Ketamine vs Traditional Antidepressants: A Comprehensive Guide

Ketamine vs Traditional Antidepressants: A Comprehensive Guide

The Albany Clinic • December 17, 2023

Navigating the landscape of mental health treatment, especially for conditions like depression and PTSD, often involves exploring various therapeutic options. For many years, traditional antidepressants have been a primary choice. However, recent advancements have introduced a new option: Ketamine. This guide delves into the nuances of Ketamine, particularly in its IV form, as compared to traditional antidepressants, offering insights for those still seeking effective treatment.


The Albany Clinic provides a balanced perspective, shedding light on the effectiveness, potential benefits, and considerations of each treatment modality. This comparison is important for patients and healthcare providers alike as they make informed decisions about mental health care. Understanding these options is key in the journey toward healing and stability for those affected by these challenging mental health conditions.

Understanding Their Mechanisms

Traditional Antidepressants: These medications have been a cornerstone in managing depression. They function as reuptake inhibitors, a process involving neurotransmitters, the brain's chemical messengers. After these neurotransmitters have facilitated communication between nerve cells, they are typically reabsorbed. Antidepressants inhibit this reabsorption, allowing neurotransmitters to remain active longer, thereby enhancing communication and emotional regulation. This mechanism aims to create a more balanced chemical environment in the brain. By keeping more neurotransmitters in the space between the nerve cells, they enhance communication and improve mood and emotion regulation​. It's a process that requires patience, as the full benefits of these medications often take weeks to manifest.


Ketamine: IV Ketamine represents a different approach. It influences the brain's glutamate system, which is vital for mood regulation. Ketamine blocks specific receptors, which leads to an increase in glutamate activity. This triggers the formation of new neural connections, fostering the development of healthier brain pathways. It's akin to supporting the brain in building new and more effective communication routes. Ketamine also potentially repairs damage inflicted by stress hormones on the brain's proteins.

Speed and Duration of Effects

One of the standout features of Ketamine when compared to traditional antidepressants is its rapid onset of action. A 2022 study  published in the National Library of Medicine demonstrated that a single subanesthetic-dose IV ketamine infusion can rapidly improve depressive symptoms within just one day, with antidepressant effects lasting from three days up to seven days. This swift response is particularly vital for individuals with severe depression or suicidal ideation, where time is often a critical factor. In such scenarios, the ability of Ketamine to provide almost immediate relief can be a significant advantage, offering a much-needed reprieve in acute phases of depression.


Traditional antidepressants, in contrast, can often take several weeks or even months to exhibit their full therapeutic effect. This slower onset of action could pose a limitation for patients requiring immediate relief. The gradual improvement seen with these antidepressants may contribute to more sustained long-term benefits, but they may not be as suitable for patients in need of urgent care. This difference in the speed of response between Ketamine and traditional antidepressants underscores the importance of tailoring treatment to the individual needs of each patient, particularly in emergency mental health situations.

Efficacy in Treatment-Resistant Cases

The role of Ketamine in treatment-resistant depression (TRD) is particularly noteworthy. TRD, defined as depression that does not respond adequately to at least two different antidepressants, presents a significant challenge in mental health care. In these instances, Ketamine has emerged as a beacon of hope. The S-enantiomer of ketamine, known as esketamine, has been studied extensively for its potent antagonistic effects at the NMDA receptor, a key component in its antidepressant properties. This has led to esketamine's exploration as a viable treatment option for TRD, providing relief for those who have found traditional antidepressants ineffective.


Numerous studies, including those cited on platforms like the National Center for Biotechnology Information (NCBI), have highlighted the rapid and robust antidepressant effects of ketamine in individuals with TRD. These studies indicate that ketamine can produce significant improvement in depressive symptoms, often within 24 hours of administration, a remarkable feat considering the typically gradual onset of traditional antidepressants. This rapid action can be particularly beneficial in acute cases, offering a much-needed alternative for individuals struggling with severe symptoms. Additionally, ongoing research suggests that repeated treatments with ketamine might lead to sustained improvements, potentially transforming the treatment landscape for TRD.

Comparing Side Effects and Safety Profiles

While both Ketamine and traditional antidepressants have their side effect profiles, they differ significantly in nature and duration. Ketamine's side effects are generally transient and occur during or immediately after infusion. These can include changes in blood pressure, dissociation, and nausea but typically resolve quickly without long-term consequences. Traditional antidepressants, on the other hand, can have more persistent side effects like weight gain, sexual dysfunction, and emotional blunting. These side effects can sometimes persist for the duration of the treatment and may influence a patient's willingness to continue the therapy.

A Balanced Perspective

The choice between Ketamine and traditional antidepressants isn't straightforward. It involves considering various factors like the severity of symptoms, previous treatment history, and personal health profile. While Ketamine offers a rapid and effective alternative, especially for treatment-resistant cases, it's essential to have a thorough discussion with healthcare professionals to determine the most suitable treatment plan. Beyond medication, therapy plays an effective role in treating mental health disorders. Integrating therapies like cognitive-behavioral therapy (CBT) with medication can provide a more holistic approach to treatment. This combination can address the underlying causes of mental health issues while managing symptoms.

