What is Ketamine-Assisted Psychotherapy for Depression?
Why Ketamine-Assisted Psychotherapy?
While ketamine itself produces positive mental health effects, pairing it with psychotherapy produces much more satisfying and long-lasting results. Several studies have shown that ketamine contains certain properties that can help alleviate symptoms of depression, including drug-resistant cases. While these studies agreed that more research is required to establish these effects on patients, with the available evidence both from anecdotal reports and scientific works, a growing body of research clearly shows that, in addition to common mental health disorders including anxiety, panic disorder, chronic pain and trauma, depression, in particular, can be safely and effectively treated using KAP.
The following are some of the available findings on ketamine effects on depression, anxiety and other mood disorders:
Rapid and Sustainable Effects
Effective against Suicidal Thoughts and Acts
Ketamine-Assisted Psychotherapy Results
Researchers from Yale compared ketamine effects with antidepressants and other conventional treatments for depression. According to their work, ketamine produces positive effects that had not been seen before in other treatments. Firstly, it appeared that ketamine triggers the creation of glutamate, which prompts the brain to develop new neural connections. This effect makes the brain become more adaptable and able to create new pathways, thereby helping the patient develop more positive thoughts and acts more quickly. They based their investigations on patients who felt no meaningful improvement using other antidepressant medications. The results from those studies were “dramatic”, as more than half of the participants demonstrated a significant, rapid decrease in depression symptoms after just 24 hours. Further, with the help of brain imaging techniques, medical experts have been able to see direct changes in the brain which signal improvement after a person has undergone a ketamine-assisted psychotherapy session.
What Happens During a Ketamine-Assisted Psychotherapy Session?
Ketamine-Assisted Psychotherapy For Depression Treatment Guidelines
- Are American Society of Anesthesiologists Patent Status 1 (A normal healthy patient) or 2 (A patient with mild systemic disease) are usually considered appropriate candidates and are considered ideal candidates for ketamine administration.
- Report moderate/severe depressive symptoms who have failed to respond to at least 2 adequate treatment trials, those reporting acute suicidal ideation with a history of depression, and patients with co-morbid depressive symptoms and pain who cannot receive standard oral antidepressant therapy due to medical problems affecting their PO intake.
- Are without contraindications for ketamine treatment including active psychotic symptoms or history of a primary psychotic disorder (e.g., schizophrenia or schizoaffective disorder), manic symptoms, hypersensitivity to the drug or its components, history of severe, ongoing alcohol or substance dependence (including ketamine).
- A Patient Monitor: A qualified medical provider (e.g., attending or resident physician), mid-level provider (Nurse Practitioner-NP or Physician Assistant-PA), or registered nurse (RN), who observes, assesses, and documents the patient’s response during ketamine administration. The Patient Monitor must have current credentials in basic life support (BLS) and be competent in the administration of medications.
- Medical Provider: A a person licensed to practice medicine in the relevant jurisdiction. Providers in residency training must be monitored and supervised for the entire event by a faculty or fellowship-level physician with current privileges to administer moderate or deep sedation.
How to Know If Ketamine-Assisted Psychotherapy is Right for You?
How to Talk to Your Doctor About Ketamine-Assisted Psychotherapy for Depression
Simply inquiring about the appropriateness of ketamine therapy can be a source of great anxiety for many new prospective patients. While the treatment is undoubtedly beneficial for many patients, many mainstream doctors are not yet recommending ketamine treatment, so patients are best served coming to the discussion armed with knowledge, facts, and a reasoned argument. As medical practitioners deal in evidence and fact, the patient should arm themselves with widely-recognized, evidence-based results from medical journals. With this evidence, and demonstration that you fit the criteria for treatment and are aware of the costs. Remember, KAP therapy is a relatively new field of study, and your doctor may simply not be focused on the subject (and thus knows little of the research). Of course, your doctor might be a proponent of ketamine treatments, and will recommend a provider for you.
Choose a Trusted Ketamine-Assisted Psychotherapy Provider
Be Open with the Provider
Preparing for your first KAP session: Pre- and Post-Treatment Guidance
There are certain things you must observe before and after the treatment. The instructions may vary between clinics, but generally, will be as follows:
Before the Therapy
- Get a good sleep the night before your ketamine therapy to avoid feeling stressed out or overtired during the treatment.
- Do not eat for 4 to 6 hours before your appointment. While some clinics also do not permit any liquids during that period, some allow clear liquids to be consumed up to 2 hours before the treatment.
- If you are taking daily medication, you will need to seek the opinions of both your ketamine therapy provider and primary physician, as there is always the potential for interactions between new and existing medications of any kind. Your doctor(s) will let you know if you should discontinue or reduce the medications prior to the treatment.
- Wear comfortable clothing, as discomfort can affect your state of mind. You might want to bring a blanket or sweater.
- If you have quiet music you would love to listen to during the session, you should be prepared to bring headphones.
- Reschedule any important engagements for the day of your treatment, and also prepare to stay in the clinic to recover for around 20 to 30 minutes before leaving.
During the Session
- <li”>A ketamine-assisted psychotherapy session may take anything from 90 minutes to 3 hours. The exact time will depend on the particular circumstances of the patient, including how well you respond to the treatment, the dose being administered, and the scheduled recovery time after the intake of the drug.
- You will most likely be asked to sign a consent form, indicating that you are fully aware of the therapy and its potential risks.
- If the drug is to be administered intravenously, a small needle will be placed in your vein (most likely in your forearm) while you are seated in a comfortable recliner.
- Medication will be administered slowly, over the course of around 30-60 minutes, depending on what the provider deems best for your case.
- In some clinics, treatment is carried out by a team of professionals composed of psychiatrists, psychotherapists, and anesthesiologists.
- You will be monitored throughout the treatment by a nurse or another professional with expertise in life support. Resuscitation and monitoring equipment, appropriately sized to the patient, will be available at the location and the recovery area. </li”>
After the Therapy
- Arrange for a driver to take you home after the session. You should not attempt to drive for the rest of that day. You should also not try to operate machinery for the next 24 hours.
- Stay away from alcohol or other recreational drugs for 24 hours.
- Do not make any important decisions for the rest of the day!