Category: Research

What exactly is it that makes ketamine therapy “work” on mental health disorders such as depression? How does ketamine therapy work in the brain? A study co-lead and co-seniored by Alex Proekt, MD, PhD, an associate professor of Anesthesiology and Critical Care at Penn, shows how researchers found the “Switch” that ketamine activates in the brain.

Ketamine Therapy Neuroscience

The “switch” was located in the NMDA receptors and ion channels (HCN channels) in the brain. Neuro-electrical activity is blocked at this junction in the brain’s neurons while under the effect of ketamine. Researchers then surmised that they could induce the same effect on these receptors and channels without ketamine or other chemical stimuli.

Their theories were proven correct when they were able to recreate ketamine’s effects in the brain without administering the drug, instead by inhibiting the specific neuroreceptors.

Psychedelic Therapy Without Ketamine?

The miraculous new idea that has been drawn from this study is that in the future, researchers and therapists may be able to induce psychedelic therapy (like is done in ketamine therapy clinics), but without having to administer ketamine itself.

Though the research is still in its infancy, this adds to the already numerous studies into ketamine therapy that therapeutic potentials for depression, anxiety, mood disorders, and many other mental health conditions.

The Science of Dissociation

The study also noted that while some neurotransmitters were blocked by ketamine, other areas were activated with the use of ketamine. It is thought that this is what provides the “Wakefulness” of psychedelic experiences and the euphoria associated with dissociative effects. The mind is simultaneously activated and deactivated in all the right regions to allow a state where the ego can be suppressed and the individual gains spiritual insight.

Cichon, J., Wasilczuk, A.Z., Looger, L.L. et al. Ketamine triggers a switch in excitatory neuronal activity across neocortex. Nat Neurosci 26, 39–52 (2023). https://doi.org/10.1038/s41593-022-01203-5

Ketamine therapy is incredibly young — with the majority of research studies only completed within the past 10 years (2013-2023). However, the most compelling research on topic has been from the actual patients and psychotherapists using ketamine therapy.

Patients, therapists, the Food and Drug Administration (FDA), and National Institute of Mental Health (NIMH) are all giving their feedback on ketamine therapy, with many calling the successful ketamine treatment cases “life-changing.”

One of the biggest proponents of ketamine therapy is also the researcher responsible for bringing ketamine therapy to a broader audience in recent years: Dr. Carlos Zarate.

A Brief History of Ketamine Therapy for Depression

In the article: “Cracking the Ketamine Code,” Dr. Carlos Zarate of the National Institute of Mental Health does a wonderful job of summarizing the early successes through the current innovations with ketamine.

Dr Zarate and colleagues are diving deeper into how ketamine works to treat depression in even newer studies, including “Role of NMDAR inhibition in ketamine action.”

Podcast on Ketamine Therapy with Dr. Carlos Zarate:

Dr Zarate is a leading researcher and advocate for ketamine for medical uses. We highly recommend his research, podcasts, media, and opinions for those interested in the scientific side of ketamine therapy.

Carlos A. Zarate, M.D. is Chief, Section on the Neurobiology and Treatment of Mood Disorders and Chief of Experimental Therapeutics and Pathophysiology Branch (ETPB) at the National Institute of Mental Health, and Clinical Professor of Psychiatry and Behavioral Sciences, at The George Washington University.

Ketamine Therapy for Bipolar Disorder?

Ketamine therapy for bipolar disorder is currently an off-label use of ketamine, but Zarate and other researchers are hoping to see the same success as seen with depression. In his research: “Bipolar disorder: candidate drug targets” Zarate details what drugs may offer therapy for treatment-resistant bipolar disorder and mania.

 

 

Ketamine therapy is a promising new type of psychedelic assisted psychotherapy that has been used in treating a variety of mental health issues including trauma, PTSD, anxiety, and depression. More recent studies have shown that ketamine therapy also has therapeutic potential for Obsessive Compulsive Disorder (OCD), Eating Disorders, and Substance Use Disorders (SUDs).

What is the Obsessive–Compulsive Spectrum?

Obsessive Compulsive Disorder (OCD) is one  mental diagnosis within the Obsessive Compulsive Spectrum.  The Obsessive Compulsive Spectrum  features even more disorders that are linked to OCD through the symptoms of obsessive thoughts, compulsive disorders, and anxiety.

