Types of Ketamine for Therapeutic Use

Written by Admin Strange DM on August 18, 2023. Posted in Depression, Grief, Ketamine Assisted Therapy, Ketamine Lozenges, LGBTQ. No Comments on Types of Ketamine for Therapeutic Use

The mental health landscape is continuously evolving, with novel treatment methods to help individuals deal with various conditions.

One such breakthrough has been the utilization of ketamine – a substance used to treat mental health issues that are difficult to overcome with traditional methods.

How Ketamine Affects The Brain

Ketamine is known to have a profound impact on glutamate, a neurotransmitter that is responsible for synaptic plasticity and neural communication. This property allows for a rapid and profound alteration in mood, perception, and cognition.

With a heightened awareness and the ability to connect seemingly disconnected parts of the brain, patients can arrive at profound insights that may take weeks or months with regular mood stabilizers or antidepressants.

What Can Ketamine Treat?

Clinical studies show that ketamine can treat a range of mental health conditions, even in patients who have shown resistance to conventional methods.

While research is relatively small, there’s enough evidence suggesting that ketamine has the potential to alter the therapeutic landscape and how we view certain illnesses.

Here are a few conditions that have been treated with ketamine along with links to clinical trials supporting these cases.

PTSD – This is an area where ketamine has shown great promise
Clinical Depression – Ketamine’s rapid effects can relieve symptoms after only a few sessions
Addiction – While it’s still in the works, ketamine has proven effective in controlled settings
Anxiety – The relaxing effect of this substance provides an immediate reduction in anxiety
Eating Disorders – While relevant literature is limited, ketamine has shown promise in helping those suffering from eating disorders
Caregiver Distress – Ketamine-assisted therapy offers caregivers a transformative approach to alleviating distress, fostering resilience, and promoting mental well-being.
LGBTQ and Self-Identity – Ketamine-assisted therapy provides LGBTQ+ individuals a supportive space to explore and affirm their self-identity, fostering acceptance and emotional healing.
Grief – Ketamine-assisted therapy offers a profound pathway to navigate grief, facilitating deeper emotional processing and fostering healing.

Types Of Ketamine Administration

Ketamine can be administered in four different ways.

Intravenous: This is the most common method and involves the controlled infusion of ketamine through an intravenous tube and directly into the bloodstream.
Sublingual: A ketamine-infused tablet or liquid is placed under the tongue, which dissolves and subsequently enters the bloodstream.
Nasal Esketamine: This method uses a nasal spray containing esketamine, a derivative of ketamine, sprayed into the nostrils and absorbed through the nasal mucosa.
Intramuscular Injection: Ketamine is directly injected into the thigh or buttocks and gradually absorbed into the bloodstream.

The speed of onset, duration, intensity of the experience, and potential side effects vary depending on the method.

The Rationale Behind Different Routes Of Ketamine Administration

While the same substance is administered in each situation, there are nuances that can alter the efficacy and results of the therapeutic process.

Let’s look at the different methods of administration, their pros and cons, and studies that show how they are being used.

IV Ketamine

The intravenous method involves ketamine being administered via controlled infusion directly into the patient’s bloodstream through a vein.

This method ensures that the substance bypasses the digestive system, leading to a quicker onset of effects compared to other methods.

Benefits

Rapid Onset: The key benefit of the IV method is the immediate onset, often noticeable minutes after the infusion begins. This swift response quickly alleviates depression and other severe symptoms.
Precise Dosage: The dosage can be regulated and tailored according to the patient’s needs and responses, which can optimize the therapeutic outcome.
Clinically Monitored: IV infusions involve a healthcare professional who monitors the patient’s vital signs and mental state closely and makes adjustments when needed.
Established Efficacy: There are plenty of clinical trials substantiating the efficacy of IV ketamine in treating severe conditions like treatment-resistant depression and PTSD.

Drawbacks

Discomfort: The insertion process may be uncomfortable and even scary to patients with a fear of needles.
Intense Effects: The rapid onset through IV administration and the dissociative effects can be overwhelming for some people.
Medical Equipment: This method requires medical equipment for the infusion as well as monitoring the patient’s vital signs to make changes if needed. This can limit accessibility to regular sessions.

IV infusion continues to gain recognition as a viable form of treatment. And the rapid onset is a beacon of hope for those grappling with severe mental health conditions such as treatment-resistant depression.

Sublingual Ketamine

Sublingual ketamine offers an alternative to the traditional intravenous approach, by combining convenience and rapidity of effects.

Here, patients place ketamine-infused tablets or liquids under their tongue and the medication is absorbed through the sublingual mucosa (mucous membrane) into the bloodstream.

