What is Ketamine Assisted Therapy(KAT)?
Ketamine-assisted therapy (KAT) is a unique therapeutic method used to address a variety of mental health conditions, including depression, post-traumatic stress, chronic pain, addiction, and some forms of anxiety. It involves the use of the psychoactive substance ketamine to enhance and deepen the therapeutic process, and the use of psychotherapy and other integrative forms of treatment to amplify and prolong the curative effects of ketamine.
What is Ketamine?
Ketamine is a psychoactive drug classified as a dissociative anesthetic. It was first synthesized in 1962 and has been used in the United States as an anesthetic in medical settings since 1970. It is on the World Health Organization's List of Essential Medicines. It was first used for American soldiers who were injured during the Vietnam war.
Ketamine has been used off-label in sub-anesthetic doses for the past 20 years to treat chronic pain, depression, and a variety of other mental health concerns, thanks to its rapid onset antidepressant effects, sometimes providing nearly immediate relief from emotional and physical pain. While the antidepressant effects tend to be temporary after a single ketamine treatment, multiple treatments have proven to have a cumulative effect, successfully alleviating symptoms in approximately 30 - 60% of individuals with treatment-resistant depression.
In low doses, ketamine can serve as a supportive adjunct to psychotherapy, as it provides an opportunity for the temporary softening of the psychological defenses, allowing for deeper self -reflection and psychotherapeutic processing.
In moderate doses, ketamine has psychedelic effects, which have been shown to facilitate profound transpersonal experiences. These types of experiences can help people in a variety of ways, offering important clarity and insight into one's struggles, adding a spiritual dimension to ongoing therapeutic work, and facilitating a sense of meaning and interconnectedness.
How does Ketamine work?
Ketamine’s mechanism of action is complicated. It works on a variety of receptors, but its most potent effect is through antagonism at the NMDA receptor. This action causes a surge in glutamate, which is the most abundant neurotransmitter in all vertebrates. Glutamate is involved in learning and memory formation, as well as stress reactivity. There is an accompanying release of BDNF (Brain Derived Neurotrophic Factor), also known as “miracle grow for the brain." BDNF promotes neuroplasticity and synapse formation, and is thought to be necessary for the anti-depressant effects of ketamine.
Who should consider KAT?
Ketamine is used off-label for a variety of mental health struggles, including depression, chronic pain, anxiety, post-traumatic stress disorder, and addiction. There tends to be a cumulative effect to medicine sessions and the positive mental health changes tend to be more sustained with multiple doses and better integrated when used in the context of therapy.
Some medical and psychiatric conditions need to be treated before you can safely work with ketamine. These include hallucinations, untreated mania, cardiovascular disease, uncontrolled hyperthyroidism, increased intracranial pressure, cystitis, or evidence of liver disease.