Difference between IIT and infusion clinics
While all clinics are different, many infusion clinics do not provide psychotherapy.
At IIT, extensive, thoughtful and informed psychotherapy is THE most important part of the process. In fact, the process is psychotherapy, and Ketamine is simply a tool to enhance the process. We fully customize our process based on individual needs, and emphasize creativity and collaboration in working with each person to develop the best possible treatment plan.
Additionally, IIT offers Intramuscular Injection (IM), which is the most powerful and psychedelic-type of Ketamine treatment.
We also have an excellent network on highly specialized, creative providers who we can connect you to post-integration. We believe that ongoing support is often a super helpful way of deepening the connection to your experience, and in furthering the work of healing and self-discovery.
Most importantly, research suggests that integrating psychotherapy into the Ketamine treatment process produces better outcomes for mental health related struggles. The results thus far suggest a synergistic effect, meaning Ketamine and psychotherapy have the potential to work better together than separately.
Differences from other psychedelic assisted therapy clinics
Every clinic has different approaches to this work, and offer a variety of options to people interested. We pride ourselves on the clinical expertise of our staff, as well as the creative work that we do to integrate art, music and design into the therapeutic process. Art, music and stories move us as human beings, and somehow connect to our deep sources of meaning. We work to use such universal human elements for the therapeutic process itself. We do not do "woo woo", but instead work to uncover sources of meaning for each individual, and since everyone is different, the process is unique, every time. We emphasize creativity and collaboration in helping you tell your story.
Traditional therapy has many different modalities that focus on the reduction of symptoms of whatever diagnosis a person has and is typically focused on the interaction between two people. Ketamine promotes immediate changes in brain functioning, that accompany drastic changes in consciousness and sense of being. Both the pharmacological impact and the subjective experience of a non-ordinary state of consciousness can allow for rapid positive changes in mental state and perception. These effects, combined with the supportive presence and knowledge of a trained psychotherapist, work to maximize the healing potential that Ketamine allows.
We administer Ketamine in two different ways, and the experiences are a bit different depending on these modes of administration: oral or intramuscular injection (IM). We start everyone on the oral route of administration, because this helps to orient you to the experience and get a sense of what it is like. Based on someone’s initial experience with the oral route, we will help determine if they are a good candidate for IM and what kind of dose is most appropriate.
Set and setting is a common phrase in the world of psychedelic medicine. Set refers to the "mindset" of the individual having the experience, and includes how they're feeling in the moment, their current mood, personality type, tendencies, beliefs and ways of thinking. Setting refers to the physical, sensory and emotional/relational environment including all sensory inputs across the 5 senses (the sights, sounds, smells, tastes, tactile feelings), the "place" (the room or space) and the people who are present to support.
This is where we invest a lot of thought, time and intention- in curating the optimal space, sensory environment and strong therapeutic relationships. While we cannot control the psychedelic experience itself, we can always strive to better enhance the environment with the aim to produce more safety, connection and positive outcomes.
Science, Art & Design
We believe that concepts and practices from art and design traditions can be used to help enhance the therapy process and spark the imagination to move towards wholeness and integration. Our focus on art and design informs the way we structure the environment, and curate the experience for each individual. Our goal is to constantly improve the way we design and curate our setting to help provide an increasingly solid foundation for the medicine experience to unfold.
The importance of music to IIT and personal experiences cannot be overstated. Music as a form of expression is critical to Psychedelic Therapy. Music allows nonverbal ways of communication and evokes emotional responses that words often are not able to. The playlist is curated to help clients move through challenging life experiences, memories, or trauma in ways that traditional psychotherapy is not capable. Music is meant to allow the clients that ability for further introspective thought and insight into issues they are wanting to work on. Music is an immensely important part of the experience and provides a framework for how the experience unfolds. Music is a vehicle to assist in the experience of medicine-psychotherapies. Often times music is equated to the ship that one rides on, through the oceanic experience provided by the medicine. Medicine-psychotherapies often have a degree of being ineffable; music assists in the narration of that experience that words cannot.
