How is Ketamine Therapy Used for Depression Photo

How is Ketamine Therapy Used for Depression?

Today, there are many effective medications and treatments for the millions of people who experience depression. But none of them are a “one-size-fits all” solution. In fact, for nearly a third of those diagnosed with depression, conventional depression treatments are not effective. Every person’s genetics and experiences are so diverse and unique that it often takes trying a variety of therapies to find the treatment that works best for you—sometimes even more so for those with severe or treatment-resistant depression

The good news is that as science and medicine advance, experts continue to discover more treatment options for depression. One of the most groundbreaking treatments for depression and other mental health disorders is ketamine-assisted therapy (KAT).

You may have heard of ketamine because of its most common medicinal use: as an anesthetic during surgical procedures. Today, medical professionals know that lower doses of ketamine can have fast acting and, even sometimes long-lasting, antidepressant effects. And decades of mental health research support this. 

This breakthrough in depression treatment has led to hundreds, if not thousands, of outpatient KAT clinics opening throughout the U.S. At The Sanctuary, though, we’ve holistic ketamine-assisted treatment for depression as a complementary therapy for our inpatient rehab clients. 

If antidepressants or other treatments for depression have not helped you, ketamine may be the effective alternative you’ve been waiting for. Understanding exactly how professionals use ketamine therapy to treat depression may help you decide if it’s a treatment you’d like to include in your recovery journey. 

Ketamine as an Alternative Treatment for Depression

Gaining a full understanding of how ketamine is used starts by learning about its clinical uses, what its physical and psychological effects are and how long the medicine stays in your body. 

Administering Ketamine for Medicinal Use

Ketamine is classified as a schedule III substance in the U.S., which means that while the government controls it, it’s legal for certain medical purposes such as sedation. Because of this, when used as a treatment for depression and other mental health or substance use disorders, ketamine can only be administered by medical professionals in a clinical setting. 

Unlike oral antidepressants which are in pill form, you can receive ketamine treatment intravenously, through an IV,  or intranasally, via a nasal spray. In 2019, Sparavato, a ketamine nasal spray, was approved by the FDA as a prescription medication for treatment-resistant depression. With a prescription, patients usually take the nasal spray (made of esketamine—a form of ketamine) in addition to oral antidepressants to ease the symptoms of depression. 

Studies do show that intravenous ketamine is more effective than intranasal esketamine. One review, published in January 2021 in the Journal of Affective Disorders, concluded that “relative to intranasal esketamine, intravenous ketamine demonstrated more significant overall response and remission rates, as well as lower drop-outs due to adverse events.”

Both outpatient and inpatient ketamine clinics have now provide intravenous ketamine treatments to clients who qualify for ketamine therapy. At The Sanctuary, we also offer IV ketamine sessions for our residential rehab clients at our state-of-the-art, on-site ketamine clinic. 

Ketamine’s Effects on Our Bodies and Brains

One of ketamine therapy’s most unique qualities is how quickly it starts working. Its rapid antidepressant effects are what make ketamine a particularly lifechanging treatment for many people with depression, especially those experiencing suicide ideation. Whereas conventional antidepressants, such as SSRIs like Prozac, can take several weeks before being effective, ketamine typically begins working within hours.

One 2006 trial, published by the American Medical Association, tested ketamine’s rapid antidepressant effects in people with major depression and found that patients “showed significant improvement in depression… within 110 minutes after injection.” The medicine continued to have a “very large” effect after 24 hours and a “moderate-to-large” effect after one week.

Scientists are still researching and learning exactly why ketamine has rapid and, in some cases, long-lasting effects. What we do know, as shown in many studies, is that ketamine helps decrease the stress response in the brain by blocking certain proteins that “overexcite” the brain’s cells. At the same time, research shows that ketamine also helps some patients’ brains build more neural, or synaptic, connections. In other words, ketamine therapy can help regenerate connections between brain cells that have been damaged by stress and depression. This in turn then opens up new neural pathways for the formation of positive thoughts, behaviors and connections.

Read more about the science behind ketamine therapy. 

Ketamine for Treatment-Resistant Depression

As mentioned above, ketamine’s rapid antidepressant effects are especially beneficial for people who have treatment-resistant depression and are also experiencing suicidal thoughts. One study reported that “a single subanesthetic dose of IV ketamine has rapid effects on suicidal cognition” and that “acute improvements in suicidality can be sustained through repeated ketamine infusions.” Though researchers in the same study acknowledge that ketamine therapy may not be suitable for everyone, when clinically administered and safely monitored, IV ketamine is “an attractive therapy for acutely suicidal depressed patients.”

The Director of the Yale Depression Research Program, Gerard Sanacora, PhD, MD, told Yale Medicine in a 2017 interview, that ketamine’s fast-acting effects “is important because we know that the longer someone stays in a depressive state, the higher chance they might do something to harm themselves.”

“The most rewarding thing for me, as a doctor, is seeing severely depressed patients who have failed multiple treatments experience changes on the same day they start this new drug,” said Dr. Sanacora. 

How Often Do You Need Ketamine Sessions?

