WHAT IS KETAMINE? AND OTHER FREQUENTLY ASKED QUESTIONS (FAQ)
What is psychedelic medicine?
Psychedelic medicine is an emerging field of therapeutics that is very different from other interventions like SSRIs, benzodiazepines, and conventional talk therapy. Drugs like Prozac and Xanax treat second-order symptoms, whereas good talk therapy can reveal new insights into the causes of one’s problems, and psychedelic medicines are remarkable because they hold potential to do both at once, with limited use. They do so via the induction of anomalous states of conscious experience wherein one can directly access alternative perspectives to long-standing life challenges by stepping out of heavily conditioned thought-patterns.
What is psychedelic therapy?
Psychedelic therapy is the intentional accessing of anomalous states of conscious experience to ascertain insights that, when applied, can lastingly improve one’s daily life satisfaction. Ketamine, like other psychedelics, can open a door to entire new dimensions of inner experience. And although the experiences themselves are transient, it is extremely common that people discover applicable insights during the time their consciousness is expanded by ketamine.
What is Ketamine?
Ketamine, a “dissociative anesthetic,” is a uniquely safe medicine that shows efficacy across multiple domains of medical practice. At high doses, ketamine works like a numbing sedative, and is used during intensive surgery across age groups. At lower, “subanesthetic” doses, ketamine brings about a psychedelic effect which can produce visions and alterations to your subjective sense of self-identity, especially your awareness of your body and the perceived linearity of your thinking mind.
Is it safe?
Under clinical supervision, the use of ketamine is extremely safe. For the application of treating mental health disorders, we use doses that are significantly lower than when ketamine is used as a sedative anesthetic for intensive surgeries. There is essentially zero risk of overdose or lasting negative consequences from the use of ketamine barring highly specific circumstances such as a pre-existing history of schizophrenia or psychosis. Our clinical team will work with you to help identify any factors that may be important to consider when asking if ketamine is right for you.
Is it effective?
Ketamine reliably provides remarkable anomalous experiences, and clinical research suggests that ketamine therapy is particularly effective as a response to depression. The going hypothesis is that ketamine interrupts ruminative thinking and emotional suppression by inducing the anomalous state of conscious experience.
What are the benefits?
Ketamine provides a robust yet transient experience of significant symptom relief from depression by interrupting ruminative thought-patterns. The relief is brought about quickly and immediately by the acute, temporary effects of the drug experience itself, and lasts up to days, even weeks following.
What are the side/after effects?
It is common to experience nausea and brief periods of confusion or fear during the ketamine journey. We can help with these by administering anti-nausea medications and providing skillful reassurance and guidance during your session – fear is normal, and when acknowledged and faced directly, it often dissipates quickly.
Immediately following a ketamine journey, it is very common for people to experience disorientation and dizziness. This is rather common and your awareness stabilizes quickly as the drug effects fade.
The dissociative effect of ketamine is often experienced positively, but sometimes, people experience this negatively. If you experience depersonalization or extended feelings of “disconnection” from your body, we will work with you to identify whether or not continued use of ketamine is appropriate. In particular, we often recommend practicing some kind of embodied movement such as yoga, or another physical exercise, if these feelings arise.
Is it addictive?
Ketamine is a schedule III-controlled substance and is subject to all applicable rules and regulations under the Controlled Substance Act of 1970 and related legislation. When used therapeutically in a controlled setting, risk for abuse and physical dependence is minimal. Ketamine and other hallucinogenic compounds do not meet criteria for chemical dependence, as they do not result in tolerance and withdrawal symptoms. Ketamine can have effects on mood, cognition and perception that may result in the desire for repeated use by some individuals. Therefore, ketamine should never be used except under the direct supervision of licensed Medical Professionals. Please note for your safety, Within providers may request a urine drug screen at any time during your treatment course.
How is Ketamine taken?
Our highly experienced nurse practitioners will administer ketamine to you via intramuscular (IM) injection at our beautiful in-person clinic on W 22nd St. And we’ll work with you throughout the course of your care at Within to help you determine what quantities of dose will be most appropriate given your psychiatric history and familiarity with the psychedelic experience.
How do you administer Ketamine?
While there are several different methods of administering ketamine, we’ve found Intramuscular Injection (or IM) to be the most effective, so at present we only do IM.
What does it feel like to be on Ketamine?
For a very brief period of time, you will encounter what our facilitators call an “anomalous event within conscious experience.” We call this event “anomalous” because the ketamine experience is extremely unique, and hard to put into words. The most prominent effect is the “dissociative” aspect, you will feel perceptually “disconnected” from your body, almost as though you were astral projecting or lucid dreaming. You can remain aware of your body and immediate surroundings, if you try, but you can also drift away from the scene and enter indescribable realms – or what may appear to be realms – of direct, formless conscious experience.
The strangest aspect of this experience is that what you feel to be “you” – your awareness of the general situation – remains essentially the same while your awareness of your body dissolves. If you “embrace” these perceptual changes, and “accept” the experience as it arises, and “let go” of your preconceptions and expectations, and worries of the past and anxieties of the future, and enter this new experience with curiosity, then very powerful states of experience can manifest themselves.
What happens in a session?
