Reviewed by Dr. Omar Elhaj
Ketamine therapy has recently gained popularity as an innovative approach to treating various mental health conditions. As with any emerging treatment, ketamine-assisted healing underwent extensive research and peer review before it became available to the public. Still, with recent headlines connecting ketamine to the tragic death of beloved “Friends” actor Matthew Perry, we understand the rise in public speculation about ketamine’s safety and efficacy as a mental health treatment.
In light of recent headlines and the alarming increase of at-home ketamine providers, we want to clear up some misinformation about ketamine therapy. In this blog post, we’ll explore four key considerations that individuals should be aware of before starting ketamine therapy.
Related: Learn more about the origins of ketamine-assisted healing, its effects, potential mental health applications, and the treatment process in a previous blog post, What Is Ketamine-Assisted Healing and Therapy?
Ketamine Therapy: What You Should Know
1. Avoid At-Home Ketamine Companies
While the ease of access may be appealing, at-home ketamine use can be extremely dangerous – ketamine therapy should not be self-administered.
The rise of online platforms offering “too easy” access to ketamine subscriptions or sessions is a cause for concern. Many ketamine delivery companies will approve use with a simple questionnaire before collecting payment information, but ketamine is a powerful dissociative anesthetic, and its effects can vary widely among individuals.
Prescribing ketamine and allowing consumers to self-administer at home is extremely risky; when used without proper medical supervision, ketamine can lead to various health risks and adverse effects, outlined below.
Potential Risks of Unsupervised Ketamine Use
Overdose
Taking too much ketamine can result in an overdose, which may cause serious health complications, including respiratory depression, cardiovascular issues, and even death.
Dependence and Addiction
Regular use of ketamine, even in lower doses, can lead to tolerance and dependence. Chronic use may result in addiction, with individuals experiencing cravings and compulsive drug-seeking behavior.
Adverse Psychological Effects
Ketamine can induce intense and unpredictable psychological effects, including hallucinations, confusion, and dissociation. These effects may be overwhelming and potentially lead to accidents or risky behavior.
Impaired Coordination and Judgment
Ketamine can impair motor coordination and cognitive function, increasing the risk of accidents, falls, or other injuries – especially if the individual attempts to perform activities that require focus and coordination. This side effect can be especially hazardous outside of a controlled clinical environment.
Allergic Reactions
Some individuals may be allergic to ketamine, and self-administration can lead to severe allergic reactions. Symptoms may include difficulty breathing, swelling, and rash. Taking ketamine outside of a clinical environment also increases the risk of adverse drug reactions – especially for individuals who fail to disclose their medication regimen or substance use.
Risk of Contaminated Substances
Obtaining ketamine from unregulated sources increases the risk of receiving a product that is contaminated or adulterated with other substances. These contaminated substances can lead to unpredictable and potentially fatal effects.
Calling out companies that provide ketamine without proper medical oversight is essential – the absence of a qualified medical professional during administration increases the risk of adverse reactions and potentially dangerous situations. At-home ketamine companies are just one step beyond recreational ketamine use, and both options are not the same as medically supervised ketamine therapy.
Individuals seeking ketamine therapy should prioritize clinics or practitioners who adhere to strict medical guidelines and provide in-person supervision. This leads to our next point …
2. Professional Supervision Is Essential
Before embarking on any treatment protocol – mental health or otherwise – providers should always discuss any potential safety and efficacy concerns with their clients. Ketamine therapy is more than just a conversation with a therapist or a virtual meeting with a doctor; it requires the presence of a qualified medical team in person throughout the treatment. This team should be capable of preventing or reacting promptly to any unforeseen issues that may arise during the ketamine session.
A well-rounded medical team may include healthcare professionals and therapists with experience in emergency response. Professional supervision from multiple providers ensures the best possible treatment experience for every client and facilitates a comprehensive approach: therapists guide the psychological aspects of the experience, and medical personnel provide an added layer of safety and support.
Ketamine providers must complete extensive training before administering ketamine therapy – and only administer treatment in a controlled clinical environment. Providers are required to conduct extensive screenings before approving a client for treatment. Most importantly, healthcare professionals can determine the proper dosage, potential treatment contraindications, and any adverse medication reactions.
3. Ketamine Requires Thorough Assessment and Monitoring
Before initiating ketamine therapy, a thorough assessment is imperative. Responsible ketamine providers should consider a client’s medical history, previous treatment approaches, any past or active substance misuse, and the client’s individual mental health goals before recommending treatment. Overlooking any of these factors can pose significant physical and mental health risks.
