As a psychiatrist and lifelong student, I am frequently researching the advancements in mental health care and the best possible treatment plans available for my patients. My interest in exploring ketamine therapy as a practitioner started after learning about the success other practitioners were experiencing with their patients suffering from trauma. Through my research, I found that ketamine therapy in connection with psychotherapy provided patients with a safe psychedelic experience under the care of a trained practitioner.
Ketamine is an anesthetic that can be used to help treat a variety of mental health conditions, including treatment-resistant depression/major depression, anxiety, PTSD (post-traumatic stress disorder), OCD (obsessive-compulsive disorder), bipolar disorder, and certain addictions/SUDs (substance use disorders). It also has amazing effects for people with chronic pain and has fewer side effects than other pain medications. When administered by a practitioner in a controlled environment using a variety of techniques, it can help patients heal by processing, overcoming, and releasing trauma.
In preparing to provide ketamine therapy, I am addressing the frequently asked questions about the benefits, use in mental health, and treatment plans available.
What can patients expect from a ketamine treatment session?
In order for patients to have clear expectations of what they will experience, it should be thoroughly explained prior to their first ketamine session. This helps alleviate fear when the psychedelic effects are experienced. In addition, it also takes into account their intentions and desired outcome of the therapy. It is important for the practitioner to communicate that a patient might have a certain expectation of the experience and outcome and they should not be bound to this idea, but rather open and welcoming to their unknown journey. The more a patient is willing to surrender to the experience, the more enjoyable, beneficial, and helpful it will be to themselves and their healing process.
When done in a safe and supportive space, the patient can have a more beneficial experience (Gorman, I., Nielson, E., & Paleos, C., 2021). This experience can include soothing music, incorporate the connection to nature through plants, and provide the use of light. This is very different in comparison to how ketamine is often used recreationally where there might be loud music, an unfamiliar dark environment, and potentially unsafe variables. Music plays a very important role in the journey and should be carefully curated (Wavepaths, 2022). Sound therapy can include deep-toned instruments and tribal music as a way to connect to our ancestors. This is designed to facilitate patients going into a state of deep meditation and relaxation. EEG studies have demonstrated that these types of music help organize the brain waves to match those of someone who is in deep meditation, promoting healing from traumatic memories (Wavepaths, 2022).
Which method of ketamine administration has the most benefits for the body’s absorption and effectiveness?
The bioavailability, or the rate that the body can absorb a substance, varies depending on how the ketamine is administered. For instance, if it is delivered intravenously, it has a bioavailability of 100%, intramuscularly 90-93%, intranasally 25-50%, sublingually 15-25%, and orally 10% (Gorman, I., Nielson, E., & Paleos, C., 2021). When the dose is administered intramuscularly, the patient tends to feel an intense dissociation for 30-45 minutes with about a 60-90 minute time period to return to a clear state of mind. The sublingual, or oral method, usually has a period of 30-40 minutes of intense dissociation, accompanied by a 30-60 minute time frame to return to their original state (Gorman, I., Nielson, E., & Paleos, C. ., 2021). This process can vary depending on different factors of digestion. With the intravenous “all at once” method, the patient feels dissociation for 5-15 minutes and experiences about a 15-30 minute incremental return to their previous state. A benefit of using the IV method is that it can also be delivered gradually via the drip method. This has the advantage of being able to stop the infusion at any time (Gorman, I., Nielson, E., & Paleos, C., 2021).
How many treatments are typically required to experience optimal healing?
The recommended amount of treatment sessions may vary depending on the patient and the desired results. If a patient is seeking a fundamental physiological and behavioral change, then the treatment plan will require multiple sessions prescribed by the practitioner. Repeated treatments during a short time span have been shown to elongate healing results by three to six months. Patients often notice a temporary relief from pain and suffering after only one session (Gorman, I., Nielson, E., & Paleos, C., 2021).
When seeking ketamine treatment for mental health, it is important to consider the environment, form of administration, and the desired outcome. Treatment plans and healing centers designed by practitioners offer a safe and controlled environment to experience the therapy. In order to achieve optimal healing, a treatment program should be followed and used in connection with psychotherapy.