Benefits

Quick Onset: While it’s not immediate, this method exhibits a faster onset of effects than oral ingestion. Combined with the ease of administration, it’s ideal for patients seeking quick relief.
Reduced Discomfort: There are no needles or medical equipment involved, making this a more comfortable way to ingest ketamine.
Home Administration: Studies show that sublingual ketamine can be administered at home in safe doses for a significant reduction in depressive symptoms. It is generally recommended that the administration of sublingual ketamine be supervised by a trained professional.

Drawbacks

Variability In Absorption: Factors like saliva production and mucosal health differ among individuals, which leads to varying levels of effectiveness among patients.
Slower Onset: While it’s absorbed quickly, sublingual ketamine still takes longer to act than IV administration.
Dissociative Effects: Like IV, sublingual ketamine can cause dissociation.

Clinical studies show that sublingual ketamine has the potential to significantly reduce symptoms of anxiety and depression.

While this treatment hasn’t been tested as extensively as IV, there is growing research to help us better understand how it works so we can discover its potential for therapy.

Nasal Esketamine

This approach utilizes a nasal spray to deliver esketamine such as Spravato, a derivative of ketamine. The difference isn’t just in the method of administration, but also in the substance being administered.

Esketamine is similar to ketamine, albeit with lesser dissociative effects. When the nasal spray is administered, esketamine is absorbed through the nasal mucosa and quickly enters the bloodstream.

Benefits

Ease of Use: It is non-invasive, reducing the discomfort associated with this form of treatment. Patients may even self-administer under medical supervision.
Mitigated Dissociative Effects: Esketamine is formulated to reduce the intensity of dissociative experiences. This makes the effects more tolerable for patients.

Drawbacks

Frequency Of Treatment: The effects of nasal esketamine are short-lived and most patients require frequent sessions to maintain the therapeutic benefits.
Variability In Response: Like sublingual ketamine, nasal administration shows variability in response depending on the absorption rates of different individuals.
Requires Medical Supervision: Nasal esketamine is relatively newer than other forms of treatment. As such, it may still require the supervision of a medical professional.

While the efficacy of nasal esketamine in the long term requires further examination, studies show that it can alleviate symptoms of treatment-resistant depression.

This study even labeled esketamine as a breakthrough treatment for depression and its associated symptoms.

Research continues to prove that esketamine is effective in treating mental health conditions, with great promise that this treatment will be integrated into the therapeutic landscape.

Intramuscular Injection

Intramuscular administration involves injecting ketamine solution into a muscle, usually the thigh or buttocks.

This method capitalizes on the gradual absorption of ketamine through the muscle tissue, leading to a sustained release into the bloodstream over an extended period.

Benefits

Longer Duration: Unlike other forms, intramuscular injections have a longer-lasting effect and provide extended relief, reducing the number of treatments required.
Greater Stability: The gradual release leads to a more sustained level of medication in the bloodstream, minimizing abrupt mood fluctuations.
Reduced Dissociation: While dissociation occurs, it is often mild due to the gradual release of ketamine, making the experience more comfortable.

Drawbacks

Slower Onset: It takes longer to feel the effects of intramuscular ketamine as it must be absorbed from the muscle into the bloodstream.
Injection Required: While it’s not as invasive as an IV, there is still an injection involved, which may cause anxiety in some patients.
Professional Administration: Intramuscular injections are usually administered by healthcare professionals and require a clinical setting, or specialized training for outpatient administration.

While intramuscular injections take longer, the difference is only a few hours.

This study found that intramuscular ketamine caused a significant reduction in depressive symptoms of two individuals diagnosed as highly depressed with suicidal ideation.

The reduction in symptoms continued three days after the injection and dropped further when a second dose was administered.

Another study found that 0.25 mg/kg of intramuscular ketamine was as safe and effective as a higher dose of 0.5 mg/kg using the IV route. This proves that the IM method of administration is a powerful and promising method to reduce severe symptoms of depression without a full medical setup.

Comparison Of Different Ketamine Treatments

Here’s a table comparing the different ketamine administration routes depending on specific factors.

