Ketamine was created in 1956 as a pharmaceutical anesthetic. It was placed on the World Health Organization’s list of “Essential Medicines” in 1985. Researchers in the 1990s discovered that this medicine can be a valuable tool for use in mental health treatment, especially in people who have not responded to other measures and have exhausted most avenues of treatment.
Ketamine is a legal medicine which is currently being used off-label by doctors to treat treatment-resistant depression (TRD), Bipolar Depression, Suicidal Ideation, Post Traumatic Stress Disorder (PTSD), Substance Use Disorders, Anxiety and Panic Disorders, Anxiety related to chronic or life-threatening illness, and other psychological conditions. It is distinguished from other psychotropic medications by its rapid action, often producing transient relief in as soon as a few hours to days.
Ketamine can be used in a variety of ways: intravenously, intramuscular injection, through a nasal spray, sublingually (placement under the tongue), subcutaneously, or even orally. Sublingual and Intramuscular Ketamine treatments take place in our offices and are medically monitored and supervised by Dr. Ascani.
Ketamine has dissociative effects that create a time-out from our ordinary mind. It disrupts well-established and conditioned patterns of thinking and repetitive thought loops characteristic of depression and anxiety. As prominent researcher Robin Cahart-Harris explains in metaphor: Imagine the mind is a ski slope, with certain paths becoming carved out as more people ski down. These paths are akin to thought and behavior patterns, which become more and more entrenched as people age. Taking a psychedelic, he explains, is like shaking the snow globe. For the duration of the psychedelic experience, the snow becomes level again, and all paths are available. It is an opportunity to begin new thought patterns and erase old ones. Eventually, the snow settles again, hopefully with healthier patterns in place. Ketamine helps the brain through this neuroplastic effect, leveraging this in the context of psychotherapy, creating opportunities to explore novel ways of being, sensing and feeling in a safe and calm therapeutic setting.
It is well-established that ketamine has antidepressant effects. Studies specifically looking at ketamine used together with psychotherapy are limited (see recently published KAP article). However, other work with psychedelic compounds that create similar shifts in consciousness – such as MDMA, LSD, and psilocybin – suggest that altered state experiences combined with psychotherapy can have benefits beyond the use of the medicine alone. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050654/
Ketamine is unique among anesthetic medications because it is extremely safe, having been used in various settings for more than fifty years, from pediatric emergency treatment to the battlefield. Ketamine has a higher margin of safety when used to treat depression because the doses used are much lower than those used in anesthesia.
Health conditions that might make someone not be eligible for ketamine include a recent heart attack, stroke, uncontrolled high blood pressure, poor cardiovascular health, recent history of psychosis (hallucinations, delusions), untreated thyroid dysfunction and recent bladder inflammation.
Our medical team is uniquely qualified to safely prescribe and administer Ketamine given their combined academic, medical and clinical experience. As a Psychiatrist, Dr. Ascani was trained in psychotherapy and psychopharmacology, and has specialized in the treatment of mental health conditions including Schizophrenia and Schizoaffective disorder, Depression and other mood disorders such as Bipolar Disorder, Anxiety Disorders such as Panic Disorder, and trauma-based disorders such as PTSD and Dissociative Disorders. He is adept at combining psychopharmacology, herbal and natural remedies, ketamine treatments, diet and lifestyle factors to determine what best fits with the goals of his patients. Our medical and therapy providers are all licensed professionals with specific training in Ketamine-Assisted Psychotherapy and other psychedelic healing modalities.