Ketamine Assisted Psychotherapy
Ketamine is a popular anesthetic used for several decades for surgeries and in emergency rooms for pain management. It is a dissociative anesthetic, dissociation meaning a sense of disconnection from one’s ordinary reality and usual self. Ketamine also has mild anxiolytic, antidepressant, and, potentially, psychedelic effects. Altered mental states, such as mystical and spiritual, often occur with its use.
Recently ketamine has been a novel and effective treatment of mental health issues and has been utilized in the psychiatric field to treat depression, suicidality, PTSD, OCD, and, interestingly enough, substance abuse issues. Ketamine works when other medications and treatments have failed due to its different mechanisms of action. In short, ketamine works on the glutamate receptor systems, while most antidepressant medications work on serotonin, norepinephrine, or dopamine. Specifically, ketamine binds to the NMDA receptor and is very fast acting. Many people will improve after their first treatment, although most improve after their third to fourth treatment. Its fast-acting nature is particularly helpful in treating suicidality when time is paramount.
How does ketamine work?
When ketamine binds to NMDA receptors, it leads to a release of glutamate, which is a major excitatory neurotransmitter in our brain. This increase in glutamate causes a cascade of changes in our brain that helps promote neuronal growth and plasticity, which are essential in strengthening neurons and improving communications with other neurons. Loss of neuronal plasticity or atrophy is common in depression, chronic stress, trauma, and age. So, being able to reverse these changes is what has gotten the mental health community excited about its use.
Ketamine and Therapy
Another way that ketamine can help individuals is through the brief opening of the mind. When ketamine works in conjunction with therapy, it helps reduce defense mechanisms and temporarily allows one to process past or current traumas or painful situations differently. It will enable one to re-evaluate and process past hurts, ideas, and maladaptive thoughts through a different mental state, promoting proper healing. Ketamine-assisted psychotherapy is now incorporated into practices nationwide to enhance and expedite therapy for qualified individuals. Therapy is performed by a mental health professional during or after ketamine sessions, depending on ketamine usage.
How is ketamine administered?
At Lopez-Larson and Associates, we combine oral lozenges with psychotherapy to potentiate the powerful antidepressant and anti-anxiety effects of ketamine. When utilized along with psychotherapy, ketamine helps to open the mind, reduce defenses and process past traumas and conflicts.
In addition to oral lozenges or troches, there are three other ways to administer ketamine, and each delivery method has its pros, cons, and uses. The routes of administration include intravenous (IV) infusions, intramuscular (IM) injections, and intranasal sprays. It is important to review the pros and cons of ketamine treatment and its uses with your psychiatric health professional to determine which treatment type would be optimal for you.
What are the response rates and side effects?
The response rates for ketamine treatments are as high as 70 to 80 percent, even for those struggling with treatment resistance. The side effects are minimal outside of treatment, but some level of dissociation is typical during treatment. Other side effects include nausea, vomiting, sedation, dizziness, and increased blood pressure and heart rate. The intensity of the dissociative effects and side effects vary depending on the ketamine dose and frequency of administration.
Ketamine is a powerful medication with a unique action mechanism, making it a potentially life-saving and transformative treatment. If you want to learn more about ketamine and ketamine-assisted psychotherapy, please schedule a free consultation. Help IS a phone call away!