Unlike oral antidepressants, you do not need to ketamine daily. Rather, KAT takes place in medically supervised sessions that can last up to a few hours. It is common for people receiving ketamine therapy to need repeat sessions at regular intervals, either a few days or a few weeks apart, depending on their needs. If ketamine-assisted treatment is a part of your inpatient rehab program at The Sanctuary, you’ll likely receive two ketamine sessions per week, which is standard at many residential rehab centers.

The dosage and frequency of ketamine therapy that is right for you, as well as your body’s physical response to KAT, depends on several factors including your age, body mass and metabolic rate. One 2012 study comparing the results of different trials reported that the response rates of intravenous ketamine after a single, subanesthetic dose “ranged from 25% to 85% at 24 hours postinfusion and from 14% to 70% at 72 hours postinfusion.” This difference in response and the variety of factors that might affect your response are why all clients, whether outpatient or inpatient, must consult with medical professionals and can only receive KAT in a clinical, supervised setting. 

How KAT Takes Place in Inpatient Rehab Centers

In most outpatient KAT clinics, clients receive a ketamine infusion and then may or may not have a debriefing session with a counselor before going home. Either way, they’re essentially left to process the effects of the ketamine therapy on their own. At The Sanctuary, we do not believe that ketamine therapy should be administered or offered as a standalone treatment. We do recognize the healing potential of ketamine-assisted treatment, though, which is exactly why we’ve created an on-site ketamine clinic. 

Ketamine therapy has the potential to be incredibly healing because it opens up your mind, physically and psychologically, to new thoughts and behavior patterns. But these healing effects may be even more effective when combined with other forms of therapy, like talk therapy and cognitive behavioral therapy (CBT). The results from one 2021 study show that “CBT may sustain the antidepressant effects of ketamine” in people with treatment-resistant depression. 

For this reason, we believe it’s important to integrate ketamine-assisted treatment into your overall recovery program. After a KAT session, many of our clients feel a more direct, clearer connection to their thoughts and feelings. They may even have a clearer idea of the source of their traumas. 

But having this new perspective is not enough. You must be able to process these emotions to address the issues at the core of your depression. One of the best ways to do this is through individual and group counseling, or talk therapy. An inpatient rehab setting allows you to maximize the benefits of ketamine therapy. This takes place in the combination with other, equally important therapies. 

The Sanctuary’s Ketamine-Assisted Treatment for Depression

The Sanctuary’s residential rehab program for depression consists of a combination of treatments. These complement each other to benefit you the most on your path to recovery. This is why ketamine therapy at The Sanctuary isn’t simply an “add-on” treatment. 

First, your clinical team will see if you qualify for KAT and wish to proceed with treatment. Then, your ketamine therapy sessions at The Sanctuary are holistically integrated into your customized healing program. Here, there’s no one “primary” treatment that is more important than the others. Rather, all of your treatments work together to support you synergistically as you work towards healing. 

The Setting

The first noticeable difference between The Sanctuary’s inpatient ketamine treatment center and outpatient ketamine clinics is the atmosphere. A relaxing, comfortable environment is an essential part of your healing journey. We now extend that comfort to our KAT center. This specialized treatment room does not feel like a sterile clinic. Though it does house all necessary medical equipment for ketamine sessions. Big, cozy couches and warm blankets help you ease into your session. You’ll be soothed by a curated playlist and surrounded by plants, healing crystals and landscape paintings.

During Your Ketamine Treatment

Every KAT session at The Sanctuary begins with an intention-setting ceremony. This special time invites you to clear your mind and focus on being present with your thoughts and emotions. Up to five other clients may join you in receiving KAT. We make sure each of your sessions are intimate and inviting. The Sanctuary’s on-staff licensed medical professionals will administer and supervise the ketamine infusion. While you receive your treatment, two to three expert staff members remain present to support each person during their experience. 

After Your KAT Session

Once you finish treatment, you’ll attend a light processing session so you don’t have to reflect on your experience alone. Then, you’ll enjoy an organic, home-cooked dinner accompanied by your peers. This intimate dinner takes place separately with clients who also received KAT. 

The following day, you’ll have an individual therapy session. This allows you to process your ketamine therapy experience in detail with your personal counselor. This is how your KAT sessions integrate into your overall healing journey. And through this full-circle process, you can take advantage of all of the healing benefits ketamine has to offer.

Is Ketamine the Right Depression Treatment for You?

In the past several decades, ketamine-assisted therapy has opened up new pathways to healing and recovery. This breakthrough therapy benefits many people with depression who may have otherwise lost hope. KAT isn’t a treatment option for everyone. But for those who qualify, it may have the potential to change your life. And it’s especially effective when integrated into your holistic residential rehab program. 

Discover if The Sanctuary’s holistic ketamine treatment program for depression is right for you. Contact us today to learn more. 

B. Forrest Shenkman, N.M.D. Signature Photo

Dr. Forrest is a licensed Naturopathic Physician specializing in retreat-style holistic medicine, natural detoxification and cleansing, mind/body medicine, and regenerative medicine. Dr. Forrest brings to his work a sense of humility, respect, and compassion that is too often absent in the sterile, rigid world of modern medicine. He is deeply honored and grateful to be continuing this work as part of the community and healing that is taking place at the Sanctuary. [email protected]