Ketamine Treatments

Ketamine Therapy is the use of ketamine to treat psychiatric conditions. When used in this way, ketamine is given in doses much lower than when it is used as an anesthetic. During Ketamine Therapy, these low doses of ketamine are administered very slowly either through an intravenous (IV) infusion or an intramuscular (IM) injection (in the muscle, like a vaccine). This type of ketamine treatment is not intended to induce general anesthesia and is sometimes called “off-label” use. Ketamine is not approved by Health Canada as a treatment for psychiatric conditions, including depression.

Substantial research suggests that Ketamine Therapy is safe and effective to treat certain psychiatric conditions. Most of this research has involved adults with depression. In the research studies, about one third of individuals noticed improvement in their depression symptoms, even after their depression did not respond to established antidepression therapies. For many of these individuals, they noticed these beneficial effects rapidly.

These results have led to more research on the use of ketamine in psychiatry. Some research suggests that Ketamine Therapy may also be helpful to people suffering from posttraumatic stress disorder (PTSD) and some forms of chronic pain. These uses of ketamine are considered experimental, and ketamine is not approved by Health Canada for treatment of depression, PTSD, or chronic pain.

Ketamine Therapy is generally safe. However, some health conditions may increase the risk of Ketamine Therapy in some individuals. These include certain heart or cardiovascular conditions, liver disease, substance use disorders, or psychotic disorders such as schizophrenia. The effects of ketamine on a developing baby still in the womb, or on a breastfeeding infant, are unknown and may be harmful. Women who are sexually active and could become pregnant should talk to their doctor before deciding to receive Ketamine Therapy.

Before receiving Ketamine Therapy, an assessment is completed to evaluate your health and whether ketamine treatment may be right for you. Completing this step helps make sure that each person is safe and healthy to receive Ketamine Therapy.

Ketamine Therapy is typically given as a series of treatments. When the patient arrives for treatment, a number of steps will take place before the treatment begins. First, the patient has a brief exam by the nurse and doctor. Next, the risks and benefits of the treatment are reviewed. And then the treatment itself begins.

Ketamine may be administered through an injection into the muscle. Blood pressure is often measured. After the injection, the treatment team will monitor for a period of time until they are safe and ready to leave the treatment suite.

A typical course of Ketamine Therapy for depression is a total of 6 treatments given 2-3 times per week. A typical course of ketamine therapy for PTSD is 1-2 treatments administered 2-3 days apart. The exact number of treatments may vary for each person. The treatment team will work closely with the patient before and throughout the course of Ketamine Therapy to determine the number of treatments that are right for each patient.

Like any medical treatment, Ketamine Therapy has risks and potential side effects. Each person who receives Ketamine Therapy may respond differently. To reduce the risk of side effects, each person receiving Ketamine Therapy receives a medical evaluation before beginning treatment. Most side effects from the treatment go away on their own within a few minutes or after the treatment is over. There are no reports of long-lasting side effects in published studies.

Common side effects include: fast or irregular heartbeat, increased blood pressure, clear dreams that may seem real, confusion, irritability, floating sensation, feeling “out-of-body,” breathing problems, coughing, nausea, vomiting, muscle twitching, muscle jerks, muscle tension, increased saliva (spit), increased thirst, headaches, metallic taste, constipation, and blurry or double vision.
Rare side effects include: allergic reactions, skin rash or pain at the infusion site, ulcerations (open sores) and inflammation (swelling or irritation) in the bladder, hallucinations (seeing or hearing things that are not really there), euphoria (a feeling of extreme happiness), involuntary eye movements, low mood, or suicidal thoughts.

Ketamine can be a drug of abuse. When used to “get high,” ketamine is taken more rapidly and at much higher doses than are used in Ketamine Therapy. During Ketamine Therapy treatments, individuals should not feel intoxicated or “high.” Still, for some people, Ketamine Therapy may carry the potential for abuse and dependence. These problems have not been reported with repeated administration of ketamine for the treatment of depression. Nonetheless, an individual with addiction or a substance use disorder may not be a good candidate for Ketamine Therapy.