Dr. Soto

Mar 222 min

Ketamine Assisted Psychotherapy (KAP): Your Q&A Guide and Resource Bank

Ketamine is now an “off-label” treatment for various chronic “treatment-resistant” mental health conditions. Ketamine is a Schedule III medication that has long been used safely as an anesthetic and analgesic agent and now, often effectively for treatment of depression, alcoholism, substance dependencies, PTSD and other psychiatric diagnoses.

How Does It Work?

The current, most probable, understanding of ketamine’s mode of action is as an NMDA antagonist working through the glutamate neurotransmitter system. This is a very different pathway than that of other psychiatric drugs such as the SSRIs, SNRIS, lamotrigine, antipsychotics, benzodiazepines, etc.

Ketamine is classified as a dissociative anesthetic, dissociation meaning a sense of disconnection from one’s ordinary reality and usual self. At the dosage level pre prescribed to you for your KAP session and will self-administer, you will most likely experience mild anesthetic, anxiolytic, antidepressant and, potentially, psychedelic effects. Reaching a psychedelic or "dissociative" effect can be important for a "transformative" experience. This may well include a positive change in outlook and character.

Essential to the method is a time-out of usual experience, this period can vary in duration, usually 30 minutes to 2 hours, that tends to be dose and method of administration related. Relaxation from ordinary concerns and usual mind, while maintaining conscious awareness of

the flow of mind under the influence of ketamine is characteristic. This tends to lead to a disruption of negative feelings and obsessional preoccupations. It is our view that this relief and the exploration and experience of other possible states of consciousness are singularly impactful.

What is the Therapist doing?

The therapist acts as a guide to the experience and process of the experience and its impacts with our patients before, during and after the sessions. You may experience important changes in personality, mood and cognition during treatment, in the aftermath, and in the days and weeks that follow. Some experiences may be temporarily disturbing to you. The ketamine experience itself is designed to enable your own healing wisdom to be accessed and beneficial to you. The psychotherapy support you will receive will aid you in making your experience(s) valuable and understandable to you. We will endeavor to assist you in changing patterns of mind and behavior that are of concern and cause you difficulty.

Resources:

Psychology Today: An Introduction to Ketamine-Assisted Psychotherapy

Ketamine-assisted psychotherapy provides lasting and effective results in the treatment of depression, anxiety and post traumatic stress disorder at 3 and 6 months: Findings from a large single-arm retrospective effectiveness trial

Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy

Ketamine Assisted Psychotherapy: A Systematic Narrative Review of the Literature

The Impact of Childhood Maltreatment on Intravenous Ketamine Outcomes for Adult Patients with Treatment-Resistant Depression

Efficacy, Safety, and Durability of Repeated Ketamine Infusions for Comorbid Posttraumatic Stress Disorder and Treatment-Resistant Depression

Ketamine and psychotherapy for the treatment of psychiatric disorders: systematic review

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