Ketamine Assisted Psychotherapy
The Treatment that Can Break Through
I'm excited to be able to help people with mental health problems with ketamine. The ketamine sessions are usually about 2 hours, sometimes longer, and can either be ketamine alone or ketamine with some types of therapy integrated into the session. I use the IM (intramuscular) injection form of racemic ketamine (which is similar to getting a vaccine shot) and I'm with you for the entire session, supporting you and helping you feel safe and comfortable in your journey. Your therapist can also be with you during your session.
There are over 20 years of research suggesting ketamine has healing and symptom reducing effects on a wide variety of mental health problems. While many people are helped with standard mental health medications and psychotherapy, many also continue to struggle with symptoms that don't get better. Ketamine can bridge the gap between current treatments with the hope of a novel treatment in the medication itself, but also in the combination of ketamine and psychotherapy's powerful synergy that can speed up the healing work you already do in therapy.
How Ketamine Works
We don't know exactly why or how ketamine works, but it is believed to work in the brain in multiple ways by affecting neurotransmission (the psychological chemicals in the brain). It most directly works through the neurotransmitter glutamate through the AMPA receptor and has downstream effects on other neurotransmitters that are involved in reducing depression and anxiety-as well as other mental health symptoms, and in reducing inflammation and increasing BDNF.
Increasing BDNF results in brain neurogenesis and neuroplasticity, which are the brain's ability to form new neurons or parts of neurons (eg: dendritic spines) and the ability of neural networks to change by growing and reorganizing, basically improving connectivity in the brain.
So, the brain actually changes and improves its physical structure as well as how it functions after receiving ketamine (the same happens with psilocybin). The net effect of ketamine is the potential to reduce mental health symptoms and the emotional suffering they cause. Some of these effects may be short lived, others are longer lasting and may be why some people need ongoing treatment with ketamine.
New dendritic spines in a rat brain form on the neuron just 2 hours after ketamine exposure in the bottom picture where the yellow arrows show the new spines. The top dendrite is before ketamine. From Rong-Jian Liu, George Aghajanian & Ronald S. Duman.
Ketamine can also create a meaningful psycho-spiritual experience. The psychedelic, dissociative, or trance effects of ketamine can be deeply meaningful spiritual or psychological experiences that can help a person see previous experiences, themselves, or others from different healing perspectives.
Sometimes the effects of ketamine are short lived, and other times they are long lasting. Ketamine is not a panacea, as much as I wish it were, but for some people it can have a profound effect on mental health symptoms, seemingly, about 60% of people respond positively to ketamine.
For more on information on ketamine I suggest reading Listening to Ketamine or Ketamine—50 years in use: from anesthesia to rapid antidepressant effects and neurobiological mechanisms which is a great, though technical, read as well. For more information about Ketamine Assisted Psychotherapy benefits, see the Journal of Psychoactive Drugs article.
Contact us to learn more about how ketamine could help you or to schedule an evaluation.
Reading About Ketamine and Ketamine Assisted Psychotherapy
Brainfacts.org Listening to Ketamine
New York Times Opinion: I Was Paralyzed by Severe Depression. Then Came Ketamine.
What I wish I'd known before ketamine therapy
Science in the News: Worth the trip: psychedelics as an emerging tool for psychotherapy.
Pharmacological Reports: Ketamine—50 years in use: from anesthesia to rapid antidepressant effects and neurobiological mechanisms.
Biochemical Pharmacology: Is (R)-ketamine a potential therapeutic agent for treatment-resistant depression with less detrimental side effects? A review of molecular mechanisms underlying ketamine and its enantiomers.
Journal of Psychoactive Drugs: Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy.
Therapeutic Advances in Psychopharmacology: Ketamine as an antidepressant: overview of its mechanisms of action and potential predictive biomarkers
British Medical Journal: Ketamine for treatment-resistant depression: recent developments and clinical applications.
Frontiers in Neuroscience: Repurposing Ketamine in Depression and Related Disorders: Can This Enigmatic Drug Achieve Success?
About MDMA and Psilocybin Assisted Psychotherapy
Nature Medicine: MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study.
Frontiers in Psychiatry: Breakthrough for Trauma Treatment: Safety and Efficacy of MDMA-Assisted Psychotherapy Compared to Paroxetine and Sertraline.
Journal of Psychopharmacology: Neural mechanisms underlying psilocybin’s therapeutic potential – the need for preclinical in vivo electrophysiology.
Visualization of the brain connections in the brain of a person on psilocybin (right) and the brain of a person not given the drug (left) showing higher connectivity and plasticity after psilocybin. From the Journal of the Royal Society Interface.