Ketamine Therapy

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First synthesized in 1962, Ketamine is a powerful dissociative drug that health experts are only just now starting to understand the full potential of. This medicine was first approved in the U.S. circa 1970, and saw widespread, popular use as an anesthetic, both for the medical treatment of animals, and as a surgical anesthetic for wounded soldiers in the Vietnam War.

For a long time, it was primarily used as an operating room anesthetic, but researchers are now beginning to probe the potential off-label uses for ketamine. More and more researchers are now starting to probe the benefits of off-label uses of the drug; in small doses, ketamine has shown immense promise in alleviating the symptoms of common behavioral health maladies like depression, anxiety, and PTSD (post-traumatic stress disorder).

In addition, researchers are exploring this psychedelic medicine’s use as a remedy for more physical health maladies, from general chronic pain treatment to palliative cancer care. This 2021 Frontiers In Neuropharmacology article offers a more comprehensive overview of some of those exciting developments. 

But if you’re curious how exactly ketamine therapy works, and how exactly it could benefit or detriment your health, you can read through this in-depth treatment guide to learn more.

How Ketamine Therapy Works

Generally speaking, there are two types of ketamine treatments that healthcare providers deploy in a therapeutic context, usually for remediating treatment-resistant depression:

• Racemic Ketamine: This therapy is administered intravenously through an infusion formula. It entails a mixture of “R” and “S” ketamine molecules and was the first type of ketamine treatment approved by the FDA. This mode of treatment is how ketamine is typically administered as an anesthetic, however, it has demonstrated efficacy as a possible depression treatment in lower doses.

• Esketamine: Manufactured by Janssen Pharmaceuticals, this low-dose ketamine nasal spray is FDA-approved for treatment-resistant depression. It only contains the “S” ketamine molecule and is expressly approved for use in conjunction with traditional antidepressant medications.

It’s actually not 100% clear how ketamine specifically acts on the brain. Researchers are only just beginning to understand how this dissociative works. Many experts, including those at Harvard Health Publishing, believe that ketamine specifically interacts with the brain’s NDMA receptors.

When it binds with these particular receptors, ketamine tends to increase the presence of the neurotransmitter glutamate. In turn, this activates new neural connections and pathways along the brain’s AMPA receptors, which tends to improve overall neural network communication across the board.

But how does that enhanced communication translate into salient, demonstrable wellness results? Here’s how.

Does Ketamine Therapy Help Anxiety?

Ketamine has exhibited tremendous potential as a treatment that could potentially alleviate the symptoms of anxiety disorders. One NIH-published Neuropsychopharmacology journal specifically examining ketamine’s use in treating social anxiety disorder, exhibited response rates as high as 88.9%!

Moreover, ketamine may even have a significant effect on more severe anxiety disorders, including panic disorder and post-traumatic stress disorder. A different journal, published by the Neurobiology Of Disease, extrapolated that ketamine’s enhancement of neural communication, specifically with mTORC1 signals, “accelerates fear extinction” in the mind. 

Although that journal in question was centered around an animal trial, this is still a promising step forward, highlighting ketamine’s potential promises as a novel, profound relief option for those who suffer from PTSD and other anxiety disorders.

Can Ketamine Therapy Help With Addiction?

A lot of attention has been drawn toward the promising therapeutic wellness benefits potentially offered by psychedelic drugs in a therapeutic setting. One of those therapeutic utilities, believe it or not, entails alleviating the symptoms of addiction. 

For instance, while it shouldn’t be viewed as an antidote for drug addiction, the psychedelic compound ibogaine has shown immense promise in alleviating its symptoms. A 2018 NIH-published study observing ibogaine use for opioid dependence found that the drug significantly reduced withdrawal symptoms in the subjects being analyzed, with most experiencing opioid use reduction or cessation even 12 months after the initial treatment.

Unfortunately, the research on ketamine’s benefits for addiction is still extremely limited. Not many definitive facts have been established about the dissociative’s therapeutic benefits with regard to addiction, and ketamine has been known to have a potential for addiction and abuse if used improperly. Just as you would do with any traditional medication, this medicine should only be used in tandem with the guidance of a trusted professional.

Ketamine Therapy For Depression

Besides anxiety, ketamine has demonstrated significant promise as a potential novel remedy for the symptoms of depression. This doesn’t just apply to standard cases of clinical depression, but even more severe and treatment-resistant cases that aren’t responding to most traditional antidepressant medications. 

Studies on this treatment area have shown that ketamine can deliver remarkably rapid, fast-acting relief toward alleviating the symptoms of severe depression and suicidal ideation. One 2021 Cambridge University meta-analysis, covering 83 of these studies, concluded that ketamine can have an antidepressant effect as soon as 1-24 hours after use!

Moreover, a single ketamine treatment can alleviate depression systems for a week or two after use. These two findings alone are wholly indicative of ketamine’s potential as a novel antidepressant, especially when you consider that most traditional antidepressants require a few weeks of sustained use before their therapeutic benefits begin to take effect.

According to the administration protocol set forth by the American Psychiatric Nurses Association, therapeutic infusions should generally be conducted:

• Over a timeframe of 40+ minutes
• Twice a week, over 4-5 weeks before tapering
• Extensive monitoring of the patient

While there are no “universal” guidelines for ketamine therapy length, those are the rules you should expect most providers to abide by, should you wish to go down the racemic ketamine route. In a telehealth setting, this will usually be done through video.

However, if you’re considering trying ketamine nasal spray for your treatment-resistant depression, you should consult a trusted psychiatrist about the possibility of working it into your current antidepressant regimen.

Ketamine Therapy Side Effects

Ketamine has shown incredible, unparalleled, and unprecedented promise as a potential novel mental health treatment, but you shouldn’t conflate that with it being a one-size-fits-all miracle drug. Like any drug, there are potential risks and side effects associated with ketamine, and those risks are as follows:

• Dizziness
• Double vision
• Anxiety
• Heart problems
• Irritability
• Vomiting
• Raised blood pressure
• Hallucinations
• Difficulty breathing
• Memory problems
• Drowsiness
• Chest pain
• Disorientation
• Substance abuse
• Decreased focus

If you suspect that any one of those symptoms could crop up and raise potential concerns along your ketamine therapy journey, be sure to let your provider know ASAP, and consult them to determine whether or not this treatment is right for you. 

A popular phrase in the psychedelic community is “set and setting”, meaning that in order to reap the most potential therapeutic potential out of your experience, you should approach it with a healthy, intention-driven mindset, and in a safe, comfortable setting to process the drastic changes such an experience can invoke.

Any licensed, professional ketamine-therapists will want to promote a healthy set and setting for your treatment, so if any risk factors arise that could jeopardize this healthiness, be sure to let them know right away. 

Is Ketamine Therapy Covered By Insurance?

While certain insurers may cover certain aspects of ketamine therapy treatment, most providers, unfortunately, will not cover the treatment itself. However, more affordable and promising telehealth options are starting to spring up in the ketamine therapy space. 

Mindbloom, for instance, offers affordable treatment rates as low as $58 to $99 a month, and the digital ketamine therapy clinic is only one of many telehealth providers which have begun to offer this experimental, cutting-edge treatment.

We’ll continue to follow this space as it evolves, and we’ll be happy to see the bright future this novel therapy assuredly has in store.