Ketamine also has smaller effects on other receptor subtypes, such as the dopaminergic and opioid receptors. The NMDA receptor plays a role in how glutamate transmits messages between brain cells. Whereas most antidepressants affect levels of serotonin, ketamine works on a different receptor, called the NMDA receptor.
- During treatment, clinicians may adjust ketamine dosages to achieve various states of consciousness.12 Dosages and frequency of administration may vary, and psychotherapy may be provided before, during, or after ketamine administration.
- The pair are then seen hooked up to IVs and blood pressure monitors as they sit in headphones and eye masks, receiving small doses of the notorious party drug through their veins.
- But some people come back for boosters if symptoms return.
- Lozenges are also less likely to be taken under the supervision of a doctor, meaning you might be on your own in the case of any adverse reactions and medical emergencies, Dr. Ni points out.
- If you’re searching locally, try “ketamine therapy near me” or ask your mental health provider for referrals.
- Some people describe ketamine therapy as calming or dreamlike; others find it disorienting at first.
- Ketamine therapy has shown promising results in reducing PTSD symptoms, particularly when combined with psychotherapy.
Psilocybin shows promise for treatment-resistant depression, while MDMA-assisted therapy is in late-stage trials for PTSD (Butler et al., 2024). A range of alternatives to ketamine therapy exist, spanning psychedelic, mind–body, and neuromodulation approaches. With ongoing treatment and proper psychotherapeutic support such as positive pain management, some patients experience sustained relief.
Research on the ketamine dose–response relationship in the context of mental health is equivocal.15 Early studies to treat addiction used higher doses of 2–3.0 mg/kg administered via intramuscular injection,16–19 whereas more recent studies typically use 0.4 mg/kg or 0.5 mg/kg administered intravenously, infused over 40–60 min.20–22 Ketamine effects in depression generally last from a few days to 2 weeks,15 so repeated dosing is usually necessary to extend recovery. Since ketamine was developed in 1964, largely as a replacement for phencyclidine, it has been used primarily in veterinary and paediatric anaesthesia, but interest in recent years has burgeoned in psychiatry after reports of its rapid-acting antidepressant effects.1 The potential for ketamine to be used in the treatment of psychiatric disorders was first noted in the 1970s,2 and has been the focus of formal investigation since the 1990s, with investigative and off-label use in the context of mental health increasing across North America and Europe since that time. Ketamine therapy uses low doses of the dissociative anesthetic drug ketamine to manage a range of mental health conditions (Rasmussen, 2024). Electroconvulsive therapy (ECT) can be a highly effective treatment for severe depression and other medication-resistant mental health disorders.
- Finally, extant research does not speak conclusively to the safety of repeated administration over time, and as such, longitudinal research on safety is essential for informed estimation of risks and benefits of ketamine relative to other therapeutic options.
- Choosing a ketamine therapy provider should involve more than locating the nearest clinic.
- Though esketamine/Spravato is offered exclusively as a nasal spray, racemic ketamine can be administered in several ways, including noninvasively through oral and nasal routes, as well as by injection (i.e., subcutaneous, intramuscular, or intravenous), with each route of administration having advantages and disadvantages.
- When used illegally, ketamine can be snorted, smoked (by placing it in either marijuana or tobacco cigarettes), added to beverages, turned into tablets that can be taken orally, or injected.
- This protein plays a role in neuroplasticity, or your brain’s ability to adapt as you experience new things.
- Whether you’re eyeing an IV ketamine clinic, want to ask a doctor about esketamine, or perusing a telehealth company, there also are a few red flags to look out for.
It can be helpful when combined with other treatments for long-term benefits. You may need to repeat these tests later in the treatment course. The urine will be tested for drugs and pregnancy (if applicable). Before your 1st ketamine infusion, you will need to give a urine sample. Follow these instructions before your ketamine infusion procedure.
Ketamine for Treatment-Resistant Depression
When used illegally, ketamine can be snorted, smoked (by placing it in either marijuana or tobacco cigarettes), added to beverages, turned into tablets that can be taken orally, or injected. Yet, the recreational use of ketamine, or its use without a what’s the difference between ecstasy and molly prescription, has increased since 2006, as has its availability. Almost one in three (30%) reported that ketamine provided some benefit. Each additional infusion decreased participants’ depression scores by another two points. Ketamine is a dissociative anesthetic, meaning that it can make you feel detached from your environment while also easing pain.
