Ketamine Therapy to Treat Depression and Anxiety

What is Ketamine?

History of Ketamine

While initially developed as an anesthesia agent in the 1960’s, ketamine has more recently become recognized as a medication that can be used in the treatment of multiple mental health disorders (1). Ketamine functions as an anesthesia agent by blocking incoming sensory information to the brain. It is unique among other anesthesia medicines because it does not slow down the brain or stop a patient from breathing on their own.

How Does Ketamine Work?

Because less sensory information is coming into the brain, the nerve cells there create new branches to reach out for new connections and information.  The ability to build new pathways in the brain after a ketamine experience is known as “neuroplasticity,” and this is the phenomenon that is believed to be responsible for the ability to build new neural networks, or streams, as we integrate that experience into our therapeutic relationship with a mental healthcare provider (2).

Even a brief break from the constant influx of sensory input and the sometimes disorganized or harmful cognitive patterns that we live with every day can provide an opportunity to rethink the way we appreciate our own existence and how we interact with the people around us.  This is how one may be able to “break free” from the deeply entrenched crushing burden of depression, anxiety, and possibly other soon-to-be indicated medication-resistant mental health disorders.  A recent seminal publication in the New England Journal of Medicine further supports the effectiveness and safety of infusion ketamine in the management of treatment-resistant major depression (3).

What Happens During a Ketamine Treatment Session?

While some mental health providers perform psychotherapy after administering ketamine orally or under the tongue, we provide ketamine either via an intramuscular injection or through an intravenous infusion drip, which results in a deeper psychedelic experience. This is typically done in 6 planned sessions delivered over a 3-6 week period, with each session lasting for several hours. During the session, patients typically wear headphones playing peaceful music or soundscape, along with a light-blocking eye mask. At MindStream, there are no separating curtains or portable room dividers because all patients have their own personal treatment room.

No talk therapy takes place while the patient is under the influence of the medication, so that they may focus on the experience itself. Patients are closely monitored by a trained medical professional in the treatment room, usually by the medical director, at all times. This is to ensure that any potential negative reactions from the medication, though rare, can be handled quickly and appropriately by our board-certified emergency medicine physician, Dr. Husted. Unlike some other ketamine clinics, no one is left alone by him/herself during the entire process.

What Happens After a Ketamine Treatment Session?

It is in the days following the session that the patient will return to their therapist to talk about their experience and how it relates to their goals in therapy, a process known as integration.

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801551/
(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047599/
(3) https://www.nejm.org/doi/full/10.1056/NEJMoa2302399/