August 13, 2026
Depression can affect nearly every part of daily life, from sleep and concentration to relationships, motivation, and work. While many people improve with traditional antidepressants and psychotherapy, others continue to experience significant symptoms despite trying appropriate treatments.
For some patients, ketamine-based treatment may offer another option. Ketamine has received considerable attention in psychiatry because it works differently from conventional antidepressants and may be considered in certain cases of difficult-to-treat depression.
At Saltmeadow Psychiatry in Savannah, GA, treatment decisions begin with a comprehensive psychiatric evaluation. The goal is not simply to treat symptoms, but to determine which evidence-based approach is appropriate for each individual.
Ketamine is a medication that has been used in medicine for decades, primarily as an anesthetic. In more recent years, researchers and clinicians have studied its effects at lower doses in people with certain psychiatric conditions, particularly depression.
Unlike many conventional antidepressants, which primarily affect serotonin, norepinephrine, or dopamine systems, ketamine acts largely through the brain's glutamate system.
This different mechanism is one reason ketamine-based treatments have become an important area of interest in modern psychiatry.
The exact antidepressant effects of ketamine continue to be studied, but research suggests that its activity involves glutamate, one of the brain's major chemical messengers.
Ketamine affects NMDA receptors, which are involved in glutamate signaling. This interaction appears to influence other processes involved in communication between brain cells.
Researchers believe these effects may encourage changes in synaptic plasticity the brain's ability to strengthen, modify, and form connections between neurons.
Rather than simply increasing the amount of a particular neurotransmitter, ketamine appears to influence signaling pathways associated with how brain cells communicate and adapt.
This mechanism distinguishes ketamine from many traditional antidepressant medications.
Traditional antidepressants remain effective and appropriate treatments for many people with depression.
Common antidepressant medications include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and other medications that influence neurotransmitter systems involved in mood.
These medications generally require consistent daily use, and improvement may develop gradually.
Ketamine-based treatment takes a different approach because of its effects on glutamate signaling.
The differences do not mean that one treatment is universally "better" than another. The appropriate treatment depends on a person's symptoms, medical history, previous treatment response, current medications, and other individual factors.
A psychiatrist can evaluate these factors before recommending a treatment strategy.
Some people continue to experience significant depression even after trying conventional treatments.
This is often described as treatment-resistant depression, although determining whether depression is truly treatment-resistant requires careful clinical evaluation.
A psychiatrist may review factors such as:
This evaluation is important because persistent depression does not automatically mean that ketamine is appropriate.
When standard approaches have not provided adequate relief, a psychiatrist may discuss other evidence-based treatment options, which can include ketamine-based therapies for appropriate patients.
The terms ketamine and Spravato® are sometimes used interchangeably online, but they are not identical.
Ketamine contains a mixture of two molecular forms of the medication. Spravato® is the brand name for esketamine, which contains one specific form of the ketamine molecule.
Spravato® is an FDA-approved nasal spray used under specific circumstances for eligible patients with depression. It must be administered in a certified healthcare setting with appropriate monitoring.
Other forms of ketamine may be used differently and can have different regulatory status, administration methods, evidence, and treatment protocols.
Understanding these distinctions is important when researching treatment.
The experience depends on the specific medication and treatment protocol being used.
Before treatment begins, patients typically undergo an evaluation to determine whether the therapy is medically and psychiatrically appropriate.
The clinician may review:
When treatment requires administration in a clinical setting, patients are monitored before, during, and after receiving the medication.
Monitoring is an important part of treatment because ketamine-based medications can produce temporary effects that require clinical observation.
Experiences vary from person to person.
Ketamine-based medications can cause temporary effects such as changes in perception, dizziness, nausea, sedation, or a feeling of disconnection from one's surroundings.
Certain treatments can also affect blood pressure.
For these reasons, ketamine-based psychiatric treatment should involve appropriate medical screening, dosing, supervision, and monitoring.
Patients should discuss potential benefits, side effects, risks, and alternatives with their treating clinician before beginning treatment.