The Institute’s physician has one primary role: to ensure your safety throughout the entire process.
That begins with an initial evaluation where past medical records will be reviewed and a physical exam will be conducted. The doses of Ketamine we work with are sub-anesthetic, meaning they are well below the doses used for surgical procedures. Because of this the risk of an adverse effect is very, very low. Regardless, we want to ensure that you have no limitations that would prevent you from having a fulfilling journey. During this initial encounter we will also discuss the medical aspects of KAP in full detail, and answer any questions that you may have.
After you are medically cleared, your next encounter with the physician will be on the day of your Ketamine medicine session. A brief exam will be conducted prior to administering Ketamine. Your therapist and physician will both be with you during the initial moments of your journey. Afterwards the physician will periodically check-in throughout the course of the session. Once your journey has ended the physician will evaluate you to determine when you can be safely discharged home. Mental fogginess is common immediately afterwards, and some patients take a little longer than others to return to baseline.
Your therapist will work with you to identify areas that you want to explore, support you through your experience, and assist in processing insights learned through your KAP session. Throughout the treatment process, the therapist is there to help ensure that you feel safe, contained, understood and supported.
The therapist is a vital component to treatment, in helping you to develop a framework for understanding and navigating your experiences and helping to identify how you can continue to move towards growth and healing. During the treatment session, your therapist is always present and asks nothing of you. They are there to support you in whatever way is best for you and will help you to identify what this means for your experience.
· To process experiences and help you to express yourself
· To ensure a sense of safety and containment
· To be a supportive presence
· To witness
· Help prepare you with a framework for the experience
· Help to integrate what lessons you’ve learned- and to apply them to future challenging life experiences
· To understand an internal narrative of what you can handle and what you can’t
· Help you feel confident/capable
Yes! You can request a preferred gender for your therapist. We believe in client choice, and that the therapeutic relationship is a vital aspect of good treatment. Please explore our staff bios to see what our specialties and competencies are.
This varies from person to person, and involves a collaborative conversation with you and your therapist and physician. However, there is a general rythm to the process as follows that is typical to everyone.
1. Assessment: We always start with a thorough mental health evaluation with your IIT therapist, followed by an exam with our physician.
2. Preparation: Then we do as many preparation sessions as you need to feel equipped for your medicine experience. Most people do 1-3 preparation sessions.
3. Medicine experience: We always start with the oral route of administration to determine how each person responds to the Ketamine, which is a much lower dose experience.
4. Integration: every medicine session will be followed by integration with your IIT therapist. This is usually 1-3 sessions.
5. Plan (and repeat): we then determine together if the Intramuscular route is appropraite for you, and then we repeat the medicine and integration process as outlined in your treatment plan.
For some, a single session is enough, but most people do at least 2 medicine sessions so that they can experience the Intramuscular Injection, which is the more potent and powerful way of experiencing Ketamine. For others, a plan may be developed for a course of treatment (sometimes 6 medicine sessions) or ongoing maintenance support. This all depends on your needs, presenting concerns and effectiveness of each experience.
For individuals who have medical insurance, much of the therapy process may be covered by your insurance plan. While the talk therapy, assessment and basic medical evaluation may be covered by insurance, the actual Ketamine experience (the treatment session) is not currently covered by insurance plans. While this may change in the future, this is currently an out-of-pocket service. The cost for a Ketamine treatment session is $850.
Part of our mission is to develop funding sources to help cover the cost of treatment for those who cannot afford access. We do not believe that these medicines can heal society if they are only accessible by the privileged few. We are continuously seeking creative solutions for reducing this barrier.
We are currently working on a policy for a "pay it forward" program, that would allow individuals-with-means to contribute directly to reducing the cost of treatment for someone in need. While we are in the beginning stages of launching our organization, we will continue to update this as we are able.
