Ketamine-assisted psychotherapy

Ketamine's neuroplasticity-promoting effects strengthen the cognitive restructuring that takes place through traditional psychotherapy, thereby leading to long-lasting behavioural change.

[9] Given its hallucinogenic properties, interest rapidly rose in the possibility of broader avenues of application, including within the field of psychiatry as a treatment for depression, substance use dependence, and more.

[10] The US Food and Drug Administration (FDA) first approved the use of intranasal esketamine (Spravato)—an enantiomer of ketamine—for the use of ketamine-derived therapy for treatment-resistant depression, in 2019,[11] leading to the creation and expansion of telemedicine-based companies that practice KAP, such as Mindbloom.

[12] Ketamine is currently one of the two injected general anesthetics that the World Health Organisation includes in its Model List of Essential Medicines.

Current antidepressant treatment is heavily limited by its delayed onset of efficacy, with noticeable effects only appearing over a period of months.

[16][18] Supplementing ketamine use with cognitive behaviour therapy (CBT), in particular, has the potential to help patients reverse their inaccurate beliefs and maladaptive processing of information, that lead to depressive mental states.

Notably, however, the effects of ketamine are now believed to be larger in scope than previously thought, ultimately leading to greater synaptogenesis and neuroplasticity.

[2] Ketamine has also demonstrated its ability to increase brain-derived neurotrophic factor (BDNF) levels within the brain in animal studies, which ameliorates the effects of acute and chronic stress.

[20] The subsequent increase in both synaptic excitation and neuroplasticity is believed to precipitate the powerful and immediate symptom reduction ketamine elicits for a variety of conditions.

Single-dose use has been found to have noticeable and rapid anti-depressive effects that tend to last up to a week, accompanied by acute side-effects that resolve spontaneously.

Repeated sessions of KAP have also been found to be an effective method for facilitating clinically-significant reduction in anxiety and depression, when conducted in private practice settings.

It employs a dosage escalation strategy[10] to achieve different levels of dissociative effects, depending on the amount of alteration of consciousness needed for treatment.