After receiving the ketamine from the nurse practitioner, you will be encouraged to make use of eye shades and headphones, to breathe mindfully and consciously, and look within to engage directly with the experience as it arises. Our highly experienced psychedelic journey guides will sit with you during the course of your session. If at any time you feel anxious or uncomfortable, we will help you identify what is needed to help you relax and feel deeply into the experience.
What is a psychedelic experience like?
The psychedelic experience is extremely difficult to put into words – it feels more akin to dream-stimulation, or spiritual transcendence, than taking a “drug.” It is common to hear folks report having never felt anything that compares to ketamine, even if they have experience with other psychedelics. Due to these highly unique effects, it is our philosophy that the therapeutic efficacy of ketamine rests on the psychological experience of the introspective journey, and not merely with the physiological action of the drug itself.
Who can get treatment?
We’re able to administer ketamine to anyone with a relevant mental health diagnosis such as depression, anxiety, PTSD, and so forth. No prescription or referral is required, and our physicians and nurse practitioners on staff are highly qualified to identify and diagnose mental disorders during the course of your application for ketamine therapy at Within.
What does ketamine treat?
The clinical research observing ketamine for mental health has mainly focused on the diagnosis of (treatment-resistant) depression, and ketamine has displayed remarkable efficacy at treating this particular condition. The going hypothesis is that ketamine works by interrupting ruminative thought-patterns by the introduction of the brief anomalous experience of oneself and inner world.
What can I expect after a treatment?
Immediately following the experience, you are going to feel disoriented, and possibly somewhat dizzy. As your awareness stabilizes, you are likely to feel persisting changes to your sense of self. Your mind may feel “quieter” and less “busy” as the ketamine experience can strongly activate departures from ruminative thought-patterns.
Our highly experienced guides and nurse practitioners will work with you on a personalized plan to strengthen your capacities for resting mindfully in this newly accessed stability and peace. We call this work “integration.”
What is Integration?
Integration means applying the insights found during your ketamine experiences to your daily life. The experience itself can be tremendously powerful, but over time, the effects will fade and continue fading until it’s only a distant memory. Ketamine, like other psychedelics, can bring about profound temporary changes to your awareness, and there are ways to adjust your habits day to day to increase and improve your daily experience of life. These life changes look different for each person, and we refrain from encouraging you to make any big changes too quickly.
Oftentimes the urgency of change, or improvement, can be illusory itself. You are already exactly who you need to be, exactly where you are. You don’t need to run, after something else or away from anything. There is no tiger, and it’s okay to come home to yourself and be at peace.
What if I can't afford the treatments I need? Are there financing options?
Within is an approved provider for Advance Care. They offer up to 14 months of true interest-free financing. Advance Care provides the most cost-effective way to finance elective medical procedures or procedures not covered by insurance. Click here to apply for Advance Care credit.
RESEARCH ARTICLES ON KETAMINE TREATMENT
BOOK | Pollan, Michael. How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence
CLINICAL TRIAL | Berman RM, Cappiello A, Anand A, Oren DA, Heninger GR, Charney DS, Krystal JH. Antidepressant effects of ketamine in depressed patients. Biol Psychiatry. 2000 Feb 15;47(4):351-4. doi: 10.1016/s0006-3223(99)00230-9. PMID: 10686270.
CLINICAL TRIAL | Price, R.B., Iosifescu, D.V., Murrough, J.W., Chang, L.C., Al Jurdi, R.K., Iqbal, S.Z., Soleimani, L., Charney, D.S., Foulkes, A.L. and Mathew, S.J. (2014), EFFECTS OF KETAMINE ON EXPLICIT AND IMPLICIT SUICIDAL COGNITION: A RANDOMIZED CONTROLLED TRIAL IN TREATMENT-RESISTANT DEPRESSION. Depress Anxiety, 31: 335-343. https://doi.org/10.1002/da.22253
CLINICAL TRIAL | Murrough JW, Soleimani L, DeWilde KE, Collins KA, Lapidus KA, Iacoviello BM, Lener M, Kautz M, Kim J, Stern JB, Price RB, Perez AM, Brallier JW, Rodriguez GJ, Goodman WK, Iosifescu DV, Charney DS. Ketamine for rapid reduction of suicidal ideation: a randomized controlled trial. Psychol Med. 2015 Dec;45(16):3571-80. doi: 10.1017/S0033291715001506. Epub 2015 Aug 12. PMID: 26266877.
CLINICAL TRIAL: Glue P, Medlicott NJ, Harland S, Neehoff S, Anderson-Fahey B, Le Nedelec M, Gray A, McNaughton N. Ketamine’s dose-related effects on anxiety symptoms in patients with treatment refractory anxiety disorders. J Psychopharmacol. 2017 Oct;31(10):1302-1305. doi: 10.1177/0269881117705089. Epub 2017 Apr 26. PMID: 28441895.
CLINICAL TRIAL | Glue P, Neehoff SM, Medlicott NJ, Gray A, Kibby G, McNaughton N. Safety and efficacy of maintenance ketamine treatment in patients with treatment-refractory generalised anxiety and social anxiety disorders. J Psychopharmacol. 2018 Jun;32(6):663-667. doi: 10.1177/0269881118762073. Epub 2018 Mar 21. PMID: 29561204.