Ketamine is a synthetic pharmaceutical compound, classified as a dissociative anesthetic. It is one of the most widely used drugs in modern medicine. It was developed in 1962, FDA approved in 1970, and adopted by many hospitals and medical offices because of its rapid onset, proven safety, and short duration of action. Ketamine is most commonly used in surgical settings, including pediatric surgery, due to its excellent safety profile, particularly around breathing/airway management. It has also been utilized successfully in managing acute and chronic pain conditions due to its analgesic properties. In the last two decades, ketamine has been increasingly clinically applied at subanesthetic doses as an off-label treatment for various chronic treatment-resistant mental health conditions, such as depression, alcoholism, substance dependencies, post-traumatic stress disorder, obsessive compulsive disorder, and other psychiatric diagnosis. Non-medical and recreational use of ketamine began in the late 1970s, leading to its cultural reputation as a club/party drug; it was also enthusiastically adopted by the psychedelic community and others who value exploration of altered states.
In 1962, chemistry professor Calvin Stevens synthesized ketamine while researching alpha-hydroxyimine rearrangements. The first human tests were conducted on prisoners in 1964. Ketamine soon replaced phencyclidine (PCP) as the go-to anesthetic in hospitals. It was first used on soldiers during the Vietnam War following FDA approval in 1970. Thanks to its success on the battlefield, ketamine was placed on the World Health Organization’s List of Essential Medicines. Ketamine has been used broadly as a sedative and anesthetic; to aid in emergency surgeries in war zones; as a bronchodilator for severe asthmatics; to treat certain types of seizures; in postoperative pain management; and now, as a nasal spray, IM, and IV medication to treat depression and PTSD with the potential to treat other conditions as well.
While it doesn’t work for everyone, ketamine’s success rate of 85% is almost double that of traditional antidepressants (45%). Although extraordinary results can be achieved with this therapy, your results will depend on the effort put into the therapy and your unique circumstances.
There has yet to be consensus on how ketamine addresses depression and other conditions such as PTSD, suicidality, and addictions. Antidepressants act on the body’s serotonin and noradrenaline systems. Ketamine seems to interfere with an amino acid derivative, NMDA. As a 2017 study published in the journal Nature, explains,
“Ketamine is responsible for blocking the N-methyl-D-aspartate (NMDA) receptor, which causes an immediate alleviation of depressive effects, while another metabolite in the drug helps the effects last for hours. This blockage is also what causes the hallucinogenic effects.”
A leading theory is that Ketamine stimulates the regrowth of synapses (connections between neurons), effectively rewiring the brain. This is a very different function than existing antidepressants. Rather than affecting one of the “monoamine” neurotransmitters, such as serotonin or dopamine, ketamine acts on glutamate, which is the most common chemical messenger in the brain. Glutamate plays an important role in the synapses involved in learning and memory, which is why researchers believe neuroplasticity could be central to ketamine’s antidepressant effects.
Ketamine also activates the limbic system (associated with memory, emotion, and behavior), which suggests a strengthened interaction between the conscious and subconscious levels of the mind. It also frees up the imagination to allow for creative, new problem and inspiring insights. It provides a break from the “default mode network” a part of the brain which perpetuates hyper-vigilance and circular, self-critical and life-limiting perspectives.
In offering some distance from the usual ways of thinking and dodging discomfort, Ketamine affords more room for curiosity and connection to one’s true self and values. This can lead to a sense of greater aliveness and a willingness to let go of the perpetual struggle to be in control.
The ketamine experience is characterized by the relaxation of ordinary concerns and usual mindset, all while maintaining conscious awareness. This tends to lead to a disruption of negative feelings and preoccupations. Some ketamine providers feels this interruption, and the exploration of other possible states of consciousness, can lead to significant shifts in overall well-being.