	IV Ketamine	Sublingual Ketamine	Nasal Esketamine	Intramuscular Ketamine
Effectiveness	High efficacy in severe cases of depression and other disorders.	Results may vary based on absorption by the patient’s body.	A notable efficacy in treating disorders. Yet, not as effective as other forms.	Extended duration of effects, showing potential for sustained relief.
Side Effects	Dissociation, dizziness, and nausea which subside quickly.	Potential for dissociative effects but more tolerable than IV.	Reduced dissociation due to esketamine formulation.	Least dissociative due to gradual release of medication.
Convenience	Must be conducted in a medical facility.	Can be self-administered.But the potential for variability can cause inconvenience.	Can be self-administered. However, the patient may need frequent sessions.	Requires a professional. But the effects last longer, which means fewer sessions.
Patient Satisfaction	High satisfaction due to rapid and profound results. There may be concerns about dissociation, but these are mitigated under a trained therapist.	Mixed satisfaction due to variable absorption rates.	Typically positive due to ease of administration and manageable side effects.	High satisfaction due to sustained effects. However, not ideal for patients who need immediate relief.

Overview of the different types of ketamine for therapeutic purposes

Factors Affecting The Choice Of Ketamine Administration

While the aim of ketamine therapy is to achieve a desired outcome, the choice of administration will influence the result.

Here are a few factors to consider.

Medical Condition: Depending on the nature and severity of the issue, the therapist may recommend a rapid relief measure (intravenous) or suggest the need for long-term stability (intramuscular).
Patient Preference: Some patients may be uncomfortable with needles and opt for sublingual or nasal administration. Others may not want to experience intense dissociation and avoid the IV method.
Frequency: For those looking to minimize clinical visits, the intramuscular method works best. However, some may require rapid relief and more frequent sessions, for which IV or nasal spray is a better option.
Accessibility: Consideration of available medical facilities, trained professionals, and the ability to self-administer will influence the chosen method.
Cost: The cost associated with each form of treatment and the medical facilities involved will affect the patient’s final decision.

Ultimately, the method of ketamine administration should be chosen through a discussion between the therapist and patient, after reviewing the patient’s medical history, preferences, and treatment goals.

This personalized approach is crucial to ensure that the chosen method aligns with the patient’s unique needs and maximizes the potential benefits of ketamine therapy.

Make An Informed Choice

Each approach carries its own set of benefits and drawbacks, catering to different preferences and therapeutic needs.

Intravenous ketamine offers immediate relief in acute situations, leading to profound insights and high efficacy. But the possibility of an intense dissociative experience is higher.
Sublingual ketamine offers a balance of convenience and efficacy. However, the outcome will vary depending on how effectively the substance is absorbed.
Nasal esketamine is easy to use and the dissociative effects are minimized. But the lower intensity means that patients may require more sessions to achieve the desired outcome.
Intramuscular ketamine provides extended relief for those seeking sustained effects. However, it takes longer for effects to kick in once the ketamine has been administered.

A patient must understand the different methods, the benefits, and the drawbacks so they can make an informed decision aligned with their unique circumstances.

Ketamine-Assisted Therapy in Los Angeles

The evolution of ketamine therapy signals a shift in the approach toward mental health.

The Psychedelic Collective aims to empower patients with the latest insights, equipping them to collaborate effectively in crafting personalized treatment plans.

Our evidence-based modalities focus on patient-centered care and prioritizing the physical, mental, and emotional safety of those who seek our help.

We urge you to explore the realm of ketamine-assisted therapy in Los Angeles as a potential avenue for relief. Call us today to learn more about your treatment options and craft a plan that suits you best.

With the help of ketamine, you can navigate your condition in a way that produces tangible results in a short time, helping you improve your overall quality of life.

Additional Reading

candles lit presumably to help remember a lost one and process grief

What is Grief Counseling: Evidence and Modalities

Written by Admin Strange DM on July 29, 2023. Posted in Grief, Ketamine Assisted Therapy, Mental Health. No Comments on What is Grief Counseling: Evidence and Modalities

Grief is a universal human experience often felt after the loss of a loved one, the end of a significant relationship, or traumatic life events.

For the purpose of this article, we will refer to grief as the emotional response to the death of a loved one.

Grief counseling therapy was designed to help people process this loss by working through the sorrow that arises from such a situation.

Everyone processes grief differently, and the intensity and time frame depends on the person, their attachment to the loved one, and several other factors. However, to move on, acknowledging and addressing grief is an essential part of the healing process.

Unattended grief can significantly affect you by disrupting your daily routine and damaging your physical, mental, and emotional health. By addressing loss through grief counseling therapy, you can work through the emotions that arise and move forward in life, eventually turning that pain into a catalyst for growth.

Understanding Grief And Its Impact

Grief is best described as a complex and multifaceted emotional response to loss. Aside from sadness, grievers experience a range of feelings, including anger, confusion, guilt, and even relief.

