At Home Ketamine
Below are some of the 23 Psychiatry frequently asked questions.
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How does Ketamine Work? Ketamine is a dissociative anesthetic which increases glutamate through N-methyl-d-Aspartate (NDMA) antagonism.¹ The increase in glutamate and brain-derived neurotrophic factor (BDNF) leads to neuroplasticity in the brain. Enhanced neuroplasticity allows neurons to form new connections with one another, and even allows our brains to re-organize damaged pathways. Through synaptic plasticity, glutamate and BDNF are involved in enhancing brain circuit activity and thus improving depression and cognitive function such as learning and memory.² Ketamine is also believed to exert therapeutic effects by reducing default mode network (DMN) activity resulting in reduced negative thinking and rumination. ¹ To harness the window opened by the neuroplastic state, it is significant in the treatment process to explore insights gained from each treatment session through integration practices in the days that follow. ¹ Integration may including journaling, mindfulness, and any other wellness practices one enjoys such as exercise, walking, spending time in nature, and connecting with loved ones.
What will the Ketamine experience be like? The experience can be different for everyone. During treatment you will likely achieve a dissociative state. This can range from a deep meditative, relaxing state to changes in emotional or physical perceptions. You are still in control. You might experience a dream like trance or heaviness in your body. You are aware of who you are, but negative self-talk can quiet down. It’s not a hallucinogen, but you could see colors or memories. Regardless of the magnitude of dissociation of each treatment session, there is an accumulated effect, with improvements in depression and anxiety increasing over the subsequent weeks.
Is Ketamine safe and what are common side effects? Ketamine’s safety and tolerability has been demonstrated since the 1970s.³ Regular, long-term, recreation use of ketamine can lead to tolerance and dependence, however, there have not been reports indicting concern for addiction in this treatment structure.² Side effect typically are transient and last only a couple of hours. Side effects include but are not limited to: elevated blood pressure and heart rate, excitability, unsteady gait, lightheadedness, dry mouth, nausea, dizziness, and mental confusion.²
What are the chances of a negative experience with Ketamine? Critical to the ketamine experience is establishing a positive “set and setting” such as your intentions and mood prior to treatment and the physical and interpersonal environment in which you undergo the treatment.⁴ The likelihood of a negative experience is lessened by establishing a safe and positive “set and setting” going into treatment. However, challenging experiences do occur and can be part of the healing process. 23 Psychiatry will be present along your treatment journey to support you.
What are the contraindications for At Home Ketamine Treatment? Ketamine allergy, cardiovascular instability, untreated hypertension, liver failure, kidney failure, current mania or psychosis, past diagnosis with primary psychotic disorder, actively suicidal with intent or plan, current substance use issues, pregnant/might be pregnant or trying to conceive, elevated intraocular pressure/active glaucoma, unstable thyroid condition, dementia, severe breathing issue, elevated intracranial pressure, or other serious medical condition. *In addition, You MUST have a supportive adult at home with you during each treatment session. We will provide you more information on their role, but in general they simply check-in on you periodically during your treatment session and can get in contact with 23 Psychiatry if needed.