Other diagnoses in the obsessive compulsive spectrum include substance use disorders (alcohol abuse, alcoholism, opioid use disorders, and drug use), eating disorders and many different anxiety disorders. These are all very closely linked, and therefore all show great potential for therapeutic treatment with ketamine therapy.

How Can Ketamine Therapy Help Treat Eating Disorders?

In a study on ketamine therapy by Giovanni Martinotti, researchers found that:

“…Glutamatergic neurotransmission plays an important role in ED, particularly in Anorexia Nervosa.”

In addition to this, ketamine therapy displays anti-obsessional effects. Eating disorders often involve obsessional thoughts; sometimes obsessional thoughts about body image, or fears, or obsessive cravings.

Sufferers of “Pica,” an eating disorder that involves “eating strange items” like wax or wood, are compelled to eat these items and have no control of their actions. This lack of control is a compulsive behavior, and pica sufferers may also suffer from OCD or other obsessive-compulsive spectrum disorders.

Links Between OCD and Substance Abuse

Substance abuse disorders and OCD are both on the obsessive-compulsive spectrum of disorders, so it is common to have an OCD sufferer also abuse drugs and alcohol. Those that recover from substance abuse issues may find themselves battling OCD in addiction recovery. Often, when quitting drugs and alcohol, the body and brain will switch obsessions. This is why many recently-sober individuals suddenly become obsessed with cleaning, organization, exercise, diet, and other obsessive thoughts. It is important to have good therapy and mental health counseling to handle all of these symptoms.

How Does Ketamine Therapy Work Therapeutically?

This is a difficult and complex question to answer, since we are talking about how the psychedelic experience changes a person’s view on their own life, personal traits, and habits. We don’t know the exact mechanism at work in ketamine therapy, but we know it shows therapeutic potential and ketamine therapy patients insist it works for them.

Once you experience a psychedelic experience, and the introspective thoughts that accompany it, you will have a more familiar understanding of what a psychedelic “trip” is and feels like. For those who have not experienced a trip, it can be described as a waking dream, but extremely focused (as opposed to a night dream that is scattered, and you often have trouble remembering details or meanings).

“Awakening The Person In Charge Of Your Body and Mind”

During a psychedelic experience, you may feel a deeper connection to your own self than you have experienced before. This experience is described as “seeing the fabric of the universe,” or becoming aware of your place-in and connection-to the universe around you. Many state that this connection “awakens” a sense that you are in-charge of your own existence, your body, and your mind. You have a job to do: keep your body and mind healthy and happy. For many, this reminder is enough for them to get over all their mental blocks, ruts of depression, and mental health issues.

Ketamine Therapy for Depression, Anxiety & OCD

Esketamine (The form of ketamine nasal spray used in ketamine therapy) is approved for use in treatment resistant depression and depression with thoughts of suicide. Ketamine therapy for OCD is an off-label use, though it shows great potential for therapy for multiple co-occurring disorders.  Depression, Anxiety, and OCD are all closely linked through the obsessive-compulsive spectrum of disorders, so it is only natural that symptoms of all the linked disorders would decrease with ketamine therapy treatment.

Eating Disorder Treatment and Ketamine Therapy

Ketamine therapy sessions at the Arizona Psychedelic Assisted Psychotherapy Institute (AZPAPTI) are overseen by Dr Melissa Ferrell and the staff with Active Recovery Care. Their specialties include all of the closely-related disorders on the obsessive-compulsive spectrum of disorders. This makes AZPAPTI the most well-equipped ketamine therapy clinic for those suffering from multiple mental health and physical health concerns.

How To Start Ketamine Therapy for OCD

The very first step in starting ketamine therapy is to start your consultation for treatment. This will cover all of your patient-intake information, and will schedule you for your preliminary screening. *NOTE – you must be pre-qualified first before you can receive ketamine therapy.

• Does Blue Cross Blue Shield Cover Ketamine Therapy?
• Does Medicare Cover Ketamine Therapy?
• Does Aetna Cover Ketamine Therapy?
• Does Cigna Cover Ketamine Therapy?

Qualification for Ketamine Therapy

Once you are qualified, our team will ensure that your therapy session lengths and dosages match your clinical needs. We will also ensure that you are scheduled for the accompanying medications and therapy sessions — which are required for treatment and qualification.