Grief can manifest in various forms, some of which include:

Feelings of emptiness
A sense of detachment from the world
Difficulty concentrating
Disruption in sleeping and eating patterns
Physical illnesses and irregularities like pain, fatigue, headaches, and nausea
An overwhelming desire to reminisce about the person lost

Emotional And Psychological Impact Of Grief

Grief triggers an emotional response that can profoundly affect an individual’s psychological landscape. Feelings rise quickly, crashing like waves into the soul of the person grieving.

In the face of these feelings, an individual may experience disruptions in their life.

For example, those grieving may experience symptoms of anxiety and depression. These intense feelings often lead to isolation as others around them aren’t experiencing the same thing. Additionally, the grieving process brings up unresolved issues that can intensify the internal turmoil the individual is trying to navigate.

Consequences Of Unresolved Grief: The Lingering Shadow

It’s easy to see how these emotional and psychological effects if left unchecked, can severely impact the individual in the future.

The long-term consequences of staying in this state include persistent emotional distress, strained relationships, and a diminished sense of self-worth. Individuals may begin coping with substances and other addictions to numb the pain, which only exacerbates their struggle.

Unresolved grief also impedes personal growth and hinders the ability to find joy and meaning in life.

Types Of Grief

Grief encompasses a vast and intricate landscape that has been studied for years. And while there are overlaps, here are some common types of grief you should know about.

Bereavement Grief – This is the most common type, arising from the death of a loved one. This involves mourning the physical absence of someone and adjusting to life without them.
Anticipatory Grief – This form of grief occurs when individuals anticipate the loss of someone dear, due to circumstances like a terminal illness, which allows them to begin the grieving process earlier.
Ambiguous Grief – A form of grief where there is no clear sign of closure, like when a loved one goes missing or in the case of severe dementia, when they lose their identity and memories.
Disenfranchised Grief – In some situations, others may not acknowledge the individual’s cause of grief, leading to disenfranchised grief. This usually occurs when the loss isn’t seen by society as being profound enough, like the death of an ex-spouse, a pet, or a non-traditional relationship.
Collective Grief – Collective grief is experienced by entire societies after a widespread tragedy, like an act of terrorism, a natural disaster, or a global pandemic.
Secondary Grief – This involves feeling the sorrow of others’ losses, often experienced by healthcare professionals, first responders, and caregivers who witness someone else’s pain.
Invisible Grief – These emotions arise from personal losses that may not be apparent to the world. It could include the loss of hopes, dreams, or goals.

The Role of Grief Counseling Therapy

Grief counseling therapy is meant to serve as a structured support system for individuals navigating the complexities of grief. The goal of therapy is to help people heal, build emotional resilience, and empower them to rebuild their lives and return to normal after loss.

The counselor creates a safe space where clients can express themselves openly while receiving guidance to cope with and process their grief.

Ultimately, the purpose of grief therapy is to help individuals find meaning and purpose amidst their journey and stay with the pain so they can work through it effectively and come out the other side.

Therapeutic Techniques And Interventions In Grief Counseling

Grief counseling employs a range of therapeutic techniques to address an individual’s needs. The most common are CBT, ACT, Group Therapy, grief-focused counseling, EMDR, and expressive therapies. We will discuss these in greater detail in a little while.

However, the most important thing to remember is that the approach, techniques used, and treatment structure will depend on the individual. As such, it’s crucial that grief counseling therapy focuses on a client-centric approach.

Why The Client Should Be The Main Focus

As mentioned before, grief is universal.

But each person experiences it differently and in different phases based on their psychological makeup, circumstances of the loss, their needs and values, and the attachment to the particular loss.

So, a client-centric approach is of paramount importance to tailor the therapeutic process to meet the individual’s specific needs. The therapist must be open and adapt to their client’s requirements while offering empathy and compassion.

They must be able to create a nurturing environment that will help clients express themselves safely so they can seek the healing and growth they need.

By focusing on the client, the therapist can create an environment that fosters recovery and allows the client to take an active role in the healing process.

Evidence Supporting Grief Counseling Therapy

There is empirical evidence suggesting that grief counseling therapy helps lower an individual’s psychological distress, improves coping skills, and builds resilience.

This study found that individuals who received grief counseling experienced a significant decrease in grief symptoms over time compared to a control group.

More importantly, they also found that those who received counseling continued to experience a decrease in grief symptoms even six months after the sessions were concluded.

This points to the possibility that grief counseling can teach individuals to cope even after treatment is concluded.

Grief Counseling Modalities

Let’s look at some of the most common modalities of grief counseling.