At lower doses, you will most likely experience mild anesthetic, anxiolytic, antidepressant, and psychoactive effects. You might experience increased sensitivity to light and sound, as well as an altered sense of time. Some people experience empathogenic (similar to MDMA) effects in this dose range. This state may also enhance participation in psychotherapy, as defenses are relaxed, yet communication with others is still possible. Higher doses are more likely to produce psychedelic, dissociative states that are largely internal journeys away from the external world. Body sensations are greatly diminished. Such journeys may provide a more robust treatment effect, often assisting in the resolution of existential concerns, accelerating psychological and possibly spiritual growth, and promoting a positive change in outlook and character that we refer to as a transformative response. Sensory effects of ketamine may include distorted visualization of colors, feeling suspended in space or floating, experiencing out-of-body sensations, vivid dreaming, and changes in visual, tactile and auditory processing. Synesthesia (a mingling of senses) may occur. Familiar music may not be recognizable. An ordinary sense of time may morph into time dilation. These effects typically start 5 to 10 minutes after ketamine dosing. The peak effects typically last 20 to 30 minutes, and then slowly diminish for the next hour. Some alterations in sensory perception, speech, and motor ability may continue for approximately 5 hours.
The first appointment includes a 90-minute holistic medical and psychological assessment to evaluate the client, make sure the treatment is appropriate and manage expectations for the therapy. Safety is of the utmost importance. While ketamine has been shown to be safe when taken in a medical setting, I am certified in advanced cardiac life support and am trained to recognize and treat rare complications.
The therapy room is a comfortable, tranquil room that creates the perfect setting for psychedelic exploration. I will be with the client the entire time, providing them with a safe space to process. Clients leave the appointment with detailed notes of their experience and typically return for another two to five additional treatments for the initial therapeutic work. While ketamine can be a catalyst, it’s one piece of the healing process.
KAP can be a very mind-opening experience. Shifts in the relationship to self and in thinking patterns can take place and it becomes possible to see through limiting beliefs and recognize a much larger world than ever experienced before. This bigger sense of self and life as a whole can serve to replace the rigid redundancy of the stories promoted by anxiety, including OCD. Traumatic memories and other difficult past experiences can become easier to face and view in a different, more self-compassionate light. The combination of the medicine and psychotherapy facilitates the processing of the new information and perspectives so that they can be integrated into daily life. I have several tips for ongoing integration practices. If you are not already working with a therapist, I can refer you to someone I know well versed in psychedelic integration.
No. Clients can return home from a KAP session with another driver. We recommend that you do not drive, operate heavy or dangerous machinery, make important decisions, sign legal documents or engage in risky activities until the day after treatment.
Evidence shows that ketamine is safe for use in people within a wide age range when taken correctly. Unlike other anesthetic medications, ketamine does not affect the protective airway reflexes and doesn’t depress the respiratory system. This has made it a safer option than many other anesthetics especially for those at high risk for respiratory compromise during surgery. However, people who combined ketamine with other drugs, particularly alcohol, may become unconscious quickly and unexpectedly, and therefore compromise breathing. Similarly taking ketamine with stimulants (such as cocaine and ecstasy) may overload your heart. Ketamine is considered a safe drug when taken correctly and in medical settings.
Ketamine is an FDA-approved anesthetic, and is available for “off-label” prescription by a licensed clinician.
Ketamine has been approved by the Food and Drug Administration (FDA) for medical use as an anesthetic since 1970. In addition to off-label ketamine prescriptions, the FDA recently approved derivatives such as esketamine for treatment of adults with treatment-resistant depression.
“Off-label” prescription is when a medicine is used to treat another condition outside of its original medicinal intent.
Ketamine is currently listed as a Schedule III compound under DEA guidelines.
This means it is generally accepted to have medical value for specific purposes, and must be administered by a licensed provider to be distributed effectively. What most Americans do not know is that FDA approval simply means that a company has government permission to advertise the drug for a specific disease. For example, aspirin is used to treat headaches, prevent strokes, prevent heart attacks, relieve pain, treat arthritis, and reduce fever; however, it is only approved by the FDA for fever and pain relief. So, utilizing ketamine for depression is no different from using aspirin to prevent strokes and heart attacks.
Do not take Ketamine if you:
If you are not sure if you have any of the above conditions, talk to your provider before taking Ketamine.
Before you take Ketamine, tell your provider about all of your medical conditions, including if you:
Tell your provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Taking Ketamine with certain medicine may cause side effects.
Especially tell your provider if you take central nervous system (CNS) depressants, psychostimulants, or monoamine oxidase inhibitors (MAOIs) medicines. Keep a list of them to show to your licensed provider.
Ajona Olsen NP / DAYTRYP HEALTH
1845 South Dobson Road, Suite 211, Mesa, AZ, 85202 (Mesa Daytryp health location)
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