NEWS Mental Health News Cognitive Function Rapidly Restored After Ketamine Treatment, Decreases Suicidality By Lo Styx Lo Styx Lo is a freelance journalist focused on mental health, sexual wellness and patient advocacy. She is based in Brooklyn and can be found on the internet @laurenstyx. Learn about our editorial process Updated on November 29, 2021 Fact checked Verywell Mind content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Karen Cilli Fact checked by Karen Cilli Karen Cilli is a fact-checker for Verywell Mind. She has an extensive background in research, with 33 years of experience as a reference librarian and educator. Learn about our editorial process Share Tweet Email Print Guido Mieth / Getty Images Key Takeaways Ketamine is an anesthetic drug used medically during surgery or for pain control, as well as illegally as a street drug. But research has revealed the drug's potential to treat severe depression.A new study shows suicidal ideation decreased significantly within 24 hours of receiving treatment. While it hasn't yet been approved by the FDA, ketamine is considered a paradigm shift for depression research and treatment as the first fast-acting antidepressant to effectively treat symptoms of treatment-resistant mood disorders. Usually used alone for pain control or with other anesthetic medicine during surgery, ketamine's potential to to treat severe depression is a hot topic of research. A new study from Columbia University presents new findings to reduce depressive symptoms and thoughts of suicide within just 24 hours. The Research Researchers conducted neuropsychological testing on 78 individuals with depression and clinically significant suicidal ideation before treatment and one day after. Half of the participants were treated with intravenous ketamine and half with the sedative midazolam, which is used to treat anxiety and depression. The findings, published in the Journal of Clinical Psychiatry, show that one dose of ketamine rapidly improved the thinking and reasoning of individuals with suicidal ideations to make them feel safer and less likely to harm themselves. Many of these individuals hadn't responded to other antidepressants previously. J. John Mann, MD We found that suicidal ideation is not just related simply to severity of depression. There are other reasons, including cognitive improvements that are related to a decline in suicidal ideation and thereby make those who are suicidal safer. — J. John Mann, MD While the exact mechanism is still unclear, the improvement in distorted thinking gives researchers a better understanding of how ketamine affects the brain. Some proposed biomedical mechanisms include down-regulation of neurological pathways commonly associated with rumination, a characteristic of suicidal thoughts. "We found that suicidal ideation is not just related simply to severity of depression," said senior author J. John Mann, MD, in a release. "There are other reasons, including cognitive improvements that are related to a decline in suicidal ideation and thereby make those who are suicidal safer." For the participants that responded positively to ketamine, the results continued for up to six weeks after the initial infusion alongside antidepressants. However, long-term effects of continued ketamine use are unknown, so further research is still necessary. Ketamine for Treatment-Resistant Depression Ketamine and Mental Health Psychotherapist Ben Medrano, MD, serves as medical director of Field Trip Heath New York, where psychotherapy is paired with psychedelic medicine. Ketamine is a regular part of treatment for individuals struggling with depression and anxiety. "We have found ketamine-assisted psychotherapy to be one of many helpful tools to springboard people to a state of greater agency to snap out of it and re-enter a flexible state where self care begins to feel more possible," Medrano says. Just as research has produced promising findings around ketamine for treating depressive symptoms, Medrano says he regularly sees the same encouraging results in practice. The introduction of ketamine allows patients to access the root cause of their issues and work toward addressing them. "We've observed that the pairing of ketamine with psychedelic modalities may offer the opportunity to access the unconscious and explore underlying issues that may contribute to depression and anxiety," Medrano says. "Meaning-making, be it spiritual or philosophical, has also been a key factor in the healing process of (ketamine-assisted psychotherapy)." Ben Medrano, MD We've observed that the pairing of ketamine with psychedelic modalities may offer the opportunity to access the unconscious and explore underlying issues that may contribute to depression and anxiety. — Ben Medrano, MD Although this evidence is promising and the FDA has approved a derivative of ketamine, Esketamine nasal spray, as an effective treatment for treatment-resistant depression in conjunction with oral antidepressants, some patients and professionals are still hesitant to explore ketamine's potential. Medrano notes that recreational use of ketamine and its association with animal tranquilizers have lead to major dismissal of its validity as a treatment. At the same time, some academics don't categorize ketamine as a psychedelic, and while it certainly doesn't produce the same effects as LSD or psilocybin, Medrano says, the limiting qualification of "dissociative anesthetic" ignores any mystical states that can be achieved through ketamine-assisted therapy. "Taking into account such misunderstandings, it's important to acknowledge their influence on the mindset of a KAP participant," Medrano says. "Psychedelics have the potential to amplify pre-existing beliefs, accurate or not. Therefore, reductive or false perspectives like these may detract from positive outcomes." What This Means For You If you or someone you know is struggling with symptoms of depression that haven't been relieved by therapy or other treatments, consult with your doctor or a mental health professional to determine whether ketamine could be an effective option. Study Shows Rapid Brain Response to Ketamine for Depression 3 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Krystal J, Abdallah C, Sanacora G, Charney D, Duman R. Ketamine: a paradigm shift for depression research and treatment. Neuron. 2019;101(5):774-778. doi:10.1016/j.neuron.2019.02.005 Keilp J, Madden S, Marver J et al. Effects of ketamine versus midazolam on neurocognition at 24 hours in depressed patients with suicidal ideation. J Clin Psychiatry. 2021;82(6). doi:10.4088/jcp.21m13921 Columbia University Department of Psychiatry. Ketamine rapidly improves cognitive function making those in suicidal crisis less likely to harm themselves. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.