What is Ketamine?
Ketamine has been commonly used for anesthesia since the 1960s. It was preferred as an emergency anesthetic due to its high safety profile, minimal impact on respiratory function, and its fast action. It was frequently used for field surgeries during the Vietnam War when traditional general anesthesia wasn’t possible. Ketamine was FDA approved for anesthesia use in 1970 and continues to be heavily used by EMS, emergency rooms, and veterinary services.
Clinicians began to notice that Ketamine, when given to agitated patients as a sedative, had positive mental health effects that lasted long after the sedative effects wore off, such as a decrease in suicidal ideation and improved mood.
For about 30 years, ketamine has been researched as a treatment option for most mental health disorders. Today, there is a significant body of evidence to support its use in the treatment of depression, PTSD, bipolar depression, substance use disorder, chronic pain and obsessive compulsive disorder.
How does ketamine work?
Like most psychotropic medications, Ketamine is not fully understood in terms of its effects on the mind and body. However, we do know that Ketamine is a non competitive N-methyl-D-aspartate (NMDA) receptor antagonist. The NMDA receptors help regulate the flow of electricity due to glutamate binding to the NMDA receptor, resulting in a flow of certain ions. This flow of energy is associated with synaptic plasticity, learning, and memory formation. Ketamine is believed to increase neuroplasticity, which is the brain’s ability to create new connections and develop new patterns.
Our brains have a common pattern of communication between neurons referred to as the default mode network (DMN) which develops over our lifetime based on our unique experiences, environment and genetics. Ketamine and other psychedelics disrupt the DMN, allowing people to have profound benefits in changing the way they view themselves, the world, and how they connect with their environment.
For additional resources on Ketamine check out the following resources:
Article with links to multiple videos
https://psychedelic.support/resources/ketamine-treatment-guide-for-mental-health/
Ketamine is considered very safe when taken in a monitored setting for clinical use. What are the risks?
Blood pressure and heart rate changes
A transient increase in blood pressure and heart rate is common and expected. It has also been observed that some patients have a decrease in blood pressure and heart rate. Your blood pressure and heart rate will be assessed prior to treatment and after treatment. Ketamine is not a good fit for anyone with underlying conditions that makes it dangerous to have an increase in blood pressure or heart rate such as an aneurysm, history of a brain bleed, or cardiac instability.
Nausea or vomiting
Approximately ⅓ of individuals undergoing ketamine treatments experience some nausea either during or after the treatment. To reduce the risk of nausea, it is recommended to avoid eating any food for 2 hours prior to treatment, and to limit fluid intake for the 30 minutes leading up to the treatment. An oral anti nausea medication such as Zofran can be provided as needed.
Sedation and Decreased Coordination
During treatment, most patients report feeling deeply relaxed and may experience dizziness, vertigo and decreased coordination if they try to walk. Therefore, patients will maintain a comfortable position during the treatment. In the event they need to walk to the restroom, they will be assisted by their provider. These effects wear off after the treatment, but it is important to use caution and avoid engaging in activities such as driving, operating machinery, taking a bath, using a hot tub until the effects wear off completely.
