We’re using Neomedicine Institute as an illustrative example, and patient experiences at other providers may vary. It’s important to note that there is increased risk of lower urinary tract symptoms with esketamine. Cases of cognitive impairment have occurred with high doses of ketamine, yet these were not seen in the clinical trials at typical doses.
How to Get Started With Ketamine Infusion Therapy
“When ketamine is in your system, you’ll likely have the dissociative effects, but that’s not the treatment,” Krystal says. Doctors who give IV ketamine tend to recommend patients continue taking their regular antidepressants, too. As for the esketamine nasal spray, it’s only approved for use along with an oral antidepressant and what is mesculin only in certified health care settings. The FDA has only approved a particular form of ketamine for treatment-resistant depression, not anxiety. However, doctors may still prescribe ketamine “off-label” to treat anxiety. This is known as ketamine therapy, and the research on its potential benefits has been steadily growing.
(Insurance may cover the cost of the psychotherapy sessions, however. Ask about your specific benefits.) “The cost of treatment is not an insignificant amount of money,” says De La Hoz. One issue is that because of the cost, it may only be available to those with higher incomes. “We have hope that this will become more accessible to all who need it, not just specific populations,” he says. After the ketamine is administered, you’ll have the opportunity to recover. You should be monitored for any adverse reactions and the practitioner should ensure you’re safe to go home.
- According to Lewis, IV infusions, intramuscular shots, and nasal sprays are the most common and effective because of how much ketamine can be quickly and easily absorbed into the bloodstream.
- A prescription version of ketamine called esketamine (Spravato), given through a nasal spray, was approved in 2019 by the FDA for hard-to-treat depression.
- They may offer you an eye mask and headphones, or you may want to bring your own.
- If you’re considering ketamine therapy, know that the protocol will depend on the individual clinic or company.
- In addition to its medical use, ketamine has also been a drug of abuse.
Health Challenges
Ketamine is a Schedule III controlled substance and is only legal when prescribed by a physician. Food and Drug Administration (FDA) approved Spravato—a nasal spray containing esketamine, which is made from ketamine—for treatment-resistant depression. Research from 2018 suggests ketamine may work by binding to the N-methyl-D-aspartate (NMDA) receptor in the brain to block glutamate.
Ketamine reduces certain nervous system functions by inhibiting normal N-methyl-D-aspartate (NMDA) receptor activity. Normally, NMDA receptors, which are located on the surface of nerve cells, bind to neurotransmitters to modulate the actions of the nervous system. There’s evidence that ketamine can have a very rapid onset of effects in neuroplasticity, says Gerard Sanacora, MD, PhD, director of the Yale Depression Research Center. The American Society of Ketamine Physicians, Psychotherapists & Practitioners (ASKP) directory is a good place to start. Ketamine can produce hallucinations similarly to other drugs such as LSD and PCP, or angel dust. The anesthetic is being used off-label for everything from psychiatric illnesses to autoimmune diseases.
Ketamine and Esketamine Are Not Cure-Alls
One of the most significant advantages of ketamine is its rapid antidepressant effects. In a 2022 study, people with depression and thoughts of suicide received six IV ketamine infusions at three separate clinics over 21 days. Within 6 weeks of starting treatment, 20% of people with depression were considered “in remission,” meaning their depression symptoms had greatly improved, and 50% of people who had thoughts of suicide no longer experienced them. In addition, if you have depression, anxiety, or PTSD and are interested in ketamine therapy, talk to your primary care doctor and mental health provider about it, in conjunction with your usual medications for mental health. It also may be indicated for patients acutely experiencing major depression with suicidal ideation. As rates of depression and anxiety have increased dramatically, people have sought therapies outside the standard regimen of oral antidepressants and talk therapy.
Ketamine’s Unique Mechanism in Mental Health Treatment
If you are using at-home ketamine, make sure you follow the aftercare directions. Because ketamine distribution for treatment is not widely regulated, each clinic or company has their own protocol for how many ketamine sessions are recommended and how follow-up sessions and maintenance doses are handled. Avoid driving or operating machinery for at least 24 hours after you receive ketamine. Ketamine use can be fatal in people who are alcoholics or acutely intoxicated with alcohol.
