Practice Statement

Dr. Cohen’s practice offers comprehensive treatment for mood and anxiety disorders. In addition to psychopharmacology and psychotherapy, Dr. Cohen’s office offers Transcranial Magnetic Stimulation (TMS), a medication-free alternative treatment for depression and other disorders; Ketamine, a cutting-edge psycho-pharmacological approach to depression; and pharmaco-genetic testing to help guide the approach to medication. 

Ketamine Uses

Ketamine therapy involves the use of an IV transfusion or nasal spray to administer the medicine ketamine. At Principium Psychiatry, we provide treatment with SPRAVATO™, also known as esketamine, in addition to IV ketamine treatments. SPRAVATO™ has FDA approval for addressing treatment-resistant depression alongside an oral antidepressant. Research suggests that ketamine and its derivatives may also treat the following conditions:

  • Generalized anxiety disorder (GAD)
  • Chronic pain
  • Post-traumatic stress disorder (PTSD)
  • Alcohol addiction
  • Bipolar disorder

Why Is Ketamine Therapy Effective?

By stimulating the production of the neurotransmitter glutamate, ketamine therapy helps the brain make new neural connections. Glutamate works alongside the neurotransmitter GABA to affect electrical activity in the brain. With glutamate having a key role in brain activity, research also indicates that it has a connection to mood. Studies show that depression and stress have a link to abnormal glutamate levels. Ketamine treatment helps a patient with a mental health condition form positive connections in the brain as they go through other forms of treatment.

The FDA approval of esketamine made ketamine treatment more accessible than ever before. Originally, patients had to receive IV transfusions of ketamine in a treatment method without FDA approval. Esketamine comes in the form of a nasal spray and requires lower doses than ketamine to produce the same results. This patient-friendly version of ketamine enables patients like you to get ketamine therapy at practices like Principium without the need for an IV infusion.

Esketamine and other ketamine therapies offer the most efficacy as part of a comprehensive treatment plan. Currently, the FDA recommends using SPRAVATO™ in combination with an oral antidepressant medicine. Your mental health provider may also recommend therapy. While ketamine allows the brain to form new connections, professionals believe that therapy and medication will further help turn these connections into positive ones.

Ketamine Therapy for Depression and Anxiety

Two decades of research support ketamine’s effectiveness as a depression treatment. Researchers believe that ketamine mainly relieves depression through glutamate stimulation. Ketamine may also address depression through other methods at the same time. It may improve communication within certain areas of the brain to provide added antidepressant effects. Some researchers think that it reduces inflammation signals related to mood disorders. Patients who have depression relief from their first few treatment sessions have a high likelihood of prolonging its effects with repeated visits.

An increasing base of research also suggests that ketamine could treat the symptoms of anxiety disorders. It shows potential for treating generalized anxiety disorder (GAD) and social anxiety disorder (SAD). Studies show that in addition to relieving feelings of anxiety in patients with GAD or SAD, ketamine can also improve work and social functioning.

Bipolar Disorder and Ketamine

Studies with patients who receive ketamine for bipolar disorder demonstrated a positive impact on the subjects’ bipolar depression. In patients with bipolar disorder who respond to ketamine, their first treatment often provides antidepressant effects within a few hours. Research involving patients with bipolar depression found similar results in patients with and without anxiety. In many cases, anxiety predicts resistance to traditional treatments for bipolar depression. The use of ketamine for anxious bipolar depression could open up new options for doctors and patients.

Currently, mental health researchers need to investigate the impact of ketamine on bipolar’s manic symptoms. They still require more evidence on ketamine’s potential to trigger mania or cycling. Thus far, there is little evidence to support ketamine leading to mania.

Ketamine Therapy for Post-Traumatic Stress Disorder (PTSD)

Since mounting evidence shows a link between glutamate and the trauma response, ketamine also shows potential as a PTSD treatment. Ketamine has a rapid effect on PTSD symptoms that lasts one to two weeks. Animal research also demonstrates that ketamine could assist in developing a healthier response to trauma. Mice that took ketamine immediately after experiencing trauma did not have an increase in passive avoidance learning. In other words, they did not change their behaviors based on traumatic events.

Alcohol Addiction Treatment With Ketamine

Through its blockage of NMDA receptors, ketamine therapy for alcohol addiction could reduce drinking behaviors. The NMDA receptors in the brain enable memory creation. Research suggests that by hindering this memory formation, ketamine can reduce maladaptive reward memories (MRMs). MRMs act as a core factor behind alcohol addiction and encourage unhealthy drinking behaviors. By suppressing MRMs, ketamine has the potential to reduce the motivation to drink.

Ketamine Therapy for Chronic Pain

The NMDA-blocking properties of ketamine may also result in relief from chronic pain. In addition to regulating mood, NMDA receptors have a connection to pain signals. When someone experiences prolonged pain signals due to chronic pain, the NMDA receptors can increase pain sensitivity. Researchers believe that ketamine blocks the excess pain signals caused by the NMDA receptors. Ketamine also has some anti-inflammatory effects that could relieve pain caused by inflammation.

While a psychiatry practice can recommend ketamine treatment for mental health conditions, patients with chronic pain may need to see a general practitioner or pain specialist.

Reasons to Choose Principium Psychiatry for Esketamine Treatment

Our patients choose Principium Psychiatry as their mental health care provider because of our:

  • Expertise: Dr. Cohen and the team at Principium have experience in multiple areas of psychiatry. They understand how to work with patients with a wide range of mental health conditions and find the right treatment for them.
  • Innovative treatments: Principium Psychiatry offers the latest treatments in mental health care, including esketamine and transcranial magnetic stimulation (TMS). Combined with established therapies in psychiatry, these new approaches provide solutions for treatment-resistant conditions.
  • Convenient location: Located by Columbus Circle, the main Principium Psychiatry office has close access to multiple metro lines. You can also find the concierge office in this beautiful Manhattan neighborhood.

Get Ketamine for Depression in New York City

Find out if ketamine therapy through SPRAVATO™ could help your symptoms. Schedule an appointment at Principium Psychiatry using our online scheduling tool.