Ketamine Therapy 101: A No-Nonsense Guide
If you’ve found your way to this blog post, then you probably already know about – and are maybe even interested in – the use of psychedelics in mental health. The latest in psychiatric psychedelics is Ketamine, which was approved by the FDA for treatment-resistant depression in 2019.
You may be hearing about Ketamine clinics popping up in your neighborhood. But what, exactly, is Ketamine-Assisted Psychotherapy (otherwise known as “KAP”) – and how can you use it in a way that’s actually beneficial to your mental health?
I know it can be confusing whenever a new treatment style starts making its rounds. So I’ve put together a comprehensive, no-nonsense guide to Ketamine Therapy, including research results, pros and cons, and how you can get started.
What is Ketamine, exactly?
First things first: what, exactly, is ketamine? You might have heard it described as a psychedelic drug, but what does that even mean?
Psychedelics are any type of drug or substance that creates an expansive, altered, dissociative experience. Some psychedelics are natural – like “magic” mushrooms. But Ketamine was created intentionally as a synthetic (man-made) drug. It was originally created to replace PCP (also known as “angel dust”) as a safer alternative for anesthesia.
Officially, Ketamine is classified as a dissociative anesthetic, and it’s been used as an anesthetic and painkiller since the 1960s. The “dissociative” in its classification means that it works on different brain chemicals and neural receptors to make you feel detached from reality, or even hallucinate (see or hear things that aren’t really there).
Long before we started studying Ketamine’s benefits for depression, it had been used as an anesthetic to save lives in both medical and veterinary settings. It was used widely for injured soldiers during the Vietnam War. It’s even included on the WHO’s List of Essential Medicines as one of two general anesthetics.
Of course, like with many other medical drugs, there are people who use Ketamine recreationally to get high. On the streets, you might hear it called “Special K". Unfortunately, unsupervised Ketamine use can be dangerous – but when it’s used under guidance for medical or psychiatric purposes, it’s considered very safe.
How does Ketamine work for depression?
Onto the interesting stuff: does Ketamine really work for depression?
I’m happy to tell you: Yes! All of the research indicates that Ketamine can be a very effective treatment for people with depression, and other mental health conditions like PTSD and anxiety.
Ketamine is especially useful for treatment-resistant depression – the type of stubborn depression that sticks around no matter what you do to try to improve it. You might have tried antidepressants. Atypical antipsychotics. Cognitive-behavioral therapy. Dialectical behavior therapy. Maybe you’ve even tried TMS or electroconvulsive therapy. But nothing’s helped, at least not for long.
But, according to research, Ketamine Therapy could help.
We don’t know exactly how Ketamine works for depression yet. But something about the way this substance interacts with the brain makes it possible for people to overcome psychological and emotional “stuckness” and really start to move past the effects of depression. Ketamine can also help reduce any suicidal feelings you might be having.
You can read more about the exact mechanisms of Ketamine if you’d like to know more – I’ve linked my favorite resources at the end of this blog.
To put it simply, Ketamine is known as a “dirty drug” – which means that it affects not only one, but multiple pathways in the brain. In particular, Ketamine is known to interact with the glutamate pathway – which can help your neurons make new connections and reestablish connections that may have been lost under stress, trauma and/or depression.
The research results are overwhelmingly positive – so much so that even the FDA (who’s not known to approve things “just ‘cause”) approved the use of a ketamine nasal spray for treatment-resistant depression in 2019 called Spravato. Ketamine is, so far, the only psychedelic drug that the FDA has approved for off-label, psychiatric use.
Here are some highlights from the research:
One large analysis looking at the effectiveness of Ketamine in real community settings found that around 50% of people who received Ketamine therapy reached remission in their depression symptoms.
In the same analysis, the positive effects of Ketamine remained for at least 4 weeks for 80% of people, even without any follow-ups.
40% of people who were suicidal no longer felt this way after Ketamine therapy.
A 2022 study found that 3 out of every 4 people saw improvement in depression symptoms after Ketamine therapy, and over a third were completely symptom-free.
A smaller study out of India found that some people started seeing improvement in their depression symptoms after just the first dose of Ketamine.
A randomized controlled trial found that Ketamine significantly lowered suicidal thoughts and feelings within just 24 hours.
Does Ketamine Therapy work for every single person with depression? No. Nothing works for everyone. But is it worth a try? These results speak for themselves.
What’s Ketamine-Assisted Psychotherapy? Can’t I just do Ketamine at home?
