The Use of Ketamine and NAD for Anxiety

Anxiety disorders are among the most common mental health issues worldwide, affecting millions of people. While traditional treatments like cognitive-behavioral therapy (CBT) and medications such as selective serotonin reuptake inhibitors (SSRIs) are effective for many, some patients seek alternative or adjunctive treatments. Nicotinamide adenine dinucleotide (NAD) and ketamine have emerged as potential options for managing anxiety. Here’s a closer look at their roles, mechanisms, and effectiveness in treating anxiety.

NAD (Nicotinamide Adenine Dinucleotide)

What is NAD?

NAD is a coenzyme found in all living cells. It plays a crucial role in energy metabolism and cellular functions, including DNA repair and cell signaling. As we age, NAD levels naturally decline, which can contribute to a variety of age-related health issues.

How NAD May Help with Anxiety

  1. Energy Metabolism: NAD is vital for the production of ATP, the energy currency of cells. Improved cellular energy can enhance brain function and reduce fatigue, potentially alleviating symptoms of anxiety.
  2. Neuroprotection: NAD supports the health of neurons and may protect against neurodegenerative diseases. Healthy neurons and efficient brain function can contribute to better mental health.
  3. Stress Response: NAD is involved in the body's response to stress. It can modulate stress pathways, potentially reducing the physiological impact of stress and anxiety.
  4. Inflammation Reduction: Chronic inflammation is linked to various mental health disorders, including anxiety. NAD helps reduce inflammation, which may have a positive effect on anxiety symptoms.

Administration of NAD

NAD can be administered orally, intravenously (IV), or through nasal sprays. IV NAD therapy is believed to provide the most immediate and noticeable benefits, as it delivers NAD directly into the bloodstream for rapid uptake by cells.


What is Ketamine?

Ketamine is an anesthetic that has been used in medical settings for decades. More recently, low-dose ketamine (often in the form of ketamine infusion therapy) has gained attention for its rapid-acting antidepressant and anti-anxiety effects.

How Ketamine May Help with Anxiety

  1. NMDA Receptor Antagonism: Ketamine works by blocking NMDA receptors in the brain. This action can lead to the rapid increase of glutamate, which helps to form new neural connections, enhancing brain plasticity and mood regulation.
  2. Rapid Onset: Unlike traditional antidepressants that can take weeks to become effective, ketamine can alleviate symptoms of anxiety within hours, making it particularly beneficial for individuals with severe anxiety or those who haven't responded to other treatments.
  3. Reduction of Suicidal Ideation: Ketamine has been shown to reduce suicidal thoughts quickly, providing relief for individuals experiencing severe anxiety and depression.
  4. Mood Stabilization: By altering neurotransmitter activity, ketamine can help stabilize mood and reduce the frequency and intensity of anxiety episodes.

Administration of Ketamine

Ketamine is typically administered via IV infusion in a controlled medical setting, ideally with a board-certified anesthesiologist. However, intranasal and oral formulations are also available. The treatment is usually given over several sessions, with each session lasting about 40 minutes to an hour.  For chronic pain, infusions can be 2-4 hours.

Combining NAD and Ketamine

Combining NAD and ketamine for the treatment of anxiety is a novel approach that aims to harness the benefits of both therapies. The rationale behind this combination includes:

  1. Enhanced Neuroprotection and Repair: NAD supports cellular health and repair, while ketamine promotes the formation of new neural connections. Together, they may enhance brain resilience and recovery from anxiety-related damage.
  2. Synergistic Effects: NAD's role in energy metabolism and reducing inflammation can complement ketamine's rapid mood-stabilizing effects, potentially leading to more comprehensive and sustained relief from anxiety.
  3. Holistic Approach: Combining these treatments addresses multiple pathways involved in anxiety, offering a more holistic approach to treatment.

Considerations and Safety

  1. Medical Supervision: Both NAD and ketamine treatments should be administered under the supervision of a board certified anesthesiologist to ensure safety and efficacy.
  2. Side Effects: Common side effects of ketamine include dissociation, dizziness, and increased blood pressure. NAD therapy is generally well-tolerated, but some individuals may experience mild side effects like nausea or headaches.
  3. Not for Everyone: These treatments may not be suitable for everyone, especially those with certain medical conditions or those taking specific medications. A thorough medical evaluation is essential before starting either treatment.


NAD and ketamine represent promising options for managing anxiety, particularly for individuals who have not found relief with traditional treatments. While more research is needed to fully understand their mechanisms and long-term effects, early results are encouraging.  At StrIVeMD Wellness and Ketamine (Dublin Ohio, Skokie Illinois, St. Charles Illinois, Champaign Illinois, Chicago Illinois, and Frisco Texas), we have optimized our protocols for outstanding outcomes.  If you wish to learn more, please call for a consultation.