Depression can be difficult to treat

It is now agreed upon that the “gut-brain” connection is real. We also know that many people with digestive issues suffer from mood disorders such as depression.  In an ideal world, integrative approaches to depression such as diet, sleep, exercise and therapy would be sufficient to treat all patients with depression. While we should never downplay the importance of integrative approaches to treat depression, after all it is the basis of what I do, at times medications are needed. In addition, some people require medication to even begin to treat their depression from an integrative approach. Yet, even with medications, up to 1/3 of patients with major depression do not respond to treatment.

Is Ketamine the answer for people with depression and chronic digestive issues?

The big news this week was the FDA approval of Ketamine, a new drug treatment for depression. It has been years since a new depression medication has hit the market, so this was a hot topic. Ketamine has a reputation as a “club drug”  going by the street name “Special K”. It has however, been used safely for years as an anesthetic in hospital settings.

Many people with digestive issues tell me their mood varies with the severity of their current digestive symptoms. Could Ketamine help people who have depression that seems connected to digestive issues?  I think it is important to clarify its use. It is used for very specific cases of depression.  Someone may have depression and chronic digestive issues but the primary indications are listed next.

Use of Ketamine Nasal spray ( Spravato)

Ketamine is FDA approved for treating “resistent” depression in adults who also take anti-depressant medication. The person must have failed multiple other medications. Ketamine works quickly and is intended for people who are suicidal or severe enough to be admitted to the hospital. Up to now, this has been done with IV Ketamine therapy and has been done “off-label”.

Who can prescribe it?

Currently, prescribing and admnistering the drug will be done at certified sites only through a program called Spravato REMS.

Side effects

Long term side effects beyond one year are not known. The treatment is intended for severely depressed or suicidal patients.  A very strict protocol is followed and the drug will be given at a treatment facility. Patients do not go home with medication.

If you think you are a candidate

Given the strict guidelines for use at this point, most people with depression will not qualify as candidates for use. If you think you may be a candidate and are looking for further information, please discuss this option with your mental health care provider. Further information is also available at