Next Steps

Exploring all treatment options is key for those struggling with depression or PTSD. Ketamine offers a swift alternative for some, presenting a potential solution for those who have not found relief with other methods. On the other hand, traditional antidepressants provide a well-established route for others, offering a time-tested approach with a substantial track record. It's essential to understand that each individual's journey is unique, and what works for one person may not be as effective for another. Consulting with a mental health professional is an important first step in this deeply personal process. Their expertise can help tailor a treatment plan that aligns with your specific needs and circumstances.


The Albany Clinic in Carbondale Illinois invites you to reach out for expert guidance and support on your journey towards healing and stability, ensuring that you are not alone in this process and that there is a team ready to assist you in navigating these complex decisions.

35 Albany Rd. Suite A Carbondale, IL 62903

Phone:   (888) 804-4330

Book Your Free Initial Consultation

In-Clinic vs. At-Home Ketamine Therapy: What’s Best for Your Mental Health?

By Kimberly Mercille • July 9, 2025
As ketamine therapy becomes increasingly popular for treating mental health conditions like depression and PTSD, more people are exploring their options. At-home ketamine therapy gained traction during the pandemic for its convenience, but without medical supervision, this approach may come with elevated risks. In this article, we’ll explore some of the key differences and pros and cons of in-clinic versus at-home ketamine therapy. What Is In-Clinic Ketamine Therapy? IV Ketamine Treatment In-clinic ketamine therapy involves receiving treatment at a licensed medical facility, such as The Albany Clinic , where professionals monitor and administer the medication under strict protocols. This ensures your safety, especially during your initial sessions. At The Albany Clinic, we specialize in intravenous (IV) ketamine infusion therapy , which has been most well-researched when it comes to treating mental health disorders. IV ketamine bypasses the digestive system, delivering the medication directly into the bloodstream. IV ketamine can help relieve symptoms of various mental health disorders, including depression , anxiety , post-traumatic stress disorder (PTSD) , and more. During an infusion at our clinic, you’ll rest in a calm, controlled environment while ketamine is delivered into a vein through a catheter. Our trained staff will closely monitor your vital signs and mental state throughout the session, adjusting the dose of ketamine if needed. We’ll observe you after treatment to ensure any side effects are managed promptly and effectively. Spravato We also offer Spravato (esketamine) at our clinic, a nasal spray based on ketamine. Unlike other forms of ketamine treatment, Spravato is approved by the FDA and is specifically for adults with treatment-resistant depression or major depressive disorder with suicidal thoughts . Spravato is only approved for in-clinic use under professional supervision and cannot be administered at home, making clinical oversight a legal and medical necessity for this treatment option. During a Spravato session, you’ll self-administer the medication under the supervision of our medical staff. We’ll then closely monitor you for a couple of hours to ensure you’re safe and all side effects have subsided before leaving. What Is At-Home Ketamine Therapy? At-home ketamine therapy allows patients to self-administer the ketamine, typically in the form of lozenges or nasal sprays, delivered via mail. While this option offers flexibility, it usually involves minimal supervision , often limited to virtual check-ins with healthcare providers. Some at-home providers offer optional video support during sessions, but this is not always the case. Patients are largely responsible for monitoring their own physical and emotional reactions, without the benefit of immediate medical intervention if adverse effects occur. At-home treatment often includes supplementary materials , such as guided meditations or journaling tools. However, the lack of real-time clinical oversight makes this option less ideal for those with complex or severe mental health needs. Safety Considerations: In-Clinic vs. At-Home While ketamine therapy is considered safe for most patients, it does come with potential physical and psychological side effects , including: Physical Risks: Elevated blood pressure or heart rate Nausea or vomiting Sedation or dizziness Impaired coordination Rare allergic reactions Psychological Risks: Hallucinations or dissociation Temporary confusion or anxiety Emotional vulnerability during treatment Risk of misuse or dependency The FDA has issued warnings about at-home ketamine use due to its potential for abuse and lack of medical supervision . Without proper monitoring, the risk of addiction and long-term complications, such as bladder damage and cognitive decline, may increase. Key Differences Between In-Clinic and At-Home Ketamine Therapy

A Guide to IV Ketamine

By Matt Rodriguez • July 8, 2025
Intravenous (IV) ketamine has emerged as a promising option for individuals struggling with treatment-resistant depression and other hard-to-treat mental health conditions. Ketamine was originally developed as an anesthetic, but is now being used in controlled medical settings to deliver rapid relief when traditional therapies fall short. This guide explores the history, science, benefits, and practical considerations of IV ketamine therapy and what you can expect from treatment at The Albany Clinic.

