What is Ketamine?
Any man could, if he were so inclined, be the sculptor of his own brain.
-Santiago Ramon Cajal
What is Ketamine?
Ketamine is now an “off-label” treatment for various chronic “treatment-resistant mental conditions. Ketamine is a Schedule III medication that has long been used safely as an anesthetic and analgesic agent and now, often effectively for treatment of depression, alcoholism, substance dependencies, PTSD, and other psychiatric diagnoses. Ketamine creates a window of neurogenesis where neurons are more actively open to looking for new connections. This makes us more amenable to new practices, changes, and new thought patterns.
The purpose of the ketamine experience is to create a non-ordinary (“altered”) state of consciousness to facilitate profound transpersonal peak experiences. These may prove to be auspicious in resolving your existential problems, accelerating your psycho-spiritual growth and leading to a deep personal transformation and optimization of your lifestyle. Such change is best facilitated within a structured supportive psychotherapeutic milieu in connection with therapists who have a view of your issues, hopes, desires, and struggles. As a byproduct of your experience, you may well feel improvement in your emotional state and reduction in symptoms that bother you such as depression, anxiety, and post-traumatic manifestations. You may well notice that you are a bit different after a ketamine experience and that difference may well be liberating and allow for new mindfulness and new behavior.
How does it work?
The current, most probable, understanding of ketamine’s mode of action is as an NMDA antagonist working through the glutamate neurotransmitter system. This is a very different pathway than that of other psychiatric drugs such as the SSRIs, SNRIS, lamotrigine, antipsychotics, benzodiazepines, etc.
Ketamine is classified as a dissociative anesthetic, dissociation meaning a sense of disconnection from one’s ordinary reality and usual self. At the dosage level administered to you, you will most likely experience mild anesthetic, anxiolytic, antidepressant and, potentially, psychedelic effects. More recent work has demonstrated the possibility of an antidepressant response to low doses of ketamine administered intravenously, intra-nasally and sublingually (orally) that produce minimal psychedelic effects, this effect tending to be more sustained with repeated use and psychotherapy.
Essential to both methods is a time-out of usual experience, this period being of varying duration, usually 30 minutes to 2 hours, which tends to be dose and method of administration related. Relaxation from ordinary concerns and usual mind, while maintaining conscious awareness of the flow of mind under the influence of ketamine is characteristic. This tends to lead to a disruption of negative feelings and obsessional preoccupations. It is our view that this relief and the exploration and experience of other possible states of consciousness are singularly impactful. As therapists we act as guides to the experience and process the experience and its impacts with our patients before and after the sessions.