
Risks of Ketamine Treatment for Bipolar
Physically, ketamine treatment is well-tolerated. There are mild side effects, but these generally wear off within a couple of hours after administration. These include:
- Nausea
- Dizziness
- Increased blood pressure
- Fatigue
In rare cases, people may have allergies to ketamine, which can cause symptoms like rash, hives, itching, and tightness in the chest.
Psychologically, ketamine can induce a state of dissociation characterized by a detachment from one’s body and everyday reality. Though this can be pleasant for some, it can be distressing and disorientating for others.
For people with bipolar disorder, dissociation can worsen or trigger depersonalization, where someone feels detached from themselves, as if observing from a distance. It may also cause derealization, a sense that the world feels unreal. Both depersonalization and derealization are common in bipolar disorder and can occur during manic or depressive episodes or in the periods between them.
Ketamine’s mood-elevating effects can bring fast relief, but for people with bipolar disorder, especially those with a history of manic episodes, it’s important to carefully manage treatment. That’s why ketamine is often used alongside mood stabilizers and under close medical supervision to reduce the risk of triggering mania.
Because of these potential risks, ketamine clinics must take extra precautions when providing ketamine to bipolar patients. At McLean NTC, we go to extra lengths to ensure the safety of our patients. We have a comprehensive screening call to ensure the treatment is safe, and our highly skilled team will closely monitor patients during and after treatment. We also offer personalized treatment plans that align with how patients respond, minimizing the risk of adverse effects and optimizing the chance of healing.
What to Expect with Ketamine Treatment for Bipolar Disorder at McLean NTC: Take a Step Toward Bipolar Relief
Our clinic provides ketamine treatment for bipolar disorder using IM ketamine. We use IM because it has a rapid effect and allows for precise dosing to suit individual needs. It also doesn’t have the same high costs and needle-related risks as IV ketamine, making it more financially accessible and a potentially safer treatment option.
If you decide to have treatment at our clinic in McLean, Virginia, your journey will begin with a pre-screening call to assess your eligibility. If you are eligible for treatment, you will then be scheduled for a comprehensive evaluation with Dr. Haq to develop your personalized treatment plan.
During each session, you’ll receive a carefully monitored IM ketamine injection, with post-session observation to ensure your safety. The treatment typically starts with twice-weekly sessions, gradually transitioning to less frequent sessions as needed. The dose and schedule will be adjusted based on your progress and response.
Take a Step Toward Bipolar Relief
If you’re in Virginia and struggling with bipolar disorder, our ketamine treatment at McLean NTC may be the answer you need. With personalized care, expert monitoring, and a focus on safety, our team is dedicated to helping you regain balance and improve your quality of life. Schedule an evaluation today to see if ketamine treatment is right for you.
Sources
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9041963/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4536929/
- https://pubmed.ncbi.nlm.nih.gov/33929489/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9199377/