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.