Learn About Ketamine -Assisted Psychotherapy

What is Ketamine?

Ketamine is a dissociative anesthetic that is also considered a synthetic psychedelic. Though it works on different parts of the brain than classic psychedelics such as psilocybin, there are similarities in its psychedelic effects. Like other psychedelics, Ketamine facilitates access to the unconscious - the beliefs, memories, and emotions we are generally not aware of in the day to day, but which have tremendous influence over how we behave, feel, and make sense of our experiences.

Ketamine was first synthesized in 1962 and was approved by the FDA in 1970 as an anesthetic. It was first used to treat depression in 2000 and in the last decade, due to its rapid antidepressant and mood-enahncing effects, has been prescribed off-label for a growing list of mental health conditions.

Ketamine is a regulated substance and can only be prescribed by licensed clinicians with the expertise to support its effective use. Ketamine can be administered in a variety of ways, including IV infusion, intramuscular injection, a nasal spray, and sublingual lozenges.  

How does it work?

When we experience stress, trauma, depression, and anxiety, our body decreases the number of synapses in the brain - the connections which link neurons in the brain to neurons in the rest of the body. The loss of these synaptic connections make it difficult for us to feel hopeful, happy, and motivated.

Ketamine blocks the brain’s NMDA receptors and stimulates AMPA receptors, which are believed to create new synaptic connections and boost neural circuits that regulate stress and mood.

Ketamine also increases the brain's ability to use the neurotransmitter glutamate, a different neurotransmitter than the ones impacted by typical antidepressants, which increases the expression of brain-derived neurotrophic factor. This prompts the brain to form new neural connections. With therapeutic support, this “neuroplasticity” allows new, healthier thoughts and beliefs to be incorporated, leading to positive outcomes not seen through either psychotherapy or anti-depressant medications alone.  

Ketamine also strengthens connections between the prefrontal cortex and hippocampus, important areas for learning and memory.

There is an interconnected group of brain regions (called the “DMN”) associated with introspective functions like self-reflection and self-criticism. During a psychedelic experience, the DMN is temporarily shut down, quieting our inner dialogue and negative thought patterns. After, regions of the brain starts to work together more cohesively.

Ketamine starts this process within 24 hours of the dosing, but also leads to longer-term synaptic regrowth in the brain over weeks. This helps to immediately modulate symptoms, as well as assists in changing patterns of mind and behaviors that may have caused difficulty in the past.

What is Ketamine Assisted Psychotherapy?

Psychedelic-assisted psychotherapy is a holistic modality in which psychedelic substances are used as a complement to psychotherapy. Psychedelic medicines like Ketamine can not only provide quick relief, but also help facilitate healing issues at their source.

Ketamine-Assisted Therapy (KAP) is multiphasic and involves Screening, Preparation, Medicinal Dosing Sessions, and Integration.

Prior to beginning the ketamine sessions, participants attend an Intake and comprehensive  medical/psychiatric assessment and screening. This is followed by Preparation sessions which involves the participant getting to know their facilitator, building trust and emotional safety, discussing their background, and clarifying intentions or goals for the journey. There are usually 5-8 Ketamine dosing sessions. Since motor and verbal abilities are reduced, participants lay down in a comfortable position during the experience, often while wearing eyeshades and listening to specially curated music to encourage an inward focus.

Integration sessions usually take place within 48 hours after each ketamine dosing session. Integration involves ongoing support to clarify, record, and process any insights, lessons, memories, or experiences from the psychedelic journey. While the experience may be quite vivid at the time, a ketamine experience can be quite dreamlike and easily forgotten if you do not take the time to write down a few details or otherwise work with the material.

While it may seem that the acute psychedelic experience is the sole or primary source of healing, integrating the insights and lessons gleaned into daily life is crucial work. Integration should be ongoing in order to reinforce these new ways of being and to ensure that therapeutic gains are sustained and integrated into one’s life moving forward. Psychedelic integration is a lifelong process of making sense of and incorporating the insights and lessons gleaned from psychedelic  journeys into daily life.

What does Ketamine feel like? 

The effects of ketamine, which most patients find pleasant, last for approximately 45-60 minutes. Most people return completely to baseline within 1.5-2 hours.

The effects vary depending on dose, route of administration, set, and setting. At lower doses, ketamine generally produces a mild trance-like or “floaty” feeling. Higher doses can produce full dissociative states in which one feels separate from the body and thoughts dissolve.

Commonly reported effects include a sense of distance from thoughts, feelings, or experiences, relaxation, pain relief, mood enhancement, a meditative mindfulness, and a sense of wonder and awe. 

The most commonly reported side effects include nausea. To minimize this, participants are asked to fast for a few hours beforehand. Other side effectswhich are temporary and only arise in 10% of people—include headache, increased heart rate and blood pressure, drowsiness, light-headedness, and dizziness. Side effects, if they occur, are usually mild and resolve without intervention within a few hours.

What are the benefits of Ketamine-Assisted Psychotherapy?

As ketamine has gained popularity, an increasing number of research studies have demonstrated its efficacy in treating depression - up to 60% of those suffering from treatment-resistant depression. Application for a range of psychiatric conditions has been explored and KAP has been found to be effective for treating social anxiety, generalized anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorders, chronic pain, ruminative suicidal ideation, substance use disorders, and eating disorders.

Ketamine appears to decrease the fear and anxiety associated with emotionally charged topics, softening the defenses and increasing a sense of connection and empathy, acting as a lubricant for psychotherapy With the drug alone, therapeutic benefits are usually short-lived and often require ongoing doses. Psychotherapy can deepen the benefits of ketamine.

A single dose has rapid onset with rapid mood improvement and a general sense of wellbeing. This typically lasts 4-10 days and can be cumulative with repeated dosing. The elevation in mood creates a more favorable state for the individual to engage in meaningful psychotherapy and take action on the insights gained, allowing them to build momentum in their lives and make long-term changes.

What are the risks?

Ketamine can cause mild, temporary increases in blood pressure and heart rate, therefore it is not recommended for individuals with uncontrolled hyperthyroidism and/or certain cardiovascular conditions such as arrhythmias or aneurysms. Ketamine is not recommended in pregnant or nursing individuals and is contraindicated in people with a history of psychosis.

The risk profile of ketamine is than other commonly used recreational drugs. In fact, Ketamine has a better safety profile and fewer side effects than traditional psychiatric medications. As with any drug, if misused or abused, there can be risks associated with ketamine. Long-term, frequent use of ketamine can lead to bladder or liver damage and memory impairment.

How much does it cost? 

Ketamine treatment is expensive—usually between $400 to $1,000 per session and between $1,500-$8,000 for the full course of treatment. Many who might benefit from psychedelics cannot afford it, and are unable to access these therapies. This is why the Psychedelic Access Fund is committed to increasing access to psychedelic healing for those who need it most.

PAF will sponsor select individuals for healing opportunities in hopes to create a healed, conscious, and connected world. 

If you think that you would benefit from ketamine assisted therapy but can not afford it, APPLY HERE.