Ketamine is a medication that has been used for various purposes, including anesthesia and pain management, for many years. In recent times, it has also gained attention for its potential therapeutic effects in treating depression and other mental health conditions, particularly when other treatments have not been effective.

When used under medical supervision and in appropriate doses, ketamine can be safe. However, like any medication, it carries risks and potential side effects. Sometimes nausea, vomiting, confusion, hallucinations, and changes in blood pressure and heart rate may occur. These are rare occurrences. Most clients have a positive experience. At Safe Pathways Wellness we have over 25 years experience using ketamine. We provide a safe and comfortable environment for our clients.

It is essential to use ketamine only as prescribed by a qualified healthcare professional and to closely follow their instructions. 

Ketamine can be administered through several routes, depending on the purpose of use and medical context. The common routes of administration include:

Intravenous (IV) infusion: Ketamine is often administered intravenously in medical settings, such as hospitals or clinics, especially for anesthesia or pain management purposes. The medication is delivered directly into the bloodstream through a vein, allowing for rapid onset of action. This requires the placement of an IV, which can be difficult and painful and generally take away from the experience.

Intramuscular (IM) injection: Ketamine can also be administered by injection into a muscle. This method is commonly used for anesthesia in emergency situations or in settings where IV access may not be readily available. At Safe Pathways Wellness this is our preferred route of administration. It is convenient, does not require the placement of an IV and allows for onset of action within a few minutes.

Oral administration: Ketamine can be taken orally in the form of tablets or capsules. However, oral ketamine is less commonly used for medical purposes due to variable absorption and slower onset of action compared to other routes. Lozenges and troches are becoming more popular with clients who cannot get to a healthcare providers office or who prefer to stay at home. There are no great studies to support their use. They can be dangerous because there is usually no onsite provider monitoring their use.

Intranasal administration: Ketamine can be administered through the nasal mucosa using a nasal spray device. This method is increasingly used for certain medical purposes, such as for the treatment of depression. Though there is controversy over whether this route is very effective for mental health treatment.

The choice of administration route depends on factors such as the medical condition being treated, the desired onset and duration of action, and individual patient characteristics. 

Ketamine works primarily as a noncompetitive antagonist of the N-methyl-D-aspartate (NMDA) receptor, which is a type of glutamate receptor in the brain. Glutamate is a neurotransmitter that plays a crucial role in synaptic transmission, learning, and memory formation. By blocking NMDA receptors, ketamine interferes with the normal function of glutamate, leading to its dissociative and anesthetic effects.

However, ketamine’s mechanism of action is complex and involves interactions with multiple neurotransmitter systems in the brain. In addition to its effects on NMDA receptors, ketamine also interacts with other receptors, including opioid receptors, monoamine receptors (such as serotonin and dopamine receptors), and cholinergic receptors. These interactions contribute to ketamine’s diverse pharmacological effects, including its analgesic, anxiolytic, and antidepressant properties.

One key aspect of ketamine’s mechanism of action, particularly in the context of its antidepressant effects, is its ability to rapidly increase synaptic levels of glutamate and enhance synaptic plasticity. This increase in glutamate transmission leads to the activation of downstream signaling pathways involved in the formation of new synaptic connections and the regulation of mood-related brain circuits.

Furthermore, ketamine has been shown to have anti-inflammatory effects and to modulate the release of various neurotransmitters and neurotrophic factors implicated in mood regulation and neuroplasticity.

Overall, ketamine’s diverse effects on neurotransmitter systems, synaptic plasticity, and neuroinflammation contribute to its therapeutic potential in treating conditions such as depression, chronic pain, and certain neuropsychiatric disorders. 

Ketamine has the potential for addiction, especially when used recreationally or inappropriately at high doses over an extended period. It is classified as a Schedule III controlled substance in the United States due to its potential for abuse and dependence.

Several factors contribute to ketamine’s addictive potential:

Psychological dependence: Ketamine can produce euphoria, dissociation, and hallucinations, which may be appealing to some individuals seeking escape or altered states of consciousness. Repeated abuse at high doses can lead to psychological dependence, where the individual feels a strong urge to use ketamine despite negative consequences.

Tolerance: With repeated abuse at higher doses than recommended or typically used by healthcare providers, the body may develop tolerance to ketamine, requiring higher doses to achieve the desired effects. This can increase the risk of escalating use and dependence over time.

