Considering Psychedelic therapy to address Trauma, Depression, Anxiety, Substance use or Chronic Pain?

Some researchers are calling this the "Future of Mental Wellness"

  How Does Ketamine Work?



KETAMINE ASSISTED PSYCHOTHERAPY (KAP)

Time and research have shown us both the limitations of modern psychiatric medicine, and the significant therapeutic benefits of psychedelic medicine for treating a broad range of mental health problems.

Therapy in a non-ordinary state of consciousness provides a completely different neurological, psychological, spiritual, and physical experience than traditional talk therapy. Now you can explore the possibility of integrating therapeutic psychedelics into your healing and growth work. If you have reached the limit of what you think you can get from talk therapy alone, psychedelic therapy might be for you.

What is Ketamine?

Ketamine is a synthetic pharmaceutical compound, classified as a ​dissociative anestheti​c. It is one of the most widely used drugs in modern medicine, and is on the World Health Organization’s List of Essential Medicines. It was developed in 1963, 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 diagnoses. 

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. 

How Ketamine Works 

Ketamine is classified as a dissociative anesthetic, where “dissociation” means a sense of disconnection between mind and body, and from one’s ordinary reality and usual sense of self. The present understanding of ketamine’s mode of action is as an NMDA antagonist working through the glutamate neurotransmitter system. (This is a different pathway than that of other psychiatric drugs such as the SSRIs, SNRIs, lamotrigine, antipsychotics, benzodiazepines, etc.) 

In depression, the spindly receptors on neurons that facilitate signal transmission may recede, and the amygdala and hippocampus (both which help govern mood) may shrink. Animal research has shown that ketamine can stimulate neural growth within days (and sometimes hours).

One hypothesis is that there is similar action in humans. 

Another hypothesis is that ketamine affords a reprieve from habitual patterns of thought that underlie mood and behavior, thereby creating an opportunity for learning new and healthier patterns of thought. There is no current consensus on mode of action, and other mechanisms may be found central to ketamine’s effects.

Medical and Psychiatric Eligibility for KAP 

Some medical and psychiatric conditions need to be treated before you can safely take ketamine. These conditions include hallucinations, untreated mania, unstable angina (chest pain/heart disease), uncontrolled hyperthyroidism, increased intracranial pressure, evidence of liver disease, or a previously demonstrated allergy to ketamine. 

Untreated or uncontrolled hypertension is a contraindication to ketamine use as the substance causes a rise in blood pressure. This increase is typically comparable to normal increases in blood pressure that occur with heavy exercise. 

Pregnant women and nursing mothers are not eligible because of undetermined potential effects on the fetus or nursing child. 

Those with a history of cystitis or other bladder issues may need to be cleared by urological consultation, due to the rare but potentially significant adverse effect of cystitis. 

Those with a primary psychotic or dissociative disorder or who are currently in a manic or mixed episode are not eligible for treatment with ketamine. Please consult your treating clinician if you are taking anxiety medications such as benzodiazepines, pregabalin, or gabapentin as they may blunt the antidepressant effects of ketamine. Opiates cannot be taken concurrently with ketamine therapy. 

Information on ketamine’s interaction with other medicines is only partially available; any possible interactions will be assessed to help determine your eligibility for ketamine treatment. 

Potential Risks of Ketamine 

Ketamine has an extensive record of safety and has been used at much higher doses for surgical anesthesia, without respiratory depression. As with any other medication, there are also some potential risks and side effects to be informed of and consider. 

The most common physical side effect is a short-term spike in blood pressure, pulse, or heart rate, which may be a risk to those with heart disease, and can be misinterpreted as a symptom of anxiety.

Other possibilities for side effects include dizziness/lightheadedness, sedation, impaired balance and coordination, slurred speech, mental confusion, excitability, diminished ability to see things that are actually present, diminished ability to hear or to feel objects accurately including one’s own body, headache, anxiety, nausea, vomiting, and diminished awareness of physical functions such as respiration. These effects are transient and resolve as the active phase of the medication ends (generally within 4 hours). 

Repeated, high dose, chronic use of ketamine has caused urinary tract symptoms and even permanent bladder dysfunction or cystitis in individuals abusing the drug. These adverse effects are much less likely in medically supervised ketamine treatment populations, but might include more frequent, painful, or difficult urination. Please inform your providers immediately if you notice any of these side effects. 

In terms of psychological risk, ketamine has been shown to worsen certain psychotic symptoms in people who suffer from schizophrenia or other serious mental disorders. It may also worsen underlying psychological problems in people with severe personality disorders and dissociative disorders. 

Management of Adverse Effects 

It is very important to abstain from eating or drinking in the 4 hours prior to your treatment so as to avoid nausea or vomiting. Additionally, due to possible blurred and altered vision, as well as impaired balance and coordination, you will be advised to lie still and keep your eyes closed or use the eye mask provided (as long as you are comfortable doing so) until the main effects have worn off. 

Driving an automobile or engaging in hazardous activities should not be undertaken on the day of the administration, and not until all effects have stopped.

Some people report the psychic experiences as bizarre or frightening, while others describe them as pleasurable, joyful, or fascinating. We have found that even frightening experiences can be of paramount value to your transition to recovery from the suffering that brought you to your KAP work.

Potential for Ketamine Abuse and Physical Dependence 

Ketamine belongs to the same group of chemicals as phencyclidine (Sernyl, PCP, “Angel dust”). This group of chemical compounds is known chemically as arylcyclohexylamines and are classified as hallucinogens (also known as psychedelics). Ketamine is a controlled substance and is subject to Schedule III rules under the Controlled Substance Act of 1970. Medical evidence regarding the issue of drug abuse and dependence suggests that ketamine’s abuse potential is equivalent to that of phencyclidine and other hallucinogenic substances. 

Phencyclidine and other hallucinogenic compounds do not meet criteria for chemical dependence, since they do not cause tolerance and withdrawal symptoms. However, cravings have been reported by individuals with the history of heavy use of psychedelic drugs. In addition, ketamine can have effects on mood (feelings), cognition (thinking), and perception (imagery) that may make some people want to use it repeatedly. 

If you are interested in KAP, I can work directly with you and 'Revitalist' to support your treatment goals.