Ketamine can be administered in a number of ways, including intravenous infusion (IV), intramuscular injection (IM), as well as via nasal sprays and lozenges or rapid dissolving tablets that are placed under the tongue. At Mindspace, presently only nasal spray and rapid dissolving tablets are used for ketamine-assisted psychotherapy. The specific dose and method is determined on a case-by-case basis with your medical team at Mindspace.
What is ketamine?
Ketamine is a synthetic pharmaceutical compound classified as a dissociative anesthetic. It is a widely used medication and is on the World Health Organization’s List of Essential Medicines. It was developed in 1963, approved for use in 1970, and adopted by many jurisdictions because of its rapid onset, proven safety, and short duration of action.
Ketamine is most commonly used as an anesthetic agent in surgical and emergency department settings due to its good safety profile. It has also been utilized successfully in managing acute and chronic pain conditions due to its analgesic properties.
While ketamine is known to be used recreationally as a street drug outside of medical applications, its use in this context is unrelated to medical and therapeutic use, which is known to be safe and associated with positive outcomes.
In the last two decades, ketamine has been increasingly clinically applied at subanesthetic doses as an off-label treatment for various chronic treatment-resistant mental health conditions, such as depression, substance use disorder, post-traumatic stress disorder, obsessive-compulsive disorder, and other mental health diagnoses. If you have any questions or concerns about ketamine itself, don’t hesitate to inquire with the Numinus medical team about it during the screening process.
What is Ketamine-Assisted Psychotherapy?
Ketamine-assisted psychotherapy combines structured psychotherapy with the medical administration of ketamine. When used in relatively small doses, ketamine is a psychoactive substance that can contribute to altered or ‘non-ordinary’ states of consciousness. Recent research has shown that, when combined with forms of counselling by trained mental health professionals, these psychedelic experiences can enable people to overcome a broad range of mental health challenges, ranging from depression and anxiety to addiction and trauma.
In the context of ketamine-assisted psychotherapy, the idea is to harness the openness of this altered state with structured psychotherapy to engage with and process strong emotions that may otherwise be painful or simply difficult to access. Cultivating this emotional awareness with your therapist can then make it possible to ‘reorganize’ core experiences, see important relationships in a new light, and create a coherent and meaningful narrative that supports transformation, and coming into balance.
How does the process work? How many sessions do I have to do?
At Mindspace we have carefully designed a protocol for ketamine-assisted psychotherapy that is meant to take place over 4 to 6 weeks, and which includes an initial medical screening, followed by 2 preparatory sessions, 3 ketamine administration sessions, 3 integration sessions (where you work with your therapist to harness the power of the experience), a closing session, and final medical follow-up. The idea is to do concentrated, well-supported work in a relatively short amount of time in order to facilitate therapeutic breakthrough, and set the conditions for long-term healing and recovery. Each of our clients who enters the program is assigned a personal Health Navigator in addition to the medical and therapeutic team to assist them through the various stages in the process.
What is the actual experience like?
At the dosages provided at Mindspace, while under the effect of ketamine, you will most likely experience mild reductions in pain, anxiety and depression, in addition to other possible psychoactive effects such as:
● Increased sensitivity to light and sound
● A dream-like or ‘floating’ feeling
● Diminished body sensations
● Altered sense of time
● Mild changes in perception of sound and vision
● Relaxation of ordinary concerns and usual mindset
● Disruption of negative feelings and preoccupations
While many clients find the effects of ketamine to be pleasurable, ketamine-assisted psychotherapy can involve experiencing uncomfortable feelings, engaging in difficult interactions, revisiting painful experiences, or being challenged to see the world in new and different ways. Additional details of the therapeutic approach will be shared with you should you choose to go forward with ketamine-assisted psychotherapy.
During the ketamine dosing sessions, you will be in a room that has been specifically designed to support ketamine and other psychedelic-assisted psychotherapies, and to feel as comfortable as possible. Most clients will prefer to rest in a semi-reclined or reclined position. You will have the opportunity to wear eye-shades if desired, and preselected music, specifically designed to enhance the experience, will be offered.
Am I eligible?
At Mindspace ketamine-assisted psychotherapy is only available to individuals between the ages of 18 and 65, and to Quebec residents. At present, youth under 18 years of age, pregnant women and nursing mothers are not eligible for ketamine-assisted psychotherapy, since the effects of ketamine on pregnancy, nursing children and youth are still relatively unknown. Though research indicates that ketamine-assisted psychotherapy may be effective for a number of mental health indications, Mindspace is currently focused on addressing treatment-resistant depression.
To be eligible for ketamine-assisted psychotherapy for depression, you must be evaluated by a medical practitioner and not have any contraindications to this therapy, including any medical or other psychiatric illnesses that suggest this treatment might be unsafe. Conditions that may make you ineligible for ketamine-assisted psychotherapy include, but are not limited to: a history of psychosis (e.g. hallucinations), mania, untreated hypertension, heart disease or stroke, and seizure. Similarly, severe liver disease, untreated thyroid disorders or other medical conditions may require management prior to ketamine assisted psychotherapy.
If you are suffering from treatment-resistant depression our team will work directly with you to determine whether you are a good candidate for treatment by taking a full medical and psychological history.