FAQ

• By age 40, about 50% of the population will have or have had a mental illness.
• Schizophrenia affects 1% of the Canadian population.
• Anxiety disorders affect 5% of the household population, causing mild to severe impairment.
• Suicide accounts for 24% of all deaths among 15-24 year olds and 16% among 25-44 year olds.
• Suicide is one of the leading causes of death in both men and women from adolescence to middle age.
• The mortality rate due to suicide among men is four times the rate among women.

• A complex interplay of genetic, biological, personality and environmental factors causes mental illnesses.
• Almost one half (49%) of those who feel they have suffered from depression or anxiety have never gone to see a doctor about this problem.
• Stigma or discrimination attached to mental illnesses presents a serious barrier, not only to diagnosis and treatment but also to acceptance in the community.
• Mental illnesses can be treated effectively.

• The economic cost of mental illnesses in Canada for the health care system was estimated to be at least $7.9 billion in 1998 – $4.7 billion in care, and $3.2 billion in disability and early death.
• An additional $6.3 billion was spent on uninsured mental health services and time off work for depression and distress that was not treated by the health care system.
• In 1999, 3.8% of all admissions in general hospitals (1.5 million hospital days) were due to anxiety disorders, bipolar disorders, schizophrenia, major depression, personality disorders, eating disorders and suicidal behavior.Sources: The Report on Mental Illness in Canada, October 2002. EBIC 1998 (Health Canada 2002), Stephens et al., 2001

• It is estimated that 10-20% of Canadian youth are affected by a mental illness or disorder – the single most disabling group of disorders worldwide.
• Today, approximately 5% of male youth and 12% of female youth, age 12 to 19, have experienced a major depressive episode.
• The total number of 12-19 year olds in Canada at risk for developing depression is a staggering 3.2 million.
• Once depression is recognized, help can make a difference for 80% of people who are affected, allowing them to get back to their regular activities.
• Mental illness is increasingly threatening the lives of our children; with Canada’s youth suicide rate the third highest in the industrialized world.
• Suicide is among the leading causes of death in 15-24 year old Canadians, second only to accidents; 4,000 people die prematurely each year by suicide.
• Schizophrenia is youth’s greatest disabler as it strikes most often in the 16 to 30 year age group, affecting an estimated one person in 100.
• Surpassed only by injuries, mental disorders in youth are ranked as the second highest hospital care expenditure in Canada.
• In Canada, only 1 out of 5 children who need mental health services receives them.

Ketamine is an anesthetic drug that blocks pain. It was first developed in the 1960s and was used to operate on soldiers during the Vietnam War. It’s also been used as an animal tranquilizer.

In addition to dulling pain, ketamine makes users feel like they’re detached from their own body. This out-of-body sensation has made it a popular club or party drug, and it goes by nicknames like “Special K.”

In 2000, researchers started studying ketamine as a treatment for depression. Over the years, they’ve discovered it improves mood much faster than traditional antidepressant drugs, and it works when some of these drugs have failed.

Ketamine is FDA-approved as an anesthetic for surgery and diagnostic procedures. It’s also used to treat depression, suicidal thoughts, posttraumatic stress disorder (PTSD), other mood disorders, and nerve-related pain.

You can get it at a ketamine clinic. There are more than two dozen clinics around the country, but the drug is only available in 12 states, mostly along the coasts. Ketamine is also given experimentally in clinical trials.

Usually, ketamine is given as an IV into a vein, which is the quickest route for the medicine to get to the brain. Most people start with about six doses over a period of 1 to 2 weeks, and then get booster IVs once every 3 to 5 weeks. You may need to continue treatments for a year or more to see long-term results.

Researchers don’t know exactly how ketamine works to treat depression, but they have some ideas. Unlike antidepressants, which work by shifting the balance of brain chemicals like serotonin and dopamine, ketamine is thought to change the way brain cells communicate with each other. “If you think of it in terms of a computer, what ketamine does is a hardware fix — not like antidepressants, which are like a software fix,” says Glen Brooks, MD, an anesthesiologist and medical director of NY Ketamine Infusions.

Ketamine blocks a type of receptor in the brain, known as NMDA, thought to play a role in depression. Recent studies find that ketamine can have long-lasting effects on depression, even though the drug only stays in the body a short time.

Ketamine also acts on other brain receptors — like opioid receptors, which affect pain and depression. “I think it is the ability of ketamine to not just hit one target like NMDA, but also to hit other receptors that create its unique effect,” says Ruben Abagyan, PhD, a professor at the UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences who has studied the use of ketamine for depression.

Unlike antidepressants, which can take weeks or longer to take effect, ketamine starts working within a few hours. For people who are suicidal, this rapid effect can be lifesaving. Ketamine can also help people who haven’t found relief from other depression treatments.

Brooks says some of the patients he sees have been to several psychiatrists and have tried half a dozen to a dozen medicines. Many have attempted suicide. “What patients report is a lightening of their mood [with ketamine]. The dread begins to lift. If there was anxiety before, all of a sudden there’s less anxiety,” he says. “It’s not uncommon for people to sit in my office and say, ‘Dr. Brooks, this is the first time I’ve gotten out of bed in a week.’ “

• Make sure your doctor asks about your depression symptoms, treatment history, other medical conditions, and whether you’ve had any problems with substance abuse before starting you on ketamine. Knowing your health history will help ensure that the benefits of this treatment outweigh the risks.
• The doctor should check your vital signs — including blood pressure, heart rate, and oxygen levels — before and after treatment.
• While you get the IV, medical staff at the clinic should monitor you for any physical and mental effects from the drug. “The facility should have a clear operating procedure on how to manage things if there is a problem,” Sanacora says.