Ketamine-assisted therapy is gaining recognition as a novel and effective treatment for a variety of mental health conditions. Despite its increasing use, there are still many misconceptions surrounding this treatment. In this article, we’ll address some of the common myths and provide clarity on what ketamine-assisted therapy truly offers.
Myth #1: Ketamine is Incompatible with Antidepressants
One of the most pervasive myths about ketamine-assisted therapy is that it cannot be used in conjunction with antidepressants. In most cases this is not true. Ketamine works mainly on the glutamate system rather than the serotonin system, which is the primary pathway affected by most antidepressants. Ketamine can usually be given alongside SSRIs or SNRIs, but some medications, including MAOIs, stimulants, benzodiazepines and lamotrigine, need review first. Your psychiatrist will review your full medication list before treatment and will never ask you to stop an antidepressant without a supervised plan.
Myth #2: Ketamine is Only for Treating Depression
While ketamine is most commonly associated with treating depression, it is far from being a one-trick pony. Research is expanding into its potential for treating a wide range of mental health conditions, including post-traumatic stress disorder (PTSD), anxiety disorders, and even chronic pain. Ketamine’s ability to enhance neuroplasticity— the brain’s ability to form new neural connections—opens up possibilities for its application in various therapeutic settings beyond depression.
Myth #3: Ketamine is Dangerous
Ketamine has garnered a reputation as a dangerous substance, largely due to its misuse in recreational settings such as nightclubs and parties. When it is given by trained clinicians in a controlled environment, with screening and monitoring, the risks are much lower, but they are real. Racemic ketamine is FDA-approved only as an anesthetic, so using it for depression, anxiety or PTSD is off-label, and its long-term psychiatric safety has not been established. It can raise blood pressure and cause sedation, dissociation and nausea. It is a Schedule III controlled substance with potential for misuse, and heavy or long-term use has been linked to bladder problems. Ketamine can usually be given alongside SSRIs or SNRIs, but some medications, including MAOIs, stimulants, benzodiazepines and lamotrigine, need review first. In a therapeutic context, the dose and purity are carefully controlled, which reduces, but does not remove, the risk of adverse effects.
Myth #4: Ketamine Causes Brain Damage
Concerns about ketamine causing brain damage often stem from instances of chronic abuse of the drug at high doses. Studies of supervised, low-dose treatment have not shown the kind of harm seen with heavy recreational use, but long-term data on repeated psychiatric use are still limited. Research suggests ketamine may enhance neuroplasticity and promote the formation of new neural connections, which may be part of how it helps some people with depression.
Myth #5: Ketamine is Only Administered Intravenously
While intravenous (IV) ketamine infusions are the most well-known method of administration, they are not the only option available. Ketamine can also be given as a lozenge that dissolves under the tongue or as an injection, and esketamine (Spravato®) is a nasal spray used in a certified office. Your clinician will explain which options are appropriate and where treatment takes place. The FDA has also warned against using compounded ketamine at home without medical monitoring.
Myth #6: Ketamine’s Effects are Fleeting
There is a misconception that the antidepressant effects of ketamine are only temporary. While it’s true that the immediate effects of ketamine may wear off after a few days or weeks, the integration of psychotherapy into ketamine-assisted treatment offers long-term benefits. Some studies suggest that when combined with therapy, ketamine may lead to more sustained improvements in mental health, as the insights and changes brought about during treatment are reinforced and integrated into the patient’s life.
Myth #7: Ketamine Causes Prolonged Dissociation
Dissociative experiences are a known side effect of ketamine therapy, but they are usually brief and manageable with the help of a clinician. During treatment, patients may experience a feeling of detachment from their surroundings or body, but this effect is temporary and typically resolves soon after the session ends. Most patients return to normal functioning relatively quickly, and the dissociative effects are generally mild and short-lived.
Bonus Myth: Ketamine is Ineffective for Anxiety
Though ketamine is most commonly associated with treating depression, it is also showing promise in treating anxiety. While there is more research on ketamine’s effects on depression, early studies suggest it may reduce anxiety symptoms and improving the quality of life for those suffering from anxiety disorders. As research continues to evolve, ketamine may become a valuable tool for addressing anxiety in addition to other mental health conditions.
Conclusion
Ketamine-assisted therapy is a powerful and emerging treatment that holds great promise for a variety of mental health conditions. By debunking these common myths, we hope to provide a clearer understanding of the potential benefits and limitations of ketamine therapy. When administered responsibly and as part of a comprehensive treatment plan, ketamine can offer a new path to healing for those struggling with mental health challenges.
References
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