Ketamine is a dissociative anesthetic commonly used in surgery, as well as an analgesic used for pain management. A safe, widely-used medicine in hospital settings worldwide, Ketamine has gained more widespread use in recent decades as a fast-acting antidepressant as well as as a psychedelic medicine used as an adjunct to psychotherapy.
Safety Profile
Ketamine has been FDA approved for anesthesia and analgesia since 1970, and as a mental health treatment since 2019, and is currently listed on the World Health Organization's essential medications list. Its track record of safety in emergency rooms, outpatient and psychiatric settings has created an extensive body of clinical evidence that supports its safety for psychotherapeutic use (source: Gao et al., 2016). The side effects of ketamine are mild and transient (if they do occur) and it can be safely administered with most other medications. Journey Clinical’s patient-centered collaborative care model has rigorous patient safety policies and procedures in place to safeguard patient health and support improved clinical outcomes. Click here to read our commitment to patient safety.
Routes of Administration
There are several ways to work with ketamine, including IV infusion, intramuscular injection, via nasal spray and sublingual lozenges. At Journey Clinical, we prescribe sublingual ketamine in conjunction with psychotherapy (Ketamine-Assisted Psychotherapy, or KAP). This method is more accessible and cost-effective for patients, and allows patients to experience KAP in a variety of settings (in-person, remotely, etc). Journey Clinical’s medical team only prescribes sublingual ketamine in the context of Ketamine-Assisted Psychotherapy (KAP), in which a patient is in a therapeutic alliance with a licensed psychotherapist in our network.
Ketamine and the Brain
Ketamine has rapidly-acting antidepressant and mood-enhancing effects, which can begin to take effect within 1-2 hrs of administration. It works by blocking the brain’s NMDA receptors as well as by stimulating AMPA receptors, which are thought to help form new synaptic connections and boost neural circuits that regulate stress and mood. Ketamine has also been shown to enhance overall neuroplasticity for lasting symptom improvement.
How Ketamine Feels
The effects of ketamine last for approximately 45 minutes. These effects can make patients feel "far from" their body, and facilitates shifts in perception that can often feel expansive in nature. Motor and verbal abilities will typically be reduced. During Ketamine-Assisted Psychotherapy, patients typically lie down in a comfortable position during their dosing session, wearing headphones and an eye-mask. While it may feel hard to articulate what happens during the experience, many patients feel like the insights gained are clear.
A Transformational Medicine
Ketamine’s positive effects include decreasing negative thoughts, improving neuroplasticity and building new synaptic connections for a stronger and more resilient brain. When administered under supervision in a safe environment, ketamine can help patients create lasting change, break free from old thought patterns and embrace new perspectives.