Ketamine-Assisted Psychotherapy 

Why Ketamine in depression?

Studies have shown that when conventional antidepressants have failed, ketamine can help achieve remission from depression. Ketamine is not a new drug.  It has been used for many years, and is still used in special circumstances, in anaesthesia. We have known for 20-25 years that it could also be helpful to treat depression and the first specialist clinic to use it for this indication in the UK started in Oxford 10 years ago.  We do not know how Ketamine helps people recover from depression, but we do know that it stimulates the brain to form new connections, leading to better communication between parts of the brain that, with depression, have stopped ‘talking’ to each other.  

Why Ketamine and Psychotherapy?

Ketamine works quickly in depression (for this reason, it is sometimes called a ‘rapid-acting’ antidepressant), but its effects tend to be short-lasting. Psychotherapy, on the other hand, is good at helping people think differently about their life and circumstances, and stay better for longer, but it works slowly, possibly because it requires new learning.  Thus some mental health services we combine Ketamine and Psychotherapy to maximise their effects.  Studies have shown that Ketamine does indeed make psychological therapy more effective for some people. In addition, with this combination approach the amount of medication a patient takes during treatment is much less than with standard antidepressants.

How does it work?

Unlike other antidepressants, Ketamine has to be taken at the clinic, under the supervision of a clinician.  This is primarily to prevent and to manage the acute side effects of Ketamine (i.e., those that occur in the first 60-90 minutes). In addition, as ketamine is sometimes abused by people, this requirement enables clinicians to maintain an accurate record of how Ketamine is being used.  Thus, during treatment, patients must attend the clinic to take the medication. This may be once, twice or three times a week, for between two and six weeks. When psychological therapy is paired with ketamine it tends to take place after each ketamine self-administration session.