Ketamine + Ketamine Assisted Psychotherapy
What is Ketamine?
Ketamine ia a pharmaceutical drug that was initially introduced in 1962 (Domino & Warner, 2010). Ketamine is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, which was initially created as an alternative to the anesthetic, phencyclidine (PCP).
Ketamine quickly became known for its potent anesthetic-analgesic properties and unique alterations of consciousness at variable dosages. Ketamine is now a commonly used anesthetic in human and veterinary medicine and an analgesic agent in multiple pain conditions.
What is Ketamine Assisted Therapy?
Ketamine-Assisted Psychotherapy (KAP) is a therapeutic approach that combines the administration of prescription ketamine, a dissociative anesthetic, with psychotherapy to address mental health challenges. Ketamine assisted psychotherapy has been shown to be beneficial for people who experience conditions that are often resistant to traditional therapies, such as severe depression, anxiety, post-traumatic stress disorder (PTSD), and certain chronic pain syndromes (Drozdz et al., 2022).
How is Ketamine Administered?
Ketamine is a prescription medication and can be given intravenously (IV), Intramuscularly (IM) or through Nasal Spray in a controlled medical setting.
How Does KAP Work?
Ketamine + The Brain
Ketamine, at sub-anesthetic doses, has profound effects on the brain. It has been shown to increase neuroplasticity (Kopelman et al., 2023), enhances connectivity between neurons (Wu et al., 2021), and influences glutamate (Lazarevic et al., 2021), an important neurotransmitter involved in learning and memory.
These effects have been shown to create a window of opportunity for patients to explore their thoughts, emotions, and memories in a new way, often with reduced fear or resistance.
Psychotherapy Integration:
The psychotherapy component is tailored to leverage the altered state of consciousness ketamine induces. This state can facilitate deep insights, emotional breakthroughs, and a sense of detachment from ingrained patterns or trauma.
Trained therapists help guide the process, ensuring the experience is safe, meaningful, and integrated into the patient’s broader therapeutic goals.
Research suggests the following conditions could be helped by Ketamine and Ketamine Assisted Therapy:
Treatment-Resistant Depression (TRD):
Recent evidence has shown that ketamine can have a rapid and robust antidepressant effects, including in treatment-resistant patients for whom other therapies, such as other forms of therapy and medications like SSRIs, and SNRIs have been ineffective.
Ketamine has been shown to quickly alleviate depressive symptoms, often within hours or days, compared to weeks for conventional antidepressants.
Anxiety Disorders:
Particularly for individuals with generalized anxiety, social anxiety, or existential anxiety (Tully et al., 2022).
Ketamine helps reduce anxiety by creating a sense of calm and disrupting repetitive negative thought patterns.
Post-Traumatic Stress Disorder (PTSD):
Individuals with PTSD may find ketamine helpful for processing trauma with reduced emotional reactivity and fear (Almeida et al., 2024)
Obsessive-Compulsive Disorder (OCD):
Ketamine may reduce the intensity of obsessive thoughts and compulsive behaviors, allowing space for cognitive-behavioral therapy (CBT) or other modalities(Algin et al., 2024).
Chronic Pain Syndromes with Emotional Components:
Conditions like fibromyalgia, complex regional pain syndrome (CRPS), or migraines often have intertwined psychological and physical aspects (Israel et al., 2021).
Ketamine can help by altering pain perception and reducing associated emotional distress.
End-of-Life Distress/Existential Anxiety:
For individuals facing terminal illness or existential crises, ketamine can alleviate emotional suffering and foster a sense of peace and meaning (Oyetunji et al., 2023).
Who Could benefit from KAP?
Individuals open to introspection and willing to engage deeply with the therapy process.
Those who feel "stuck" in their current emotional or mental state and are seeking a different therapeutic perspective.
People who value integrative approaches that combine medicine with psychological work
Contraindications for Ketamine + KAP?
History of Psychosis or Schizophrenia:
Ketamine’s dissociative properties may exacerbate symptoms of psychosis or trigger hallucinations and paranoia.
Unstable Cardiovascular Conditions:
Ketamine can elevate heart rate and blood pressure, so it is not recommended for individuals with uncontrolled heart conditions.
Substance Use Disorders:
While ketamine itself is not highly addictive at therapeutic doses, individuals with a history of addiction may require careful monitoring to avoid misuse.
Pregnant or Breastfeeding Individuals:
There is limited research on ketamine’s effects in these populations, so it’s usually avoided unless absolutely necessary.
Here at Well Mind Body we are committed to staying up to date on research and therapeutics. If you are someone who is suffering from chronic pain or mental health issues that have been difficult to overcome, please know that we are here to support you.
Thank you for reading!
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