Withdrawal symptoms: Abrupt discontinuation of ketamine after prolonged abuse with high doses can lead to withdrawal symptoms, including cravings, anxiety, irritability, depression, and insomnia. These withdrawal symptoms can contribute to continued use and difficulty in quitting.

Polydrug use: Ketamine is sometimes used in combination with other substances, such as alcohol or stimulants, which can increase the risk of addiction and adverse effects.

It’s important to note that not everyone who uses ketamine will develop an addiction, and individual susceptibility to addiction varies based on factors such as genetics, environment, mental health, and patterns of use. However, anyone considering using ketamine should be aware of its potential for addiction and use it only under medical supervision and as prescribed. At Safe Pathways Wellness we use the lowest dose (60-100mg) of ketamine to get the desired therapeutic effects. Our ketamine therapy sessions are usually held once a week and they last about 1-2 hours. This is different from folks who abuse ketamine and may use upwards of 3000mg per day!

The effects of ketamine can vary depending on factors such as the dose taken, the individual’s tolerance, the method of administration, and the setting in which it is used. At Safe Pathways Wellness we strive to create a safe and comfortable environment that maximizes the positive and minimizes the negative feelings. Common transient experiences after using ketamine may include:

Euphoria: Ketamine can induce feelings of euphoria or well-being, often accompanied by a sense of relaxation and detachment from reality.

Dissociation: Ketamine is known for its dissociative effects, which can include a feeling of detachment from one’s body or surroundings. This may manifest as a sense of floating, distortion of time and space, or an out-of-body experience.

Hallucinations: Some individuals may experience visual or auditory hallucinations while under the influence of ketamine. These hallucinations can range from mild distortions of perception to more vivid and immersive experiences.

Changes in perception: Ketamine can alter sensory perception, leading to changes in how sights, sounds, and physical sensations are perceived. This may result in feelings of numbness, tingling, or a lack of sensation.

Impaired coordination and motor function: Ketamine can cause muscle relaxation and impair coordination and motor function, leading to difficulties with movement and balance.

Changes in mood: Ketamine may temporarily elevate mood and reduce feelings of anxiety or depression in some individuals. However, mood effects can vary widely, and some people may experience negative emotions or dysphoria after using ketamine.

Side effects: Ketamine can cause various side effects, including nausea, vomiting, dizziness, confusion, and changes in heart rate and blood pressure. These effects are short-lived and resolve before the end of the session.

It’s important to remember that ketamine use can also have risks and potential adverse effects, particularly when used outside of medical supervision or in combination with other substances. Additionally, individual experiences with ketamine can vary widely, and not everyone will have the same response.

Psychedelic integration refers to the process of integrating insights, experiences, and emotions that arise from the use of psychedelic substances into one’s life in a meaningful and constructive way. At Safe Pathways Wellness ketamine is the psychedelic substance used to achieve this. It involves reflecting on and making sense of the psychedelic experience, incorporating any insights gained into one’s beliefs, behaviors, relationships, and overall well-being.

The psychedelic experience can be profound and transformative, often involving shifts in perception, consciousness, and emotional processing. People may encounter a range of experiences during a psychedelic journey, including ego dissolution, mystical or spiritual experiences, confronting repressed emotions or traumas, and gaining insights into the nature of reality and the self.

Psychedelic integration acknowledges that the work doesn’t end when the psychedelic experience itself concludes. Instead, it emphasizes the importance of integrating these experiences into everyday life in a way that promotes personal growth, healing, and positive change. This process may involve:

Reflection and integration: Taking time to reflect on the psychedelic experience, including the thoughts, emotions, and insights that arose during the journey. Integration involves making sense of these experiences within the context of one’s life, beliefs, and values.

Journaling and creative expression: Writing about or expressing the psychedelic experience through art, music, movement, or other creative outlets can help facilitate integration and deepen understanding.

Integration practices: Engaging in practices such as mindfulness, meditation, yoga, breathwork, and self-care can support the integration process by promoting self-awareness, emotional regulation, and overall well-being.

Therapeutic support: Working with a therapist, counselor, or psychedelic integration coach can provide valuable support and guidance throughout the integration process. At Safe Pathways Wellness we believe these professionals can help individuals explore and process their experiences, identify areas for growth, and develop strategies for integration.

Community and support: Connecting with others who have had similar experiences or who understand the psychedelic journey can provide a sense of validation, support, and community. Support groups, online forums, and integration circles can be valuable resources for sharing experiences and insights.