There are many different evidence-based options for treating depression and other mental health conditions. A responsible provider should consider recommending traditional medications (including antidepressants, antianxiety medications, etc.) and therapy (or a combination of the two modalities) before referring a client for ketamine treatment.
After conducting extensive screening and approving a client for treatment, monitoring throughout the treatment process is equally important. Regular check-ins with the medical team help track a client’s progress, adjust treatment plans as needed, and address any emerging concerns promptly. This proactive approach enhances the overall effectiveness and safety of ketamine therapy.
Providers must follow the science and clinical guidelines properly to realize the benefits of ketamine-assisted healing safely.
4. Ketamine Therapy Is Not a Mental Health Silver Bullet
While ketamine therapy can be a powerful mental health tool, it is not a cure-all or a silver bullet; ketamine alone does not solve all problems. To maximize its benefits and ensure the highest safety standards, individuals undergoing ketamine therapy should also engage in regular therapy and psychiatric care.
The integration of ketamine therapy with ongoing mental health support ensures a holistic approach to well-being. Therapy helps individuals process and integrate the insights gained during ketamine sessions, fostering long-term emotional and psychological growth. Neglecting regular therapy sessions and psychiatric care in favor of ketamine alone is not only irresponsible but may limit the sustainable benefits of the treatment.
Other Considerations for Ketamine Therapy
JAMA Psychiatry recently published an article outlining the key points healthcare practitioners, policymakers, patients, and families should consider in regard to ketamine therapy. This publication emphasizes the rapidly shifting landscape of ketamine treatment in the US; as treatment providers, we have a duty to our clients, and we must stay up to date on the latest science regarding emerging treatments.
Plus by APN Ketamine-Assisted Healing
At Plus by APN, ketamine-assisted therapy happens in four distinct stages.
Initial Contact and Screening
First, a client interested in ketamine-assisted healing reaches out to our team. Our contact center will follow up to gather your information and send it along to our ketamine-assisted healing team.
You will receive a call from a Plus by APN team member to assess your story, discuss treatment options, review payment, and take steps to see if you are qualified for treatment.
Preparation
Next, the client meets with a provider to discuss their goals, intentions, and concerns before their first session. The provider will explain what to expect and attempt to alleviate any concerns. They may also offer specific cues related to individual symptoms.
Treatment
A ketamine-assisted therapy session typically lasts three hours. First, a medical provider administers ketamine in a calm environment with limited stimuli. A therapist, psychiatrist, nurse practitioner, or physician assistant remains in the room and offers support based on the client’s needs.
Clients typically start noticing the effects of ketamine after 15 to 20 minutes. Effects peak for about 40 minutes and slowly dissipate over the following two hours.
Sometimes, challenging emotions and experiences surface during the session. Therapists can respond accordingly and help clients navigate emotional discomfort. As the effects wear off, clients work with a therapist to process emotions and integrate the experience.
Continuous Monitoring
A medical provider and therapist work together to monitor progress, make adjustments, and bolster client outcomes throughout the course of treatment. You can contact your treatment team at any time to provide feedback for the best possible treatment outcomes.
Final Takeaways: Is Ketamine Therapy Safe?
Many clients who complete ketamine-assisted therapy refer to the experience as life-changing – this treatment offers another tool to help them transform their lives for the better. However, like any other treatment, ketamine must only be administered in a clinical environment by a medical professional.
Embarking on ketamine therapy is a significant decision that requires careful consideration of various factors. From the dangers of self-administration to the importance of a qualified medical team and the need for thorough assessment and monitoring, individuals should approach ketamine therapy with a well-informed perspective. Providers are responsible for their clients and must conduct extensive screening and inform them of any potential risks and shortcomings.
Remember: ketamine is a valuable tool when integrated into a comprehensive mental health care plan, but only when that plan includes regular therapy and psychiatric support. At Plus by APN, we prioritize our clients’ well-being with a holistic approach to mental health treatment. Every client is different and requires a personalized treatment protocol to ensure the best possible outcomes.
Reference
- Wilkinson ST, Palamar JJ, Sanacora G. The Rapidly Shifting Ketamine Landscape in the US. JAMA Psychiatry. Published online January 03, 2024. doi:10.1001/jamapsychiatry.2023.4945
