Ketamine therapy is gaining popularity, growing from a surgical anesthetic and street drug to one of the most effective solutions for treatment-resistant depression. Since the FDA approval of esketamine (Spravato) in 2019, the growing use of IV ketamine has been gathering increased recognition for its powerful effects. In addiction to depression, it can also treat PTSD, anxiety, and chronic pain.

If your doctor has recommended ketamine treatment, you may be ensure of what to expect. This article explains the process to ensure you are fully prepared.

What is Ketamine Treatment?

Administration

Ketamine cann be administered as a nasal spray ot IV treatment, as follows:

  • Nasal Spray: A prescription medication typicall used in combination with oral medications to relieve treatment-resistant depression.
  • Ketamine Infusion Therapy: Off-label, meaning it has not been FDA-approved; typically administered in clinical settings onnly.

According to a JnJ Medical Connect study, IV infusion therapy produces 54% success rates compared to 37% with nasal spray.

Treated Mental Health Conditions

Ketamine is typically offered to people who haven’t responded to two treatments for major depressive disorder. It can also treat other mental health disorders, like:

  • Post-traumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)
  • Chronic pain
  • Suicidal thoughts

How It Differs From Typical Antidepressants

Unlike typical antipressants, which target serotonin and dopamine, ketamine acts as an N-methyl-D-aspartate (NMDA) receptor agoinst, influecing the brain’s glutamate system. These alterations increase the brain’s neuroplasticity, allowing it to develop new connections, pottentialy minimizing feelings of anxiety and depression. Ketamine also works faster than traditional medications, with results often occurring after a single session.

A 2022 PubMed study reveals that a single dose of ketamine increased dentritic spine density and reduced depression within a day. however, ongoing effects are environment-contigent.

Ketamine vs. Typical Antidepressants Table

Typical Antidepressants Ketamine Therapy
Onset of Action 2-6 weeks Hours to 24 hours
FDA Approved Yes Esketamine only
Treats Suicidal Ideation Slowly, if at all Rapid effect
Maintenance Daily oral medication Perioidic infusions
Insurance Coverage Yes Esketamine only
Requires Clinical Setting No Yes

What Happens Before Your First Treatment

Before ketamine therapy begins, clinical professionals will conduct an in-depth analysis. They will want to know your physical and mental medical history, including any history of substance use disorder.

The proiveder  will then offer informed consent, explaining off-label status, if necessary, alternatives, and side effects. Pre-session instructions are typically part of that consent and include:

  • Not eating for at least six hours before infusion
  • Not taking certain medications before infusion
  • Having someone available to drive you home after treatment

What Ketamine Therapy Is Like

Ketamine is always administered in a private treatment room in a clinical setting. IV infussions typically take 40-60 minutes;  intranasal therapies may be a bit shorter.

Providers typically create a shooting environment during treatment by using eye shades and music and guiding patients through the session.

How Does Ketamine Therapy Feel Like?

Patients often describe sessions as realxing or even euphoric. However, some have bad experiences as they relive negative experiences and emotions. An experienced provider can guide the sessions in a positive direction.

What Happens After a Typical Session?

Ketamine therapy has been shown to increase neuroplasticity, promoting new connections. As a result, individuals are often open to new emotions and experiences. However, the way they experience emotions can vary.

Therapy is necessary to promote a positive result. Cognitive-behavioral talk therapy is often integrated because it helps people experience emotions in a positive way. Even a discussion with a therapist can help.

After a session, most patients report feeling emotional clarity. However, ketamine therapy side effects like grogginess, cognitive fog, dissociative effects, and emotional rawness may linger. It is even possible to experience flatness and dread, which may dissipate in time.

Follow-Up Protocol

While treatment plans may vary, most patients receive six to eight doses over two to three weeks. After the initial stage of treatment is complete, they may continue therapy with monthly or quarterly treatment sessions. However, follow-up may be more intense, depending on the severity of the condition.

Who Isn’t a Good Candidate for Ketamine Therapy Sessions?

Depression can be treated with ketamine therapy

While ketamine therapy is generally safe, it is not recommended for people with the following conditions:

  • Cardiovasculat Conditions: Ketamine stimulates the parasympathetic nervous system, producing spikes in blood pressure that can be dangerous for people with cardiovascular conditions.
  • Certain Psychiatric Disorders: The therapy can cause adverse effects in individuals with psychosis and schizophrenia. Bipolar disorder is more nuanced and should be carefully assessed before the application of ketamine assisted therapy.
  • Substance Misuse: Illicit substances can increase ketamine’s negative side effects.
  • Pregnancy and lactation: Ketamine has not been proven safe for people who are pregnant ot lactating.
  • Medications: Certain medications can interact with ketamine, notably benzodiazepines and antipsychotics.

BNI Treatment Centers Offers Effective Treatment for Mental Health Symptoms

At BNI, we understand the intricacies of mental health conditions in teens. We take a customized aprroach, ensuring our therapies are suited to our clients’ lifestyle and recovery goals. Our academic support ensures students can get through our program without missing school.

Contact us to learn more about our treatment options.

FAQs

Ketamine therapy nasal spray is typically covered by insurance as it is FDA-approved. IV ketamine therapy may not be covered.

While ketamine can be addictive, the tendency is much lower than that of other drugs. Additionally, it is administered in a clinical setting to prevent illicit use.

Hallucinations are not likely in the clinical sense. In other words, you probably won’t see or hear things that aren’t there. However, you may experience abstract colors, patterns, and vivid imagery.

When taken recreationally, ketamine is typically administered in much higher doses in an uncontrolled setting. This varies from clinical administration, in which doses are relatively small and controlled.

The acute effects of ketamine therapy typically last 30 to 60 minutes, while the therapeutic benefits last weeks to months.

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    Dr. Aram Keshishyan

    Dr. Aram Keshishyan, PsyD.

    Aram Keshishyan, PsyD. is a bilingual, Armenian-speaking, licensed clinical-forensic psychologist who has been practicing since 2013. Dr. Keshishyan emigrated to the United States at the age of 1 and grew up in the highly diverse Los Angeles County area. He obtained a Bachelor of Arts degree in Psychology from the University of California, Los Angeles, and Master of Arts and Doctorate of Psychology degrees in Clinical-Forensic Psychology from Alliant International University, Alhambra.

    Dr. Arastou Aminzadeh

    Arastou Aminzadeh, MD

    Dr. Aminzadeh co-founded BNI to provide patients with exceptional and complete care that goes beyond the regular standards. Each individual is unique and based on each person's genetic makeup, some have a more painful response to challenges that arise on their journey and need assistance to get back on track.

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