Ketamine

Ketamine has been used at high doses in medical practices as an anesthetic agent since its discovery in 1962. In recent decades, research has demonstrated that lower sub-anesthetic doses of ketamine have rapid antidepressant effects and therapeutic benefit for other mental health conditions. In 2019, Spravato (esketamine) was FDA-approved for treatment-resistant depression making it the first antidepressant medication with a novel mechanism of action since the release of Prozac in 1987. Ketamine is a racemic mixture while esketamine is only the S-enantiomer. Limited data from controlled trials suggests similar safety and effectiveness of esketamine and ketamine which is prescribed off-label for depression, pain reduction, and other indications. Although more controlled research with head-to-head comparisons is needed, generic ketamine is a much cheaper alternative to the recently marketed Spravato (esketamine).

Ketamine-assisted psychotherapy is an approach of combining ketamine with traditional modalities of psychotherapy. The therapeutic process encapsulates preparation, intention and goal setting, facilitated ketamine sessions, and follow-up integration counseling. The overarching premise is that ketamine occasions experiences that can be further examined and reflected upon within a therapeutic context. The combination of neurobiological and psychological mechanisms reveal new insights and harmonize emotions to catalyze behavioral changes for personal growth.