Over the last two decades, ketamine therapy has gained recognition as an effective psychiatric treatment. Ketamine therapy is an innovative and evidence-based approach that can help people with treatment-resistant depression, anxiety, PTSD, and even those living with chronic pain conditions. Originally used as an anesthetic, over the last two decades, ketamine therapy has gained recognition as an effective psychiatric treatment with fast-acting antidepressant effects.
Ketamine therapy
Ketamine was developed in the 1960s as a surgical anesthetic. Now, ketamine is being used to effectively reduce symptoms of depression, particularly for individuals who haven’t responded to antidepressants and conventional treatments. This treatment can help with conditions including:
- Treatment-resistant depression (TRD)
- Major depressive disorder (MDD)
- Anxiety disorder
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Eating disorders
- Bipolar depression (in some cases)
- Substance use disorders
- Suicidal ideation
- Hospice and palliative care
- Chronic pain conditions
- Personal growth and emotional healing
Different types of ketamine therapy
Ketamine therapy is available in multiple forms, tailored to fit the individual needs of each patient.
- IM (intramuscular): A clinician injects two low doses of ketamine into the shoulder. Patients reach peak dissociation state within the first 15 minutes of the treatment.
- IV (intravenous): IV ketamine treatment aka ketamine infusion therapy is conducted by a clinician. A dose is injected into the patient’s vein, directly reaching the bloodstream for fast ketamine absorption.
- Esketamine (nasal): Esketamine is a nasal spray by the brand Spravato®. It’s self-administered under strict guidance. The patient sprays the esketamine into their nose 2-3 times, each spaced five minutes apart. This treatment is approved by the U.S. Food and Drug Administration (FDA).
How does ketamine work?
Ketamine works differently from traditional antidepressants such as selective serotonin reuptake inhibitors (SSRIs), which boost serotonin. Ketamine functions by interacting with glutamate, the primary excitatory neurotransmitter in the brain, and blocking the NMDA receptors. The blockage causes a glutamate surge and activates the AMPA receptors, responsible for mood regulation. Ketamine enhances neuroplasticity of the brain, said to promote better mood regulation and the ability to form new connections, which can stop negative thought patterns from forming.
Common antidepressants take a few weeks or months to produce results, and often need adjustments in dosage or type to start working. Ketamine offers a fast onset of effects, noticeable within hours after the session.
[Source: Neuron, Duman et al., 2016; Krystal et al., 2013]
Ketamine therapy step-by-step
Ketamine sessions follow strict protocols to ensure the optimal benefits of the treatment, with structured steps such as:
- Evaluation: Patient’s treatment history and recurring symptoms are evaluated.
- Choosing a treatment plan: The type of ketamine treatment is picked according to the patient’s individual needs.
- Preparation phase: Patients are prepared by following grounding techniques and meditations guided by a clinician.
- Medicine phase: Ketamine is administered by a clinician, and the patient is monitored throughout the session. The patient reaches the peak dissociation within 15-20 minutes. Esketamine is self-administered while being supervised.
- Integration phase: After regaining full consciousness, the patient starts the integration phase, where they can reflect on the experience.
Ketamine therapy overview
Ketamine therapy is versatile in its administration and session structure. Picking the right ketamine treatment plan depends on the severity of the symptoms and the unique needs of each patient.
| Ketamine | Esketamine | |
| Administration method | IM (intramuscular), IV (intravenous): | Nasal |
| Regulatory consideration | Off-label | FDA-approved |
| Clinical supervision | Yes | Yes |
| Duration of session | Two hours | Two hours |
| Duration of treatment | Six sessions | Twice a week for four weeks, then once a week for four weeks, followed by maintenance treatments |
| Side effects | Nausea, drowsiness, lightheadedness | Nausea, increased blood pressure, headache, decreased sensitivity, blurred vision |
The importance of ”set and setting”
Ketamine therapy is conducted in a clinical setting with medical monitoring to ensure safety and effectiveness. At Kadelyx, ”set and setting” is a fundamental part of the ketamine treatment. Set refers to the mindset or individual state of the patient, and setting refers to the space where the treatment is administered. Trained professionals are there to mentally prepare each patient and welcome them into a comfortable and safe clinical space. Common ketamine treatment models include:
- Guided ketamine therapy:IM (injections), while the guide is present in the room.
- Semi-guided ketamine therapy: IM or IV (injections or infusions), while the guide monitors the session outside the room.
- Couples’ ketamine therapy:IM (injections)
- Group ketamine therapy: IM (injections) with up to four patients inside the room.
Ketamine therapy cost
In Phoenix, Arizona, the cost of ketamine therapy varies depending on the service and session type. At Kadelyx, a single session of guided ketamine therapy costs $775, $2100 for three sessions, and $3900 for six sessions, while Spravato treatment is covered by BlueCross BlueShield of Arizona (BCBSAZ) insurance.
Ketamine is a safe and straightforward approach for mental health conditions, particularly for those who didn’t see results after traditional treatment. With careful medical oversight and personalized treatment sessions, ketamine therapy can accelerate the healing process and help you achieve a better quality of life. Learn more about ketamine therapy and book your first consultation at Kadelyx Health.
