Last month, we took a look at the idea that psychedelics aren’t just for incense burning, nor for patchouli doused and Birkenstock shod hippies. Psychedelic drugs are substances that alter perception and mood and affect a number of cognitive processes. The classic psychedelics include MDMA, aka “Ecstasy” or “molly,” LSD, Psilocybin or “mushrooms,” Ayahuasca and Ibogaine.
What Is Ketamine and How Is It Used?
Added to that repertoire is Ketamine which is considered a legal psychedelic drug used to address treatment resistant depression. It is also used for a host of other conditions such as drug addiction, alcohol use disorder, Post-traumatic stress disorder (PTSD), anxiety and chronic pain.
The DEA defines Ketamine as “a dissociative anesthetic that has some hallucinogenic effects. It distorts perceptions of sight and sound and makes the user feel disconnected and not in control.”
Street names for experiences or effects related to Ketamine include:
- “K-land” (refers to a mellow and colorful experience)
- “K-hole” (refers to the out-of-body, near-death experience)
- “Baby food” (users sink into blissful, infantile inertia)
- “God” (users are convinced that they have met their sense of God/Spirit)
Because Ketamine is used as a party drug, professional supervision of its intake is required when incorporated into treatment. One route is via IV infusion. In an article entitled “Ketamine for Depression, 4: In What Dose, at What Rate, by What Route, for How Long, and at What Frequency?”, the author indicates, “Ketamine is most commonly administered in the dose of 0.5 mg/kg, but some patients may respond to doses as low as 0.1 mg/kg, and others may require up to 0.75 mg/kg. The ketamine dose is conventionally administered across 40 minutes; however, safety and efficacy have been demonstrated in sessions ranging between 2 and 100 minutes in duration.”
Routes of Administration and Therapeutic Goals
According to Chittaranjian Andrade in an article entitled, “Oral Ketamine for Depression, 2: Practical Considerations,” “The oral route of administration is probably the least expensive and most convenient way to administer Ketamine in indicated contexts in depressed patients. Because only 20%-25% of orally administered ketamine reaches systemic circulation, oral doses of about 2.0-2.5 mg/kg may need to be administered to achieve equivalence to intravenously administered Ketamine. In case reports, case series, standard operating practice in Ketamine facilities, and randomized controlled trials, oral Ketamine has been administered through weight-based dosing and as fixed doses, and the dosing strategy has been one-size-fits-all or the dose is individualized through a dose discovery process. Administered doses have ranged from 0.25 to 7.0 mg/kg in weight-based dosing sessions and from 25 mg to 300 mg in fixed dosing sessions.”
These are other forms in which Ketamine is delivered:
- An IV treatment using racemic Ketamine, which has yet to be FDA approved
- Intramuscular injections
- Lozenges
- Using a nasal spray called Esketamine, which was FDA-approved in 2019 for those struggling with treatment-resistant depression
Robert C. Meisner, MD, a contributing writer at the Harvard Health Blog, explains that Ketamine enhances certain brain receptors’ ability to, “lead to the release of other molecules that help neurons communicate with each other along new pathways. Known as synaptogenesis, this process likely affects mood, thought patterns, and cognition.”
What to Expect From a Ketamine Session
A session will proceed with a licensed psychotherapist or MD who is specifically trained and certified to offer Ketamine Assisted Therapy, ushering the client into a comfortable and quiet room. The client will be asked about their needs, symptoms, and history with treatment. The substance does an end run around the defenses that may prevent clients from more deeply exploring their trauma and emotional reaction to it.
As is so with any substance ingested or infused into the body, there are possible side effects. Those associated with Ketamine include:
- Hypertension
- Nausea and vomiting
- Altering of perception
- Dissociation/out of body experiences
Contraindications for its therapeutic use include:
- Uncontrolled high blood pressure
- Certain serious cardiac conditions
- History of Bipolar mania
- Hallucinations due to Schizophrenia
- Dissociative Identity Disorder (DID) (which used to be called Multiple Personality Disorder)
If you’re exploring or have recently experienced this treatment, ketamine integration therapy can help you process your insights and ground them in lasting change.
Resources
- Research is ongoing via the Ketamine Research Foundation.
- The University of Pennsylvania has a series of courses and an abundance of resources for professionals who want to learn more about psychedelics as a cutting-edge form of treatment.
- Ketamine For Depression by Dr. Stephen Hyde.
- The Ketamine Papers by Phil Wolfson M.D., Glenn Hartelius Ph.D.
- American Society of Ketamine Physicians, Psychotherapists and Practitioners
- Identifying Patients Who Could Benefit From Ketamine-Assisted Therapy