During USC Verdugo Hills Hospital’s eighth annual Suicide Awareness and Prevention Conference last Saturday, associate professor Lynnette Averill discussed the use of ketamine in treating suicidality, depression, PTSD and other psychological disorders.
Ketamine is a dissociative anesthetic that can have hallucinogenic effects. In a study referenced by Averill, patients were given a low dose of ketamine — 0.5 milligrams per kilogram — rather than the higher doses used for anesthesia. According to Averill, this single dose yields treatment results for between seven and 14 days on average.
Averill, who teaches psychiatry at Baylor College of Medicine in Houston, Texas, and who works as a clinical research psychologist at the U.S. Department of Veterans Affairs, emphasized the fast-acting nature of ketamine, whose effects kick in 24 hours after a patient’s first dose, versus the slow-acting nature of traditional anti-depressant medication used to treat depression and other disorders.
“If we think about struggling with significant suicidal thoughts, depression, PTSD, any of these things, to have the potential of feeling significantly better within 24 hours rather than two to four to six to eight weeks, that in and of itself is quite literally lifesaving in many instances,” Averill said in her speech.
In addition to being slow-acting, Averill said anti-depressants such as SSRIs have high rates of limited or no response, continued symptoms, distressing side effects and a reduced chance of improvement with each time a patient tries them.
While the last few years had shown a plateau or even decreases in suicide rates, Averill said these rates increased in 2022.
“We are facing a mental health crisis unlike really anything we have dealt with before in modern times,” she said. “We are facing elevated rates of PTSD, depression, anxiety, substance abuse and unfortunately suicide.”
Averill noted ketamine’s success in reaching treatment-resistant patients, who have not seen results through traditional mental health care.
“I am very careful to say that [treatment-resistant patients] have been failed by the interventions that health care has to offer; [the patients] have not failed,” Averill said. “That is a very important distinction. … Sometimes that message gets a little muddied and honestly can further contribute to people’s symptoms.”
A major neurological implication of mental health disorders is the disruption of synaptic connectivity, which are pathways our brains use to send us messages. Averill explained that these pathways are connected to learning, memory and evaluations of experiences.
Ketamine creates rapid synaptic connectivity, which can alleviate the symptoms of depression, PTSD and suicidal thoughts. Referencing a study on the effects of ketamine on brain connectivity, Averill showed data that the brain connectivity of patients who responded to ketamine treatment was “almost identical” to the brain connectivity of a baseline group, meaning people who do not suffer from mental health disorders.
While Averill’s talk focused on ketamine, she also touched on a few other drugs being studied for mental health treatment such as MDMA, also known as Ecstasy and Molly. In addition to causing increases in serotonin and dopamine, MDMA also raises oxytocin levels, a chemical associated with intimacy and connection. Averill said this is a critical piece in MDMA treatment.
“We know that in stress and trauma and suicidal thoughts and behaviors, there is often that isolating sense of not belonging, not being loved, not being able to connect with others, not trusting others … sometimes not trusting ourselves … [and] not having empathy or compassion for ourselves or others.”
She concluded her talk by emphasizing that treatment for mental health disorders is a very personal process and there is no one size fits all. While these findings on ketamine are exciting for the future, she clarified that they may not be for everyone and that current treatments are still valid for those who are content with the results.
In addition to Averill’s talk, the conference hosted sessions with other mental health care professionals on topics such as evolving crisis response, grieving and loss, suicide risk factors, firearm suicide prevention and suicide in college students. The conference had more than 300 attendees both virtually and in person, said Marie Filipian, the community benefit manager at USC Verdugo Hills Hospital.
“Hosting a suicide awareness and prevention conference is important because it brings together mental health professionals, nurses, community members, individuals with lived experience, first responders and law enforcement to improve awareness of individuals who may be at risk, assist in ending the stigma and silence associated with suicide, gain access to resources and emphasize the significance of suicide prevention initiatives,” Filipian told the News-Press.
First published in the September 16 print issue of the Glendale News-Press.