Near-death experience
Ketamine is not recommended for individuals with uncontrolled hypertension, a history of psychosis, or certain types of bipolar disorder, as it may worsen symptoms. Less commonly, ketamine can cause emotional overstimulation, anxiety during the experience, or headache afterward. The goal is not to “erase” depression or anxiety overnight — it’s to create space for healing and change. Most people will need a series of sessions followed by occasional maintenance treatment. The effects are often strongest when therapy and lifestyle support are included.
KAP may be partially covered by insurance, but you should check with your insurance company for specific coverage details.28 Some insurance plans may cover the therapy sessions, but not the ketamine medication itself. Without a licensed provider carefully managing your use, risks could include fatal overdose, injury from lost pain sensation, and amnesia, just to name a few.27 This typically includes reviewing medical history, current medications, and previous forms of treatment.
Accessing Ketamine Treatment
In contrast to findings demonstrating the benefit of ketamine as an adjunct to ECT for treatment-resistant depression, results from MDD and bipolar disorder are less supportive. The one review that examined route of administration found no differences between a bolus dose (0.2 mg/kg) and an infusion (0.5 mg/kg).62 However, there is limited evidence on intramuscular, intranasal and oral formulations for use in suicidal ideation.65 Additionally, in one study of intranasal esketamine, no participants managed to self-administer the ten pumps to receive the full dose, because of adverse effects; suggesting that the tolerability of intranasal administration may be poor.66,67 The results were grouped according to patient population (MDD, bipolar disorder, suicidal ideation, generalised and social anxiety disorders, post-traumatic stress disorder, obsessive–compulsive disorders, substance use disorders and eating disorders) and by setting (ketamine in combination with ECT).
How ketamine is administered
Plus, some evidence—much of which, it’s worth noting, was gathered on recreational use, not medical—suggests long-term ketamine use may impair brain function, injure the liver, and damage the bladder. And because the drug may impact the health of the fetus, pregnant people should hold off. However, unlike the off-label ketamine treatments we’ve discussed, esketamine was actually approved by the FDA in 2019 to treat depression and comes with its own set of strict guidelines, Dr. Sanacora explains. Medically speaking, ketamine therapy is administered several ways. So what’s the deal with ketamine therapy—what is it, how does it work, and does it live up to all the hype? If you asked someone about ketamine a decade ago, they’d likely give you one of two answers—that it’s a party drug famous for its hallucinogenic effects or an anesthetic used in surgical procedures.
But there is a lowto moderate risk that you can become addicted to ketamine with frequent recreationaluse. Very bad side effects, such as an allergic reaction, may lead to death. If they are severe, the clinician can useanother medication to treat the symptoms. Thesesymptoms go away when the infusion is stopped. The clinician gives ketamine through an infusion. Tell your clinician liberty caps identification if you have any of these conditions.
Ketamine is a controlled substance that must be prescribed by a healthcare provider. Some people have reported feeling strange, spacey, woozy, floating, and loopy. During KAP sessions, patients often report feeling disconnected from their environment and feeling a different awareness of their own body and whats an enabler reality.17 Many describe a dreamlike or “spaced out” state.
For mental health treatment (e.g., depression, PTSD, anxiety)
Ketamine-assisted psychotherapy combines two proven treatments for psychological disorders—medication and talk therapy—potentially offering better results than either alone.18 During treatment, clinicians may adjust ketamine dosages to achieve various states of consciousness.12 Dosages and frequency of administration may vary, and psychotherapy may be provided before, during, or after ketamine administration. Antidepressant effects of ketamine in depressed patients. K-hole experiences are more common when ketamine is used illicitly, outside of a medical context, but can sometimes occur during a formal treatment session.
Understanding the financial and logistical aspects of ketamine therapy can help patients prepare for treatment. The controlled environment of a medical clinic is key to the safe administration of ketamine therapy. For many patients, ketamine therapy represents a beacon of hope when other treatments have failed.
Ketamine also helps restore neuroplasticity, which can reverse some of the brain changes caused by long-standing pain. In chronic pain conditions, the nervous system becomes hypersensitized, which can cause pain to persist in the absence of injury. As a result, many people report feeling a sense of calm detachment, clarity, or emotional reset after treatment (McInnes et al., 2022; Rasmussen, 2024). Unlike traditional anxiolytics, which can take weeks to work or cause dependency, ketamine can produce rapid relief within hours of administration. It’s often paired with psychotherapy, a combination known as ketamine-assisted therapy, to support integration and long-term healing (Rasmussen, 2024). Unlike mainstream antidepressants that can take weeks to have any effect, ketamine can produce rapid improvements in mood, sometimes within hours of administration (McInnes et al., 2022).