One reason ketamine has attracted significant psychiatric interest is that antidepressant effects may occur more rapidly in some patients than they typically do with conventional antidepressants.
However, individual responses vary.
Some people may experience meaningful improvement, while others may experience partial improvement or little benefit. Response can also change over the course of treatment.
Ketamine should therefore not be presented as an instant or guaranteed cure for depression.
The goal is to determine whether it can be a useful component of an individualized treatment plan.
Ketamine has a long history of medical use, but psychiatric treatment still requires careful patient selection and professional supervision.
Safety considerations can vary depending on the type of ketamine-based treatment being considered.
A psychiatric evaluation helps identify potential risks and determine whether another treatment would be more appropriate.
Patients should also tell their clinician about all medications, supplements, medical conditions, substance use, and previous psychiatric treatments.
Ketamine treatment obtained outside appropriate medical supervision may carry additional risks.
No.
Ketamine-based treatment is not appropriate for every person experiencing depression.
A thorough psychiatric and medical assessment is necessary to determine whether someone may be a candidate.
Depending on the individual, a treatment plan may instead involve traditional antidepressant medication, psychotherapy, medication adjustments, lifestyle interventions, treatment of another underlying condition, or another evidence-based approach.
The decision should be based on the individual rather than on the popularity of a particular treatment.
Depression can have many contributing factors, and symptoms that appear similar can sometimes have different underlying causes.
Before recommending ketamine-based therapy, a psychiatrist can evaluate the broader clinical picture.
This may include looking for conditions or factors that could influence treatment decisions, such as anxiety disorders, ADHD, bipolar-spectrum symptoms, substance use, sleep problems, medical conditions, medication interactions, and previous responses to psychiatric treatment.
A comprehensive evaluation helps ensure that treatment addresses the patient rather than simply the diagnosis.
At Saltmeadow Psychiatry, Dr. Daniel Perry, MD, MPH provides individualized psychiatric care for adults in Savannah, Georgia and surrounding communities.
Patients seeking help for persistent or difficult-to-treat depression can receive a comprehensive psychiatric assessment and discuss appropriate treatment options based on their history, symptoms, previous treatments, and goals.
When ketamine-based treatment is clinically appropriate, care emphasizes careful evaluation, professional monitoring, patient education, and ongoing psychiatric follow-up.
The objective is to create a treatment plan focused on meaningful and sustainable improvement not simply provide a particular medication.
Ketamine affects glutamate signaling in the brain and appears to influence pathways involved in communication and plasticity between brain cells. Its mechanism differs from that of many conventional antidepressants.
No. Spravato® contains esketamine, one specific molecular form related to ketamine. Spravato® is an FDA-approved nasal spray used under specific conditions and administered in certified healthcare settings.
Ketamine itself has FDA-approved medical uses, but its use for depression may be off-label depending on the formulation and method of administration. Esketamine, sold under the brand name Spravato®, has specific FDA-approved indications for depression.
Some patients may experience improvement relatively quickly, but response varies considerably. Ketamine should not be viewed as an immediate or guaranteed cure.
Patients should not stop, start, or change psychiatric medications without discussing the change with their prescribing clinician. Treatment plans vary based on the individual and the specific ketamine-based therapy being used.
The appropriate way to determine candidacy is through a psychiatric and medical evaluation that considers your diagnosis, symptoms, treatment history, current medications, health conditions, and potential risks.
If depression continues to interfere with your life despite previous treatment, there may be additional options worth discussing.
Saltmeadow Psychiatry provides individualized psychiatric evaluation and treatment in Savannah, GA, with a focus on evidence-based care and thoughtful medication management.
Patients interested in ketamine-based treatment can schedule an evaluation to discuss their symptoms, previous treatments, potential options, and whether this approach may be appropriate for their individual circumstances.
Saltmeadow Psychiatry
315 Commercial Drive, Suite D-6
Savannah, GA 31406
Phone: (912) 513-2888
Book an Appointment to discuss your treatment options with Saltmeadow Psychiatry.
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