Ketamine Therapy for Depression: What It Is, Who It Helps and What to Expect

For many people, depression improves with talking therapy, medication, or both. But a significant number try two or more antidepressants, at the right dose and for long enough, and still feel stuck. Doctors call this treatment-resistant depression. If that sounds like your experience, you are not failing treatment — the treatment has not yet fitted you. Ketamine therapy is one of the newer options designed for exactly this situation.

What is ketamine?

Ketamine has been used safely in hospitals as an anaesthetic for decades. Researchers later found that at much lower doses, given under medical supervision, it can reduce symptoms of depression — often far faster than conventional antidepressants, which usually take four to six weeks to work.

In 2019 the U.S. Food and Drug Administration approved esketamine, a closely related form of the medicine, for treatment-resistant depression. Since then, supervised ketamine treatment has become an established option in specialist psychiatric care around the world.

How does it work?

Most antidepressants act on serotonin. Ketamine works differently: it acts on glutamate, the brain's main "signalling" chemical, and appears to help the brain form new connections between nerve cells. This is thought to be why some people notice a lift in mood, energy or hopelessness within hours to days rather than weeks.

Who may benefit?

Ketamine therapy may be considered for adults who:

• have depression that has not improved after trying at least two antidepressants
• have severe depression where faster relief is important
• live with depression alongside anxiety, PTSD or chronic stress

It is not suitable for everyone. It is usually avoided in people with uncontrolled high blood pressure, certain heart conditions, a history of psychosis, current substance misuse, or during pregnancy. That is why every patient at TLC starts with a full psychiatric consultation before any treatment is planned.

What happens during a session?

1. Assessment first. Your psychiatrist reviews your history, current medicines and physical health, and checks your blood pressure.
2. A calm, private room. The medicine is given at a carefully measured low dose while you sit or recline comfortably.
3. Continuous monitoring. A clinician stays with you. Blood pressure and how you feel are checked throughout.
4. Recovery time. Most people feel back to normal within about an hour or two. You should not drive for the rest of the day, so plan for someone to take you home.

A typical course is a series of sessions over a few weeks, followed by a review. Some people then need occasional maintenance sessions; others do not.

What does it feel like?

During treatment many people feel relaxed, slightly detached or "floaty", and notice changes in sound or vision. This is expected, temporary and settles soon after the session. Some people feel mild nausea, dizziness or a headache. Your clinician will explain all of this beforehand so nothing comes as a surprise.

Ketamine is part of a plan, not a quick fix

The best results come when ketamine is combined with ongoing psychiatric care: medication review, therapy, sleep, and lifestyle support. At TLC, ketamine therapy is led by Dr. Naseem M. Chaudhry, an American Board Certified psychiatrist with more than 35 years of practice, and every treatment plan is personal.

Is it safe?

When given in a medical setting, at controlled doses, by trained clinicians who screen patients properly, ketamine therapy has a good safety record. It is very different from recreational use, which carries real risks. It should never be taken outside medical supervision.

Taking the next step

If you have tried treatment for depression without enough improvement, a consultation is the right place to start. We will talk through your history, explain whether ketamine therapy could suit you, and discuss every option — including those that don't involve ketamine.

Book a consultation at tlcmedclinics.com/patient/book or call +92 310 040 4444.

This article is for general information and is not a substitute for medical advice. If you are having thoughts of harming yourself, please go to your nearest emergency department or call Rescue 1122 immediately.