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WHAT IS KETAMINE & HOW MIGHT IT HELP ME?
Ketamine History
Ketamine was developed in the 1960's as an anesthetic agent, and FDA approved for use in humans in the 1970's. Ketamine has been extensively used since and is considered on of the safest forms of anesthesia (1). Antidepressant effects of ketamine were first noticed in animal models in the 1970's, but it was not until the 1990's that groundbreaking clinical work on humans was published. Since then, extensive research and development has gone into evaluating effectiveness and further understanding how ketamine can be used to treat psychiatric conditions, although it remains an off-label use of this medication.
Ketamine effects on the brain
While not fully understood, there are several models on how ketamine exerts its rapid-acting antidepressant effects, and why it may also be effective in treating anxiety, OCD, and PTSD. No one theory has stood alone, so it is likely that ketamine's effects are a combination of multiple actions.
Ketamine blocks NMDA receptors which have downstream effects to changing inhibitory and excitatory neurotransmitter systems in brain pathways. This inhibitory-excitatory balance regulates communication of neurons, neuroplasticity potential, and circuit wiring (1). This results in improved connectivity in neurons and pathways that effect human emotions. mTOR, brain-derived neurotrophic factor (BDNF), and opioid receptors are among the additional mechanisms that have been identified to support the positive benefits seen from ketamine administration.
Many patient will notice immediate results from a ketamine session. However, these are typically not sustained following a single treatment for more than 3 days to 2 weeks. For this reason, general practice and evidence based research has suggested that completing 2-3 sessions over a 2-3 weeks period (typically 6 sessions) as an effective protocol to initiate treatment.
Following this series, some patients will never take ketamine again, while others may continue booster session if symptoms recur. Outcomes are typically improved when patient are engaged concurrent therapy. For this reason, we recommend all patients engage in psychotherapy services before, during, and after treatments. The goals of psychotherapy are to stabilize positive behavioral change, consolidate psychological material, resolve psychological issues, improve relationships, catalyze new insight, and enhance self-awareness.
Our Ketamine Treatment program
- We meet with all patients for a New Patient Assessment to evaluate medical and psychiatric diagnoses and co-morbid conditions. Please bring a list with all current medications, along with previous psychotropic medication trials, and medical diagnosis history.
- Most patients begin with recommendation for completion of 6 sessions of ketamine, doing 2-3 sessions per week for 2-3 weeks. Session are approximately one hour long, with up to one additional hour of observation (2 hours total).
- We provide, or you can bring, headphones and an eye mask. All patients are required to have a driver after their session, as you cannot drive yourself home. You cannot drive or operate heavy equipment for 12 hours
- When asked to describe how ketamine treatment feels, patients often report they feel like they are "floating", or "very light", or "deeply relaxed".
- As mentioned above, we recommend all patient engage with psychotherapy service before and after treatment to maximize result potential. General recommendation is to complete a therapy session within 48 hours of your ketamine session and before the next ketamine administration.
- If you are interested in completing Ketamine Assisted Psychotherapy, we can coordinate to have your therapist present for your session.
References
1. Alshammari TK. The Ketamine Antidepressant Story: New Insights. Molecules. 2020;25(23):5777. Published 2020 Dec 7. doi:10.3390/molecules25235777