Ketamine-Assisted Psychotherapy – a Revolutionary New Tool in Mental Health Treatment
February 11, 2022
In recent years there has been an increase in the number of ketamine clinics offering Ketamine-assisted psychotherapy (KAP) for mental health conditions.
Using ketamine as a treatment for mental health conditions is not new. Ketamine infusions under medical supervision are used for treatment resistant depression, anxiety, PTSD and more.
This article will explore what KAP is and why it’s increasingly sought after by patients.
What is Ketamine-assisted psychotherapy?
Ketamine-assisted psychotherapy (KAP) is a new approach to treating mood disorders that combines ketamine treatment with more traditional psychotherapy (such as talk therapy) to process and integrate the experience. Ketamine-assisted psychotherapy (KAP) utilizes ketamine administered in a controlled environment with the assistance of a specially trained therapist to treat mood disorders like treatment resistant depression, anxiety, or post traumatic stress disorder (PTSD). It is used to enhance and boost the psychotherapeutic process, magnifying and deepening its beneficial effects. In KAP, ketamine is used as a tool to access the unconscious mind, allowing one to also process the experience with the help of a KAP-trained therapist.
Types of Ketamine Administration
At a clinic offering KAP, the medication can be administered orally as a lozenge, intranasally, intramuscularly, or intravenously. Each has a different timing of onset, intensity, length of action, and titratability (ability to adjust the dose during treatment).
MD Infusions uses Intravenous Ketamine infusions
At MD Infusions we use IV ketamine as the preferred method of administration. This allows rapid onset, allowing a more predictable experience that can be adjusted mid-stream, if needed, to achieve the desired level of effect. IV administration also provides the advantage of more rapidly clearing from the body after the infusion has been completed, permitting the processing and integration session with the therapist to begin. Oral, nasal, and IM formulations take longer to kick in, last much longer, achieving less predictable drug levels which cannot be adjusted as easily mid-stream to achieve the desired level of effect.
What are some benefits of Ketamine-assisted psychotherapy?
Ketamine may be used as a supportive addition to psychotherapy, since it allows for the weakening of psychological defenses, allowing for more thorough self-reflection and therapeutic processing. Many people have profound transpersonal experiences or gain access to old memories. These sorts of encounters might be beneficial in a variety of ways, including providing clarity and insight into one’s problems, adding a deeper dimension to ongoing psychological treatment, and fostering a feeling of meaning and interconnectedness. When it is administered in the controlled environment of the ketamine clinic, the therapist can assist the patient with processing the experience; patients can expect to discuss their thoughts and feelings during and after their treatment.
This discussion and integration with the therapist are important components of a transformative ketamine experience. At each stage of treatment, processing the experience deepens, extends, and amplifies the impact of therapy.
How does ketamine work in the brain to help with depression, anxiety, PTSD, or OCD?
Discovery and FDA Approval
Ketamine was discovered in 1962 by organic chemist Calvin Stevens when he synthesized it as part of a research effort to uncover new anesthetics. In 1970 it became an FDA approved anesthetic for surgical procedures.
Relief of Depressive Symptoms
After many years of clinical experience as an anesthetic, it was discovered that ketamine also appeared to relieve depression when patients were given the medication intravenously or intramuscularly during surgery. This prompted research into ketamine as a new class of antidepressant medication. In particular, the rapid improvement in symptoms combined with its new mechanism of action (compared to traditional medicines) prompted clinical trials to investigate further. Stating in the mid-2000’s medical research began in earnest into the action and effects of ketamine in the brain.
Actions in the Brain
Ketamine is an N-methyl-D-aspartic acid (NMDA) receptor antagonist that works on the glutamatergic neurotransmitter system in the brain. Glutamate is the major excitatory neurotransmitter in our nervous system, and it plays a key role in learning and memory formation. Researchers proposed that it works in the brain by blocking neuronal NMDA receptors to inhibit glutamatergic neurotransmission in the cortex, limbic system, hippocampus, striatum, thalamus, and hypothalamus.
Emotional suffering is associated with glutamatergic excitotoxicity, which means there is too much glutamate in the brain. Ketamine normalizes NMDA activity by blocking glutamate at the receptor site, improving emotional regulation, and allowing the patient to access repressed memories. This allows patients to work through difficult emotions, leading to a reduction in depression symptoms.
Ketamine has been shown to promote neurogenesis in the hippocampus where memory formation occurs. It may increase neuron generation within seven days of administration after treatment. It also stimulates the release of brain-derived neurotrophic factor (BDNF), which results in new neuron growth and increased synaptic connections. This is important for treating depression, anxiety, PTSD, OCD, addiction, chronic pain, and other mental health conditions where new learning is needed to change behavior.
What is a KAP session like?
Consultation and Meeting Your Therapist
At MD Infusions we begin the KAP process by having a consultation with the doctor to determine if you are a good candidate for KAP. Next, a meeting between the KAP-trained therapist and the patient will be set before your first KAP therapy session. On the day of treatment, you will meet the therapist in the treatment room before the infusion to establish intentions for the upcoming session.
Next, you will receive a ketamine IV infusion either with the therapist in the room to “guide” the experience, or alone with the therapist checking in periodically to see how your treatment is proceeding and to make sure you feel safe. The ketamine session will last approximately 45 minutes, after which time you will be given a brief recovery period before the processing and integration therapy session.
Integration of the Experience
The mainstay of KAP is the processing and integration session following the completion of ketamine therapy. During this session, the patient discusses the experience with the therapist. As the ketamine experience ends, it’s time for the patient to review and assess everything that the treatment exposes.
Ketamine assisted therapy is an exciting new avenue of treatment for mental health conditions. It involves a ketamine IV infusion coupled with a therapist’s guidance and help to process and integrate the experience and all that it uncovers.