What is Ketamine Assisted Psychotherapy?

Ketamine is an anesthetic drug that blocks pain. It was first developed in the 1960s and was used to operate on soldiers during the Vietnam War.  In addition to dulling pain, ketamine makes users feel like they're detached from their own body.

In 2000, researchers started studying sub-anesthesia doses of ketamine as a treatment for depression. Over the years, they've discovered it improves mood much faster than traditional antidepressant drugs, and it works when some of these drugs have failed.

Ketamine is FDA-approved as an anesthetic for surgery and diagnostic procedures. It's also used to treat depression, suicidal thoughts, post-traumatic stress disorder (PTSD), other mood disorders, and nerve-related pain.

Ketamine can be given in oral, intramuscular, and IV form. Alternative Pathways administers ketamine in orally disintegrating lozenge and intramuscular forms. Frequency of doses varies and is customized to the individual. Depending on severity of symptoms, some individuals may receive 6 sessions over a period of about 2 weeks, while others may receive 3 doses over 10 weeks. Booster doses are often used for long-term results and to reduce recurrence of symptoms. Booster frequencies also vary.

Unlike antidepressants, which work by shifting the balance of brain chemicals like serotonin and dopamine, ketamine is thought to change the way brain cells communicate with each other. Ketamine blocks a type of receptor in the brain, known as NMDA, thought to play a role in depression.  Ketamine also acts on other brain receptors -- like opioid receptors, which affect pain and depression. Recent studies found that ketamine can have long-lasting effects on depression, even though the drug only stays in the body a short time. 

Unlike antidepressants, which can take weeks or longer to take effect, ketamine starts working within a few hours. For people who are suicidal, this rapid effect can be lifesaving. Ketamine can also help people who haven't found relief from other depression treatments. The initial effects of the drug on depression can fade quickly -- within 1 to 3 days. Most people need to get repeat treatments over months or years to see long-term improvements. Adding individual and/or group therapy can help ketamine's antidepressant effects last longer.

Right after getting the drug, people often experience "dissociative" side effects, which is kind of like having an out-of-body experience. Things may look and sound different than they usually do. Colors might look blurred, or you can have the sensation that you're looking down at your body. The feeling lasts for about an hour after the injection, and then it should wear off, while the drug’s benefits continue.  The drug can also cause a spike in blood pressure and heart rate in the short term. For most people, that's probably not a problem. It's the equivalent of walking up a flight of stairs carrying a bag of groceries. Nausea is a potential side effect of ketamine. Thoughtful interventions are offered and provided to reduce the risk of nausea and vomiting during sessions.