How Does Ketamine Affect the Mind and Body?

Ketamine is a powerful drug most commonly known for its psychoactive properties and use in medical sedation. However, ketamine has long shown promise in the treatment of mental health conditions, and researchers are paying close attention to how the drug interacts with the brain and bodily functions.

What Is Ketamine for Therapeutic Use?

When people think of ketamine, they tend to associate it with recreational misuse. As a Schedule III non-narcotic, ketamine is technically a hallucinogen. However, there’s a long history of ketamine use in the medical field for general anesthesia and procedural sedation. As a dissociative anesthetic hallucinogen, ketamine can decrease a patient’s perception of pain without inducing full sedation. This is especially helpful in clinical procedures like fracture reductions and pediatric pain management.

But did you know ketamine also has documented evidence for supporting treatment-resistant mental health conditions? Ketamine-assisted therapy combines the controlled use of ketamine with psychotherapy practices to manage and reduce symptoms from conditions like depression, anxiety and post-traumatic stress disorder (PTSD). Often administered through infusions or nasal sprays, ketamine also comes in lozenge and pill form.

How Ketamine Affects the Mind

If you’re interested in ketamine therapy, it’s important to understand the way ketamine impacts the mind.

Neurological and Cognitive Impacts

Well-known for its hallucinogenic and anesthetic properties, ketamine exhibits a range of unique and varied interactions, or mechanisms of action, within the brain. In basic terms, it acts as a reset button for neural pathways.

In anesthetic uses, ketamine acts as an N-methyl-D-aspartate (NMDA) receptor antagonist, meaning it blocks the NMDA receptors from modulating the neurotransmitter glutamate. Glutamate is an essential amino acid that facilitates neural communications and other functions like pain sensitivity, learning and memory. High doses of ketamine block glutamate production, which is why it causes anesthetic effects.

However, lower doses of ketamine have been shown to increase glutamate release downstream of the receptors that ketamine binds to. This can aid in synaptogenesis, or the growth of new neural connections. Ketamine may also help repair neuron damage, which may be an essential mechanism in how it helps alleviate symptoms of depression and other mental health conditions in the long term.

In addition to glutamate, ketamine can impact the modulation of serotonin, dopamine and norepinephrine, which are essential for mood regulation and other cognitive activities. Restructuring the brain’s dopamine system may be a key reason why patients with depression respond so quickly to ketamine treatments.

Mental and Emotional Impacts

Along with its particular neurological impacts, ketamine can also alter people’s perceptions, making them feel relaxed, happy or even detached from reality. This dissociative effect is especially prevalent in high doses of the drug, but it can also occur during lower-dose clinical administration. For some, ketamine’s impacts on perception can aid in the therapeutic process — small shifts in perception and the dissolution of the ego can help people process trauma or approach challenges in a new light.

In terms of treating depression, researchers believe that ketamine’s impact on the hippocampus and the prefrontal cortex is why it’s so effective as an antidepressant. However, it functions very differently from a traditional antidepressant — ketamine can show results in a matter of days rather than weeks, and doesn’t require daily doses.

Because therapeutic doses of ketamine are so low, patients very rarely experience the extreme dissociative effects characteristic of recreational misuse of the drug. Patients may experience altered perceptions of time or space, but these are short-lived and easily managed during the treatment process.

Research is still ongoing into ketamine’s potential neurological risks and adverse reactions, making it essential to rely on an experienced practitioner for safe administration and monitoring.

How Ketamine Affects the Body

Ketamine also impacts the body, so it’s important to understand how before undergoing treatment:

• Absorption and metabolization: The body absorbs and metabolizes ketamine very quickly, though the bioavailability — or the amount of the drug that has an effect on the body — changes based on the route of administration. For example, oral administration has one of the lowest bioavailability percentages, while intravenous (IV) administration allows for full bioavailability — that’s why IV ketamine therapy is the best method.
• Cardiovascular impacts: Consuming ketamine in high doses can cause a dangerously rapid increase in heart rate that could exacerbate existing heart conditions or even cause heart failure.
• Respiratory impacts: Unlike other anesthetics, which can slow respiration and require careful monitoring, ketamine generally allows for normal respiratory functions.
• Other symptoms: In some cases, ketamine may cause nausea, vomiting, muscle stiffness, blurry vision or rapid involuntary eye movements.

Ensuring Safety in Ketamine Therapy

Every drug, even over-the-counter pain relief medication, has side effects. To ensure a safe and effective treatment, the providers at Principium Psychiatry follow the professional guidelines and best practices for ketamine administration.

Professional Supervision

While therapeutic ketamine is administered at safe, carefully controlled doses, it’s important to have a team of experienced clinicians on hand to monitor heart rate, blood pressure and oxygen levels. Every patient will receive a thorough evaluation before and during the treatment — your provider will review your goals for therapy and any concerns you have, as well as the potential side effects.

Having professional supervision means a multidisciplinary team will be able to monitor your vitals and emotional state for the entire treatment. This is especially important for anyone who has never experienced ketamine therapy before.

Eligibility and Contraindications

To understand if you are eligible for ketamine treatments, you should speak with a physician about current and past medical conditions, as well as your mental health history. You may not be eligible for ketamine therapy due to certain contraindications, or factors that make administration of the drug unsafe or unhealthy. Examples of these include:

• Pregnancy and breastfeeding: Like many medications, ketamine therapy is generally not recommended for those who are pregnant or breastfeeding, however, individualized treatment plans must balance risk vs. benefit for the specific patient and their overall health profile.
• Dual diagnosis: Ketamine is ideal for treatment-resistant conditions — however, certain co-occurring mental health disorders may impact your eligibility.
• Heart conditions: Because ketamine increases heart rate and blood pressure, some patients may require clearance from their physician or cardiologist prior to ketamine therapy. At Principium Psychiatry, we will work with your physician or refer you to a physician who can evaluate your suitability for ketamine therapy. Most patients with cardiovascular conditions can safely receive ketamine therapy.

Explore Ketamine Therapy at Principium Psychiatry

Ketamine-assisted therapy is a safe and effective treatment for conditions like depression, anxiety and PTSD, allowing patients to process trauma and explore insights that may not be available through traditional therapeutic approaches. When embarking on your ketamine therapy journey, it’s vital that you have an experienced and trusted provider by your side.

The team at Principium Psychiatry includes experienced psychiatrists, psychologists, nurses and psychiatric nurse practitioners who are all dedicated to finding effective treatments for every patient. We’re committed to providing coast-to-coast treatment services for ketamine therapy, with offices in:

• Midtown Manhattan, near Grand Central, New York City
• Lower Manhattan, near Wall Street/Tribeca, New York City
• Garden City, Long Island
• The Hamptons, New York
• Greenwich, Connecticut
• Boca Raton, Southern Florida
• Santa Monica, Los Angeles CA

Learn how ketamine-assisted psychotherapy can provide real, lasting improvement in your symptoms and quality of life. Schedule a consultation appointment today or explore some frequently asked questions about our treatment options.