What Is Ketamine Therapy?
Ketamine therapy is a medical treatment that uses a medication called ketamine to help people with treatment-resistant depression and other mental health conditions. Originally developed as an anesthetic for surgery, ketamine has been found to have powerful therapeutic effects on the brain that can quickly improve symptoms of major depression, post-traumatic stress disorder (PTSD), and anxiety. Unlike traditional antidepressants that can take several weeks or months to work, ketamine therapy often provides relief within hours or days.
Ketamine treatment involves receiving carefully controlled doses of ketamine under medical supervision. It may be administered through an intravenous infusion (IV line), an injection, nasal spray, or oral lozenge (sometimes called a ketamine troche). During treatment, patients may experience mild dissociative effects, meaning they might feel disconnected from their surroundings or have altered perceptions. These effects are temporary and monitored closely by healthcare professionals to ensure safety throughout the process.
To learn more about ketamine treatment, please contact Balanced Mind of New York to schedule a free, 15-minute consultation.
What Is Treatment-Resistant Depression?
Treatment-resistant depression refers to cases where a person’s depression doesn’t improve after trying at least two different antidepressant medications for an adequate amount of time, typically six to eight weeks each. This affects about one-third of people with major depression, leaving them with persistent symptoms despite following traditional treatment approaches. People with treatment-resistant depression often continue to experience overwhelming sadness, hopelessness, fatigue, suicidal ideation, and difficulty functioning in their daily lives.
Symptoms of severe depression can be particularly challenging for depressed patients because it may seem like nothing will help, leading to increased feelings of despair and hopelessness. Treatment-resistant depression doesn’t mean the person is treatment-resistant or that they’re not trying hard enough. Instead, it indicates that their brain chemistry may not respond to conventional medications in the typical way, making alternative treatments like ketamine therapy an important option to explore.
How Does Ketamine Treat Depression?
Ketamine works differently from traditional antidepressants by targeting a brain chemical system called the glutamate system, specifically blocking receptors known as N-methyl-D-aspartate (NMDA) receptors. This action triggers a cascade of changes in the brain that promote the growth of new neural connections and strengthen existing ones, a process called neuroplasticity. These changes help restore healthy communication between different brain regions that are often disrupted in treatment-resistant depression.
The medication appears to help “reset” certain brain circuits that have become stuck in negative patterns associated with severe depression. This neuroplastic effect can happen relatively quickly, which is why some depressed patients notice improvements in their mood within hours or days of treatment, rather than the weeks typically required for traditional antidepressants to take effect. The brain changes triggered by ketamine can also help improve the brain’s ability to adapt and respond to therapy and other positive experiences, offering new hope for relief from treatment-resistant depression.
How Is Ketamine Different From Antidepressants?
Traditional antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), work by changing levels of brain chemicals like serotonin and norepinephrine. These medications typically take four to six weeks or more to show their full effects and work for about 60-70% of people with depression. Ketamine treatment targets the glutamate system and can provide rapid relief, sometimes within hours of a single infusion, making it particularly valuable for people in crisis or those who haven’t responded to other treatments for depression.
Another key difference is how long the effects of ketamine last and how the treatments are given. Traditional antidepressants are taken daily as pills and build up in the system over time. The antidepressant effects of ketamine therapy can last days to weeks after each session. While traditional antidepressants may cause side effects like weight gain, sexual dysfunction, or emotional numbness, ketamine’s side effects are typically short-lived and occur mainly during the treatment session itself.
How Does Ketamine Treat Post-Traumatic Stress Disorder (PTSD)?
Ketamine helps treat PTSD by interrupting the brain’s tendency to get stuck in traumatic memory patterns and fear responses. People with PTSD often experience hyperactive fear circuits in their brain that cause them to remain in a constant state of alertness and reactivity to potential threats, feeling as if they are in “fight or flight” mode. The effects of ketamine treatment on neuroplasticity include calming these overactive circuits while strengthening areas of the brain responsible for emotional regulation and rational thinking.
The medication also appears to help reduce the emotional intensity attached to traumatic memories, making it easier for people to process their experiences without being overwhelmed by fear, anger, or other intense emotions. This can make traditional therapies like cognitive behavioral therapy or trauma-focused therapy more effective, as patients are better able to engage with treatment and develop healthy coping strategies. The rapid-acting nature of ketamine can be particularly beneficial for people with PTSD who are experiencing severe symptoms that interfere with their ability to participate in therapy.
How Does Ketamine Therapy Work For Anxiety?