Clearly, Ketamine has some serious benefits for mental health. So couldn’t you just do it at home? What’s this you’re hearing about “Ketamine-Assisted Psychotherapy”?
This is a no-nonsense guide, so let me be clea? You might have heard it described as a psychedelic drug, but what does that even mean? As mentioned earlier, some use it recreationally and some even use at home prescribed for therapeutic purposes (without a professional present). This can be dangerous – people have died both during and coming off of a ketamine “trip”. It’s also, unfortunately, been used as a date rape drug.
Finding the correct dosage is also a tricky issue. Too much Ketamine may not give you the desired results. In fact, in Ketamine-Assisted Psychotherapy, generally smaller amounts of Ketamine are all you need to have a successful journey.
I don’t say this to scare you – but it’s important to know the risks of trying to do this on your own. On top of these risks, doing it on your own gives you the hallucinogenic effect of the drug – but no safe space in which to process and talk through any insights you glean during that experience. In KAP, this is called the “integration” process.
That’s where ketamine-assisted psychotherapy, or KAP, comes in. KAP is where traditional talk therapy and the innovative use of Ketamine come together. The experience of Ketamine in conjunction with therapy is often profound.
Prior to the Ketamine dosing session, you may have anywhere from 1-5 sessions to prepare for the Ketamine experience with your therapist. This preparation time ensures that you are in the best mindset for the journey, attending to any anxiety about the process, as well as being prepared for what you may experience. In a KAP dosing session, you have a Ketamine experience (the “journey”) – which is usually about a 3-hour session during which you will self-administer the Ketamine and the therapist will supervise to make sure you’re comfortable and safe before, during and after. You’ll also get a chance to work through all of the insights, revelations, new feelings, uncovered memories, and more that you gained from using Ketamine in follow-up therapy integration sessions.
KAP is what takes Ketamine beyond being just a psychedelic experience into being a truly transformative process that can bring healing on both neurobiological and emotional levels.
Is Ketamine Therapy for me? Pros and cons
As beneficial as Ketamine has been shown to be for depression, it isn’t for everyone. When you get started with Ketamine Therapy, a medical provider will ask you questions and take a thorough look at your medical history to make sure you’re a candidate for Ketamine.
Keep in mind that eligibility is determined on a case-by-case basis. But, in general, you may not be a good fit for Ketamine Therapy if:
You have a history of psychotic disorders, like schizophrenia
You have a history of cardiac issues such as high blood pressure
You have a history of substance use disorder, especially if you have misused psychedelic drugs in the past
You’re a minor
You’re pregnant or breastfeeding
You’re experiencing symptoms of dementia
Is Ketamine for depression addictive?
One thing that some people worry about is whether or not they will become addicted to Ketamine if they use it for depression. Ketamine can be addictive for some people, which is why you should be honest about your history with substance use disorder when your provider is determining your eligibility. But most people don’t become addicted to Ketamine when they use it for depression because it is not given in large doses nor on a long-term basis.
Even if you are eligible, there are pros and cons to Ketamine Therapy, just like there are with any other depression treatment. Here are some:
Fast results (you can start feeling relief from depression after just the first session)
May not be for everyone
Research says it’s effective for treatment-resistant depression
Not typically covered by insurance
Can be addictive for some people with substance use disorder
Minimal side effects
Requires a financial and time commitment
Can be life-saving for people experiencing suicidality
Certain health issues may preclude some from being candidates
Whether or not to try Ketamine-Assisted Psychotherapy is entirely in your hands. Like starting any new treatment, you should weigh the pros and cons carefully and make a decision that’s right for you. It's important to note that KAP is not a "magic pill" solution, but rather a catalyst for transformation and healing.
Ketamine Therapy in New Jersey
If you’re in the New Jersey area and are looking for a Ketamine-Assisted Psychotherapy provider, get in touch with me by giving me a call at (732) 455-1623 or filling out my online form. You can also schedule a free phone consultation with me via my website.
I provide a safe and reassuring environment for your Ketamine experience, and give you everything you need to be comfortable. You can read more about exactly what this process entails here. I’m looking forward to going on this journey together!
Learn more about Ketamine for depression:
https://www.health.harvard.edu/blog/ketamine-for-treatment-resistant-depression-when-and-where-is-it-safe-202208092797 (Harvard Health blog)
https://youtu.be/d_ey_a_yN6Q (Insider Science YT video)
https://www.scientificamerican.com/article/behind-the-buzz-how-ketamine-changes-the-depressed-patients-brain/ (Scientific American article)