With a mental health crisis raging on, doctors are consistently hunting for effective treatment options that work better—and fast— for their patients who suffer the most.
One local psychiatrist, Dr. Mark D’Agostino of Bluestone Psychiatry in New Canaan, has found that using Ketamine as a way to treat medicine-resistant depression and anxiety can be a game changer.
“Ketamine treatment is very exciting for the field of psychiatry,” he explains. “Historically patients have come in knowing they might not feel better for weeks and this is providing us the opportunity to treat people in rapid and novel ways.”
While Ketamine has seen a drastic rise for use in mental health centers recently, it has been on the market as a FDA approved form of treatment since 1970. Originally used as a form of dissociative anesthesia when delivered at high doses, the medication delivered at much lower doses has proven to be effective at treating severe depression, anxiety and suicidal thoughts.
“Medications like classic SSRIs [selective serotonin reuptake inhibitors] are still valuable and critically important but they don’t work immediately the way that Ketamine often does,” says D’Agostino. “They are very effective medications but they can take weeks to start working and Ketamine can potentially help someone feel better within hours.”
Ketamine also works differently than other medications because it moves though different receptor systems. “It is approaching the same problem but from a different and often complementary angle,” he explains.
D’Agostino and his team, including Dr. Jordana Hollen and Dr. Mia Handler, prescribe tablets that dissolve under the tongue and can be used in conjunction with oral antidepressants. Prior to treatment a comprehensive medical evaluation is completed to make sure that the patient is a good candidate and doesn’t have any pre-existing conditions that might lead to complications. Blood pressure is monitored throughout treatment as some people see a rise from Ketamine. An individual in office or at home protocol is developed for each patient, based on individual needs. Some receive treatment once a week and others may take Ketamine more frequently—especially if the goal is to help bring them out of a suicidal state.
After med school, D’Agostino served as an Army physician and quickly realized that his true passion was helping those struggling with their mental health. His time as an active-duty brigade surgeon in the Army gave him a full scope view of those that he treated. Living on base meant that D’Agostino had a 360-degree picture of his patients lives. He saw where they worked, where they lived, who their friends were and what their day-to-day lives entailed. He also saw the depth of the impact that conditions like anxiety and PTSD had on his patients and the ways in which these conditions could seep into every aspect of their lives. While also working at Walter Reed Army Medical Center in Washington, D.C. at a time when the U.S. was active in the Middle East, D’Agostino saw numerous patients who had been horribly injured and countless cases of traumatic amputations. There was so much focus on these patient’s physical injuries and recoveries but D’Agostino saw equally horrific suffering from their emotional injuries. Upon leaving active duty he went on to pursue residency training in psychiatry from New York Presbtyerian/Weill Cornell Medical Center, where he continues to remain on faculty.
As a psychiatrist who specializes in addiction, D’Agostino and his staff also monitor patients closely as Ketamine can have a euphoric effect for some.
“Ketamine, despite having a lower addiction liability than other FDA approved medications like opioids or benzodiazepines, can be misused,” he explains. “We have a responsibility to make sure that the medication is used carefully and in the right clinical setting.”
Photographs: contributed; Ray Park Stock Photo – stock.adobe.com