Overall, psychedelic integration is a holistic and ongoing process that recognizes the potential for profound personal transformation and growth that can arise from the psychedelic experience. This process can take days, weeks and months. By intentionally integrating these experiences into one’s life, individuals can harness their insights and learnings to cultivate greater self-awareness, resilience, and well-being.

At Safe Pathways Wellness we use ketamine to treat a variety of conditions including:

Depression: Ketamine has demonstrated rapid and significant antidepressant effects, particularly in individuals with treatment-resistant depression (TRD) who have not responded to traditional antidepressant medications. Ketamine is sometimes used off-label or in specialized clinics for the treatment of depression, including major depressive disorder (MDD) and bipolar depression.

Anxiety: Ketamine has shown promise in the treatment of anxiety, particularly in individuals with treatment-resistant anxiety disorders or those who have not responded to traditional treatments. While ketamine is not approved by regulatory agencies like the FDA specifically for the treatment of anxiety disorders, it is being explored as a potential off-label treatment option.
Several studies have investigated the effects of ketamine on various forms of anxiety, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic disorder. Research suggests that ketamine may have rapid-acting anxiolytic (anti-anxiety) effects, similar to its rapid antidepressant effects observed in depression.
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Chronic pain: Ketamine has analgesic properties and can be used as an adjunctive treatment for chronic pain conditions, such as neuropathic pain, complex regional pain syndrome (CRPS), and fibromyalgia. Ketamine infusions or topical formulations may be used for pain management in some cases.

Post-traumatic stress disorder (PTSD): Some research suggests that ketamine may have potential as a treatment for PTSD, particularly in individuals who have not responded to other treatments. Ketamine-assisted psychotherapy is being explored as a novel approach for addressing PTSD symptoms and trauma-related distress.

Obsessive-compulsive disorder (OCD): Preliminary studies have suggested that ketamine may have therapeutic effects in reducing symptoms of OCD. However, more research is needed to establish its efficacy and safety for this indication.

Substance use disorders: Ketamine-assisted therapy is being investigated as a potential treatment for substance use disorders, including alcohol use disorder, opioid use disorder, and cocaine addiction. Ketamine may help disrupt maladaptive patterns of behavior and promote insight and motivation for change.

It’s important to note that while ketamine shows promise for the treatment of these conditions, its use may not be appropriate or effective for everyone. Ketamine should only be used under the supervision of a qualified healthcare professional, and its risks and benefits should be carefully considered in each individual case.

Whether you need to work with a therapist while undergoing ketamine therapy depends on various factors, including the specific treatment protocol, the nature of your condition, and your individual needs and preferences. Here are some considerations:

Ketamine-assisted psychotherapy: At Safe pathways Wellness we offer ketamine-assisted psychotherapy, where ketamine is administered in conjunction with psychotherapeutic support. In this approach, a therapist or counselor provides support before, during, and after the ketamine session to help you process and integrate the experience, explore insights, and address emotional or psychological challenges. Ketamine-assisted psychotherapy can be beneficial for individuals seeking a more holistic approach to treatment or those dealing with complex mental health issues.

Traditional therapy alongside ketamine treatment: Even if ketamine-assisted psychotherapy is not offered, at Safe Pathways Wellness we believe you may still benefit from working with a therapist or counselor while undergoing ketamine treatment. A therapist can provide additional support, guidance, and coping strategies to help you navigate challenges, address underlying issues contributing to your symptoms, and make positive changes in your life. Therapy can complement the effects of ketamine treatment and support your overall mental health and well-being.

Integration support: Whether or not you receive therapy during ketamine treatment, at Safe Pathways Wellness we believe integration support is essential for making sense of the experiences and insights that may arise during ketamine sessions. Integration involves reflecting on the experience, exploring its meaning, and incorporating any insights into your daily life. A therapist or integration coach can assist you in this process and provide a safe space for processing emotions, addressing questions, and setting goals for personal growth and healing.

Individual preferences and needs: Ultimately, the decision to work with a therapist while undergoing ketamine therapy is a personal one that depends on your individual preferences, goals, and circumstances. Some individuals may feel comfortable and supported solely by the clinical team administering ketamine treatment, while others may benefit from the additional support and guidance provided by a therapist or counselor.

It’s important to discuss your treatment options and preferences with the team at Safe Pathways Wellness to determine the best approach for your needs.

At this time none of our ketamine treatments are covered by insurance. You may request a super bill at the completion of your ketamine therapy and submit it to your insurance company.