Ketamine is approved for use at high doses as an anesthetic in the operating room.
Although not FDA-approved, lower dose “sub-anesthetic” ketamine injections are used “off-label” to treat depression, pain, and other mental health/substance use disorders.
In recent times, there have been many factors contributing to increased depression across wide populations. There are several medications available for depression, anxiety, and substance use disorders that involve daily administration of a medication aimed at correction of neurochemical imbalances via action at specific brain receptors (e.g. serotonin, dopamine, mu opioid).
In contrast, using a psychedelic-assisted therapy model with ketamine produces a short-lived but intense subjective experience – the mystical or peak experience – which triggers or elicits an afterglow, accompanied by a subsequent positive change in affect, insight, motivation, cognition, and behavior.
The potential for mystical experiences to produce rapid, profound, and sustained changes in insight, mood, behavior, and consciousness was recognized and first used by indigenous cultures in shamanic and other healing rituals. Psychedelic-assisted therapies for treating behavioral health disorders was studied extensively and safely in approximately 40,000 patients in North America in the 1950s and 1960s.
Patients with depression, anxiety, PTSD, end-of-life distress, chronic pain, drug/alcohol problems, and other conditions may be eligible for psychedelic-assisted therapy with ketamine.
Usually, ketamine treatment includes one or a few in-clinic ketamine dosing sessions under clinician supervision integrated with preparatory and integration counseling. By harnessing the potential psychedelic effects of ketamine, the aim is to achieve more sustained results with fewer ketamine treatments compared to IV ketamine infusions without accompanying psychotherapy.
The new year could include tackling and shedding some difficult issues and making a fresh start in 2021.
By Dr. Keith Heinzerling
Dr. Keith Heinzerling practices internal medicine and is an addiction medicine specialist at the Pacific Brain Health Center at Pacific Neuroscience Institute. His clinical and research focuses are on the treatment of alcohol, drug and substance use problems, with anti-addiction medications. As director of the TRIP program, he is involved in the development of psychedelic-assisted therapies for those suffering from addiction, depression, anxiety, and PTSD. Contact him at pacificTRIP.com, or call 310-878-0929.