Stellate Ganglion Block (SGB) for Depression

By Kimberly Mercille • May 27, 2025
Stellate Ganglion Block (SGB) is an emerging mental health treatment that targets key mechanisms linked to depression. In this article, we’ll discuss the science behind SGB and its potential benefits. If you or someone you know is struggling with depression, this information can help you make an informed decision about whether SGB might be the right option. What is a Stellate Ganglion Block (SGB)? What is the Stellate Ganglion? The stellate ganglion is a cluster of sympathetic nerves located on each side of the neck near the first rib. These nerves are part of the autonomic nervous system, which controls automatic body functions like heart rate, blood pressure, and digestion. The term "stellate" means "star-shaped" because the ganglion often looks like a star under a microscope. It helps regulate the body's stress response by controlling norepinephrine, a chemical that triggers the fight-or-flight reaction. When this system becomes overactive, it can cause various physical and psychological problems, including depression. Stellate ganglion block (SGB) therapy may help by reducing the activity of the stellate ganglion, calming the fight-or-flight response, and lessening the damaging effects of prolonged nervous system stress. How Does Stellate Ganglion Block Work? Stellate Ganglion block (SGB) is when a local anesthetic is injected near the stellate ganglion. These drugs inhibit transmission between nerve cells, dampening activity in the ganglion. They typically include lidocaine, bupivacaine, or mepivacaine, which are sometimes combined with a steroid medication. Patients may also receive another medication to relax them before treatment. SGB is typically performed using ultrasound guidance . The injection process lasts no more than 10 minutes, but patients will motinoted for another 30-45 minutes after treatment to ensure their safety. How Does Stellate Ganglion Block Work for Depression? Chronic stress is a major contributor to depression and is often linked to an overactive sympathetic nervous system. People with depression commonly show high levels of cortisol, a hormone that plays a key role in the body's stress response, in their blood stream. Cortisol is helpful in small doses, but when chronically elevated, it can disrupt neural circuits in the brain. Excessive cortisol can lead to: Neurotoxicity - Cortisol can be toxic to nerve cells, especially in the hippocampus, which is crucial for memory and emotional regulation. Overinflammation - Cortisol increases the activity of the body’s natural defense system, resulting in the system causing damage to nerve cells. Impaired synaptic plasticity - Cortisol inhibits the capacity for the brain to “re-wire” itself. This makes it harder for people to adapt to stressful situations and learn new patterns of behaviour. Disrupted sleep - High cortisol can prevent people from sleeping well. During sleep, restorative biological processes occur in the brain, and excess cortisol can prevent these from happening. SGB decreases sympathetic nervous system activity, which can reduce cortisol levels. This can help restore function in brain areas and pathways associated with positive mood, emotional regulation, and stress resilience. Evidence Supporting SGB for Depression To date, there’s very limited evidence supporting the use of SGB for depression. One pilot study found that SGP significantly reduced depression symptoms in people with treatment-resistant depression (TRD) and was well-tolerated. However, there was no significant difference to the placebo group and the sample size was very small. Nonetheless, multiple lines of research show that SGB can alleviate symptoms of post-traumatic stress disorder (PTSD), which shares similarities with depression. In a trial of SGB for PTSD , participants reported significantly lower scores of depression following treatment. Who May Benefit from SGB for Depression? SGB is primarily utilized for treating PTSD, so individuals with PTSD who also experience depression may find SGB beneficial. Additionally, SGB has shown potential in alleviating anxiety symptoms, suggesting it may be advantageous for those dealing with both depression and anxiety. Because SGB isn’t approved by the FDA, it is typically only used when standard treatments like antidepressants and psychotherapy haven’t worked. SGB is an “off-label” treatment, much like ketamine therapy or brain stimulation therapies. Importantly, SGB may not be suitable for everyone because of medical reasons. Contraindications include: Recent myocardial infarction Coagulopathy or anticoagulant therapy Glaucoma Pre-existing contralateral phrenic nerve palsy Severe emphysema Cardiac conduction block Potential Risks and Side Effects of SGB Common Side Effects Most side effects of SGB are temporary and resolve as the anesthetic wears off. These may include: Hoarseness or Voice Changes: The proximity of the stellate ganglion to nerves controlling the voice box can lead to temporary hoarseness. Drooping Eyelid (Ptosis): Temporary drooping of the eyelid on the side of the injection may occur. Red or Bloodshot Eyes: Some individuals may notice redness in the eyes following the procedure. Watery Eyes and Nasal Congestion: Increased tearing and nasal stuffiness are possible but typically short-lived. Sensation of a Lump in the Throat and Difficulty Swallowing: Some individuals may experience a sensation of a lump in the throat and have difficulty swallowing after the procedure. Warmth or Tingling in the Arm or Hand: A warm or tingling sensation in the affected limb may be experienced temporarily. Although uncommon, some individuals may experience more serious complications, such as nerve damage, seizures, and allergic reactions. Given the potential risks, patients interested in SGB at the Albany Clinic will have an in-depth consultation with one of our qualified healthcare professionals before undergoing treatment. They can assess your medical history, current health status, and the potential benefits and risks of the procedure in your specific case. SGB for Depression in Illinois If you're in the Carbondale area and interested in the potential benefits of SGB for depression, the Albany Clinic is here to help. We specialize in innovative mental health treatments, including SGB, which has been shown to provide rapid relief from mental health symptoms, with effects lasting several weeks. Our experienced team offers personalized support, guiding you through every step—from determining if SGB is the right option for you to exploring alternative treatments and financial considerations. Contact us today to learn more about how we can support your mental health journey.