Introduction to the use of ketamine
Ketamine is a drug that doesn’t have the best connotations. You may know it as the horse tranquiliser or associate it with the party scene, but did you know that it can have intriguing effects when used alongside psychotherapy? This blog will address the common misconceptions about ketamine and how it can be used in ketamine-assisted psychotherapy.
What is ketamine used for?
Ketamine is a dissociative anesthetic which has been approved for use by medical professionals for short-term sedation. Dissociatives are a class of psychedelic drugs which cause people to feel disconnected from detached from their body and the surrounding environment.
What is ketamine assisted psychotherapy?
In more recent years, ketamine has revealed further applications; ketamine-assisted psychotherapy. Such treatments have been growing in popularity for treatment of mental health disorders such as depression and anxiety.
Research spanning several decades has revealed success for ketamine-assisted psychotherapy. Due to the trance-like properties of this drug, ketamine assisted therapy can provide alternative routes for working through issues patients may have otherwise found difficult to overcome with traditional talking therapies.
Common misconceptions about ketamine
Ketamine is often dismissively referred to as just a ‘horse tranquiliser’. Due to its dissociative qualities, it is also commonly used in recreational settings. Such misuse and mislabelling has led to negative connotations attributed to the drug.
The truth is that ketamine proves to be effective in both psychotherapeutic and general medical practices. Administration of ketamine is routinely used to effectively sedate both animals and people. Lower doses are also provided for pain relief such as fractures, abdominal pain or chronic pain. Researchers are also beginning to unveil the benefits of ketamine-assisted psychotherapy for some psychiatric disorders.
In-depth look at the research on ketamine therapy and ketamine treatment
Ketamine therapy is often used in cases where depression or anxiety has shown resistance to other treatments.
On the one hand, ketamine treatment can be seen as a temporary yet swift solution for severe suffering. The NHS reported that using ketamine to treat depression reduced symptoms for only a day in 70% of their patients.
On the other hand, psychotherapy is a longer lasting approach as it requires individuals to think differently about their life. Though this shift in perspective is often more effective for long term benefits, it does demand more time.
When used in combination, the ketamine treatment has the capacity to enhance the effects of psychotherapy.
Despite the growing body of research, ketamine therapy has not been approved for use in the UK. Therefore, ketamine can only be used to treat depression ‘off-label’. This involves prescribing a treatment for something other than it is licensed for.
Ketamine infusion treatment refers to the administration of ketamine to a patient through intravenous delivery. As such, this method must take place in a clinical setting or hospital. This way of delivery allows for quick and effective absorption by the body as the ketamine enters the bloodstream right away. Ketamine infusion therapy can be prescribed ‘off-label’ for individuals suffering from treatment-resistant depression; depression which hasn’t responded to at least two medicines.
An in-depth look at ketamine treatment for depression
Research on ketamine treatment for depression is much more solidified than for anxiety. As previously stated, ketamine is not licensed for treatment of depression. However, in 2019, esketamine, a component of ketamine, became licensed for use for treatment-resistant depression. This treatment must be taken at a clinic or certified-doctor’s office, where following this, the patient is monitored for at least two hours by a medical professional. Similar to treatment for anxiety, the use of ketamine often provides rapid relief, but the effects are usually short-lived, spanning from a few days to a week. As such, the capability of ketamine to provide long-term effectiveness is in question.
In-depth look at ketamine for anxiety
It is estimated that around 50% of patients with generalised anxiety disorder (GAD) are treatment resistant. In these cases, doctors may also prescribe ketamine for anxiety ‘off-label’.
The relationship between ketamine and anxiety is less established than with depression but some studies argue similar outcomes transpire. A 2022 review revealed that single dose ketamine infusions were able to rapidly reduce panic, irritability and social anxiety with effects lasting two weeks.
How does ketamine bring about a reduction in anxiety symptoms?
The introduction of ketamine for anxiety works by quickly increasing glutamate activity in the brain. Glutamate is an excitatory transmitter which plays a key role in mood regulation, learning and memory. Whilst other treatments for anxiety target other brain chemicals i.e. serotonin prior to glutamate, ketamine activates glutamate immediately .
How fast does ketamine work for anxiety?
Unlike antidepressants, ketamine works directly on glutamate. This swift action means the use of ketamine therapy for anxiety can reduce symptoms of anxiety in mere hours. This is in contrast to antidepressants which take 4-6 weeks to come into effect. For patients with treatment-resistant anxiety, ketamine treatment for anxiety is a promising avenue to explore when other alternative routes have proved unsuccessful.
How does the combination of therapy and ketamine work to reduce anxiety?
Ketamine-assisted psychotherapy exhibits considerable promise in treating the effects of severe anxiety. When ketamine is administered to a patient, they are monitored for at least two hours by a medical professional. As the patient begins to experience the dissociative effects of ketamine, they are able to explore any feelings that may come up. Ketamine has the ability to relax the patient so discussing traumatic memories and emotions can prove less painful.
To find out more about the use of drug assisted therapies why not check out our course with international speaker Dr. Ronald Siegel:
Working with Non-ordinary States in a Psychotherapeutic Setting | 11 CPD/CE credits
‘Discover the uses of the non-ordinary states brought about by psychedelics, mindfulness, and compassion in the treatment of psychological disorders such as PTSD, depression, addictions, and end-of-life anxiety. Develop your confidence and understanding of how to use these techniques in your own practice…read more