CBT (Cognitive Behavioral Therapy): Commonly known as talk therapy, CBT helps people identify negative thought patterns associated with grief and develop healthier coping mechanisms and ways of thinking.
ACT (Acceptance And Commitment Therapy): ACT focuses on accepting one’s emotions and thoughts while acting in alignment with one’s values. This modality uses mindfulness to help clients stay in the moment and acknowledge their emotions while continuing to move forward, even in the midst of loss.
Grief-Focused Counseling: This approach is tailored specifically to bereavement and loss. Therapists provide a space to express grief and allow individuals to process their emotions and the impact of loss. This modality allows individuals to carve a unique path of recovery for their specific case.
Group Therapy: Group therapy brings together people who have experienced similar types of loss. Sharing experiences with others who can feel the depth of your grief in the present moment can be profoundly healing. It also helps foster a sense of belonging and facilitates the exchange of coping strategies.
EMDR (Eye Movement Desensitization And Reprocessing Therapy): While it was initially used to treat trauma, EMDR can also help people process obstacles that complicate the grieving process. This in turn can help reduce the intensity of grief and its symptoms.
Expressive Therapy: Art therapy, music therapy, writing therapy, or movement therapy offer alternative channels for people to express their grief creatively. Some may find it difficult to express grief verbally, and artistic expression can help them stay present and gain insights into their feelings.

Each modality provides a unique perspective on the process of recovery, and these insights may be helpful to develop a newer and more holistic form of therapy.

Ketamine-Assisted Psychotherapy (KAP) for Grief: A Promising Path To Healing

KAT is a newer therapeutic modality that combines a ketamine experience with traditional therapeutic modalities to treat a host of mental health conditions.

Ketamine has been proven to effectively treat conditions like PTSD, anxiety, depression, and addiction. The powerful antidepressant effects of ketamine along with the dissociative state it produces may provide a unique way to help individuals move through grief.

Enhancing Outcomes With Ketamine Therapy

When integrated with grief counseling, ketamine-assisted therapy can help improve the effectiveness of traditional therapy.

The dissociative state can help those grieving to step outside their identity, providing much-needed relief from symptoms and giving them a chance to engage more effectively in grief counseling and other therapeutic interventions.

Ketamine has also proven to rapidly resolve grief symptoms due to its antidepressant effects. And often, it takes such a shift for patients to see that it’s possible to return to regular life after a debilitating loss.

While the effect isn’t permanent, the shift in mood coupled with heightened awareness can help clients explore grief from new perspectives, helping them figure out ways to move forward.

Benefits And Risks Of KAT In Grief Counseling

Now we know that ketamine-assisted therapy can aid in the processing of grief. Here are some benefits and risks of using this therapeutic modality to process grief.

Benefits	Risks
Ketamine’s quick-acting nature provides rapid relief from depressive symptoms, creating a more receptive state for grief counseling.	Ketamine temporarily induces dissociative experiences which can be unsettling for some participants.
The altered state can provide emotional insights, which can help accelerate the healing process.	The sessions may lead to short-term side effects, like dizziness or nausea, although these dissipate quickly.
The vulnerable nature of ketamine-assisted therapy can strengthen the therapeutic bond between therapist and client, fostering trust and openness in subsequent sessions.	While the studies are promising, there is limited material available on the long-term benefits of ketamine therapy.

Addressing Grief Is Essential

In life, we will encounter grief. And grief counseling therapy is a beacon of support to individuals seeking to move through grief in a healthy, holistic manner.

By providing a safe and nurturing space, grief counseling empowers individuals to process emotions, find meaning, and ultimately embark on a journey of healing and growth.

Addressing grief isn’t an option; it’s an essential step toward reclaiming one’s life after loss.

Reach Out

If you are grappling with grief and loss, we encourage you to seek professional help.

You don’t have to navigate this path alone. We can provide the compassion and guidance you need to help you on this journey.

Our services can provide a better understanding of your own process and allow for hope, healing, and renewal.

The road is arduous, but with the right support, the journey can become transformative and empowering. Reach out and let us in as you embark on this path of healing and growth, and we will help you embrace the possibility of life beyond grief.

Ketamine-Assisted Therapy for Grief in Los Angeles

At the Psychedelica Collective in Los Angeles, we are committed to offering client relief from grief via a range of therapeutic modalities including ketamine-assisted group therapy. Through real-life experience and clinical trials, we have successfully integrated ketamine with other therapeutic modalities. We use this expertise to enhance the outcome of grief counseling and offer new avenues for emotional exploration and healing.

Through our client-centric approach, we tailor each therapeutic session to meet the needs of those seeking support. And we specialize in integrating KAP as an adjunct modality for a more holistic approach to the grief counseling process.