The Benefits of Ketamine-Assisted Therapy
Ketamine: A Brief History
Ketamine was originally developed in 1962 by a research team led by organic chemist Calvin Stevens at Parke Davis Company. Their goal? To develop a better anesthetic for surgery and pain management.
The first treatments were administered to volunteer prisoners who reported feeling like they were in space, floating. Some said they couldn’t feel their arms and legs. Ketamine was noted for having effective anesthetic and analgesic properties, with fewer side effects than other similar medications. It was characterized as a dissociative anesthetic, and by the 1970s was being used by doctors and veterinarians.
Ketamine Finds Modern Applications in Mental Health
Our understanding of ketamine and its uses has expanded greatly in the last 60 years. In 2000, Yale published the first study that showed ketamine as a viable alternative treatment for depression. This led to a spate of research, and since then the mental health community has worked closely with other medical fields to fine-tune how to best administer this treatment to patients.
Today, we know that ketamine-assisted therapy can be used to treat many different disorders:
- Major Depression
- Anxiety
- Post-Traumatic Stress Disorder (PTSD)
- Bipolar Depression
- Obsessive-Compulsive Disorder (OCD)
- Phobias / Fear
The Endocrinological Perspective
My field of study has a unique understanding of how bodily processes affect each other; endocrinology is the study of endocrine glands and hormones — which includes all the glands and organs that make hormones. Instead of studying each of these organs individually, I must have a comprehensive view of the overall picture that each piece of the puzzle creates.
The reason ketamine works is because it helps your brain do naturally what most other antidepressants are trying to replicate. The medication relaxes the chandelier cells in your brain, which controls when cells fire and pass messages on to other neurons. This enables your brain to dissociate from your physical and emotional responses to triggers, and helps you forge new, healthier neural pathways in your brain.
This allows patients to fundamentally alter deeply rooted routines and develop new, better habits — so instead of constantly fighting cyclical battles, patients find themselves able to enact meaningful change.
What to Expect with Your Ketamine Treatment
Most patients begin their ketamine-assisted therapy program with an intensive introduction, which is the initial focus of the treatment. A common ketamine-assisted treatment schedule will then taper off treatment sessions, and eventually the patient will be put on an intermittent maintenance schedule.
Common Ketamine-Assisted Treatment Schedule:
- 2 sessions /week spaced three days apart for the first three weeks
- 1 session /week for a month
- Maintenance, customized to patient (~1 session /month or more)
The effects of treatment can last anywhere from a few weeks to a few months. After the initial intensive therapy, some clients may remain symptom-free for an extended period of time. We monitor our patients’ health and communicate closely with their mental health provider. We can administer booster treatments as needed.
What Does My First Day of Treatment Look Like?
Patients have three options for taking ketamine: nasal spray, intravenously, or by an intramuscular shot. Doses administered by IV and intramuscular injections are more precise and easier to monitor; it also allows us to ensure that you receive the proper dosage and have someone to watch over you during the therapy. We feel the intramuscular shot is safer for patients; there is no IV to put in or pull out, meaning it’s less invasive and less bloody. The experience is also less medical — enjoying the dreamlike state brought on by ketamine therapy is harder to do when tethered to an IV, and we want patients to have a positive therapy experience.
At Endocrinology Associates, we administer two ketamine shots spaced apart. Then we loosely monitor your progress, leaving you to fully enjoy the session and receive the full effects of your ketamine treatment. I like to give patients extra options (eg. weighted blanket) because the definition of “cozy and relaxed” differs from person to person.
Patients are required to plan for other transportation home, because mild disorientation is a common side effect. I also advise patients to clear their schedule for the rest of the day — having the time and space to work through your emotional process significantly improves the effectiveness of the treatment.
What Happens Next?
The effects of treatment can last anywhere from a few weeks to a few months. After a series of treatments, some clients may remain symptom-free for an extended period. Booster treatments can also be administered as needed, and the frequency in which you’ll need them is typically determined by you, your mental health provider, and our team.
Final Thoughts
I do not prescribe treatments that lack rigorous medical backing by qualified research studies. I will always ensure that we personalize the treatment to your needs. I have carefully vetted ketamine and regularly consult with other professionals about how best to implement this into a patient’s treatment.
Ketamine may not be for everyone. But for the right person, when administered correctly by a trained professional, this unique and powerful tool can change lives.