Ketamine helps treat anxiety by targeting the same brain mechanisms that make it effective for depression, particularly its effects on the glutamate system and neuroplasticity. Anxiety disorders often involve overactive fear circuits in the brain that keep people in a constant state of worry, panic, or dread. Ketamine promotes new neural connections and strengthens healthy brain pathways, which help calm these overactive circuits while enhancing the brain’s capacity for emotional regulation and stress management.
Ketamine therapy appears to help break the cycle of anxious thoughts and physical symptoms that characterize anxiety disorders. By promoting neuroplasticity, ketamine can help the brain develop new, healthier response patterns to stress and perceived threats. This can lead to reduced physical symptoms of anxiety like rapid heartbeat, sweating, and muscle tension, as well as decreased mental symptoms, such as racing thoughts, excessive worry, and catastrophic thinking. The rapid-acting nature of ketamine can be particularly beneficial for people with severe anxiety who need quick relief to function in their daily lives.
How Is Ketamine Treatment Different From Anti-Anxiety Medications?
Traditional anti-anxiety medications fall into several categories, each working differently from ketamine. Benzodiazepines like Xanax or Ativan work by enhancing a brain chemical called gamma-aminobutyric acid (GABA) to provide rapid but temporary relief, typically lasting a few hours. These medications can be habit-forming and may cause drowsiness, memory problems, or withdrawal symptoms. Selective serotonin reuptake inhibitors (SSRIs) and other oral antidepressants used for anxiety work by changing serotonin levels but take weeks to show full effects and may cause side effects like weight gain or sexual dysfunction.
Ketamine therapy treats anxiety differently because it works on the glutamate system to create lasting changes in brain structure and function, rather than just temporarily altering brain chemistry. While traditional anti-anxiety medications often need to be taken daily and may lose effectiveness over time, ketamine treatments are given periodically and can provide benefits that last days to weeks after each session. Additionally, the side effects of ketamine are typically limited to the treatment session itself rather than ongoing daily effects.
How Is Ketamine Therapy Administered?
Ketamine therapy is administered in several different ways, depending on the specific treatment protocol and the patient’s needs. The most common method is through an intravenous (IV) infusion (ketamine infusion), where the medication is delivered directly into the bloodstream through a small tube inserted into a vein. This method allows for precise dosing and monitoring by health care providers, with treatments typically lasting 40 minutes to an hour. Another option is Spravato, an FDA-approved form of ketamine taken by intranasal administration that patients can use under medical supervision. Some providers also offer ketamine lozenges or troches, which are dissolving tablets that patients hold under their tongue or against their cheek to absorb the medication.
All ketamine treatments must be given in a medical setting with trained health care providers present to monitor the patient’s safety and response. Before treatment, patients have their vital signs checked and are made comfortable in a quiet, controlled environment. During the session, medical staff monitor heart rate, blood pressure, and oxygen levels while the patient relaxes in a reclining chair or bed. Most people remain awake but may feel drowsy or experience mild dissociative effects, which typically resolve within an hour or two after treatment ends.
What Can I Do to Get the Most Out of Ketamine Therapy?
To maximize the benefits of ketamine therapy, it’s important to approach treatment with realistic expectations and a commitment to the full treatment process. Most people need a series of treatments rather than just one session, so consistency and patience are key. Avoid alcohol and recreational drugs (club drugs) before and after ketamine treatments, as these can interfere with ketamine’s effectiveness and increase the risk of complications. Make sure to get adequate sleep and maintain good nutrition, as these factors support your brain’s ability to heal and form new connections.
Consider combining ketamine therapy with traditional psychotherapy or counseling, as many people find that the medication makes them more receptive to therapeutic work and better able to process emotions and experiences. Use the period after ketamine treatment, when you may feel more mentally flexible and open, to practice healthy coping strategies, engage in meaningful activities, or work on personal goals. Keep a journal to track your mood and symptoms between sessions, and communicate openly with your treatment team about your experiences, including any side effects of ketamine or concerns you may have.
How Do I Pay For My Ketamine Therapy?
Balanced Mind of New York is a private pay practice and does not accept insurance. We believe in providing individualized, high-quality care without the restrictions or limitations often associated with insurance-based treatment.
If you have out-of-network benefits, we’re happy to provide a superbill upon request, which you can submit directly to your insurance provider for potential reimbursement. Please consult your provider to understand your coverage and eligibility for out-of-network mental health services.
Contact Details for Balanced Mind of New York Ketamine Therapists
Please contact us at [email protected] or 646-883-5544 to schedule an appointment and take the first step toward a healthier you.