Ketamine Therapy: How Does It Work?

There has been a lot of talk about ketamine recently, particularly with the tragic death of Matthew Perry. While many folks seem concerned about this practice, most do not know the practical applications of how ketamine is used therapeutically. Here is a simple overview of the methods of ketamine-assisted psychotherapy.

Why Ketamine?

Ketamine has been used as an anesthetic for decades. That’s why we know just how safe it is. More recently, it was discovered that it can be an incredible antidepressant. In fact, ketamine is much more effective than any antidepressant you can find on the market today. Now we’re seeing that ketamine can be very effective at treating PTSD and other anxiety-related disorders. But just how exactly does it work?

Routes of Administration

IV:

There are four methods of consuming ketamine. The strongest method is through an IV. The bioavailability of an IV treatment is 99%. The way this works is you will go to a doctor's office or clinic where you will be hooked up to an IV for anywhere between 40 to 60 minutes. The benefit of the IV is that you can titrate up or down during the session, and you are getting a consistent dose the entire time. The drawback of this type of administration is the intensity. You can expect to go on a very strong journey when you receive an IV session, which some folks find overwhelming. For IV treatments, I'd highly recommend Golden Afternoon.

IM:

The other option is an intramuscular injection. The bioavailability with an injection is also quite high, between about 93% and 95%. However, the dose that you get will not be consistent. Rather, once the shot is administered, about a couple of minutes later, you will experience a very strong peak. This will last for about 10 to 15 minutes. Then the dose will gradually decrease throughout the rest of the hour-long session. You can expect to have very intense psychedelic experiences through this administration as well.

Oral:

One of the milder forms of ketamine therapy is through using an oral lozenge or rapidly dissolving tablet. The benefit of these is that you can do the treatment at home, and the experience is much milder. The drawback is that the bioavailability of this treatment is much lower, around 20% to 30%. There are many online retailers that prescribe ketamine lozenges, such as Mind Bloom.

Intranasal:

The last method is also quite mild: a nasal spray. A great benefit of this treatment is that it is actually covered by insurance, so it is very inexpensive. For the IM and IV treatments, you can expect to pay anywhere from $500 to $800 per session. The lozenges are cheaper and should cost you around $200 to $125. Your insurance company will mandate that you do this spray in a doctor's office, so you will not be able to do this at home. Again, one of the issues with this treatment is that it frankly just isn’t strong enough for most people.

Why Integration Therapy is Critical

Most importantly, you want to work with a trained therapist to integrate the experiences you’ve had. During your ketamine session, very powerful images, dreams, ideas, and even memories will surface. The intensity of these will increase dramatically, depending on the strength of the dose you take. It is essential to have a therapist to guide you through these experiences. Have a therapist with you during the ketamine journey, have a therapist to work with after the session—or both.

If you’re curious to see if you would benefit from ketamine assisted psychotherapy, you can learn more here.