During the medicine session, the doctor will administer the Ketamine, and then the therapist will be present in the room for the duration of the session. You will be provided a very comfortable chair that reclines, with pillows, blankets and other amenities to ensure optimal comfort. You will be provided with eyeshades and headphones with a music playlist designed specifically to help support your healing experience. The therapist will be available for whatever support is needed and bases their responses off of your individual needs. For example, if you have something you want to process, talk about or engage with, the therapist will be there to help. Or, if you prefer to listen to music the whole time, the therapist will support this as well. Beyond the basic measures taken to ensure your safety and that of the therapist, there’s no right or wrong way to do this. The therapist may offer you some recommendation/options based on their experience and knowledge and they will support you in determining what direction makes the most sense for you.
The Oral Route
The sublingual/oral use of Ketamine produces a trance-like state that allows you to “dis-associate” from the day-to-day patterns you may feel stuck in, and to gain some distance and ability to observe and interact with your experience in a new and different way. Many people report seeing their internal experience and the way they interact with the world around them in a new light, thus giving them the opportunity to explore new ways of operating, behaving, and of being in the world. The oral route may give one new perspective on their own life story and journey, and often feels very personal- offering lessons that may be applied to one’s day-to-day experiences. This may include insights about one’s own history, relationships, thought/thinking patterns and behaviors.
With the sublingual/oral route, you will be fully aware of your surroundings and able to communicate and interact with the therapist to discuss whatever feelings, experiences and insights you are experiencing.
With the IM administration of Ketamine, many people report gaining the opportunity to fully explore their internal world, and take a deep dive into consciousness, free of the body. Although the journey is so difficult to describe, and unique to the individual, most people experiencing the IM journey report having an “out of body experience”, where consciousness is contacted in a more “pure” state. Without the limitations of one’s body, consciousness is expansive, and this experience allows you to contact a deep inner healing intuition.
The IM route is the more “psychedelic” journey-type experience, compared to the oral route of administration, and is often described as transformational to those who experience it. While the oral route is more “personal”, the IM route can produce a “transpersonal” journey- meaning that it goes “beyond” the personal, and into the “bigger picture”- of one’s place in the world, and the connection to deep sources of meaning.
Along with other traditional psychedelics, IM Ketamine can produce “mystical” experiences, which are often felt as spiritual in nature. This does not mean religious or “woowoo”, but a deeply felt sense of connection to the world, Universe and reality itself. For someone who may suffer from a sense of meaninglessness, this sense of connection to a deeply meaningful reality can be tremendously restorative and healing. There are few words that can be found to describe such an experience, because very few of us have a reference point for understanding it.
This is one of our most frequently asked questions, and totally understandable!
In a therapy setting, we like to differentiate between "bad trips" and "challenging trips". It's our belief that "bad trips" can be avoided, with attention to set and setting and through trusting relationships with your therapist. For some people, the Ketamine therapy experience can still be challenging.... but, it's often the challenging experiences that are most rewarding. For many people, psychedelics in therapy can help them to confront and deal with things that they've struggled to address in the past. This is similar to "regular" therapy, in that it too can also be challenging at times!
In the above section "Our Approach" there is a question about Set and Setting, which is the mindset of the individual and the environment the experience takes place in. We put a lot of intention into helping with both of these- to prepare you for having the right mindset and in providing an optimal environment for your experience. Set and setting are the absolutely most important things we can control or influence, and almost always are the cause of "bad trips", when not properly cared for.
When used recreationally, without proper attention to set and setting, psychedelic experiences may be scary or unsafe- because you're senses and perceptions are so heightened and "different" with psychedelics, "normal" environments can be very overwhelming (ie. at a party, in a public space, with someone you don't know well or have had conflict with, in a space with bad lighting, outside noises, or anything that is unclean or disorganized, etc.).
In our clinic, we design the setting to help facilitate a "letting go", which is very difficult to do in settings where you do not feel safe enough. We can also provide additional preparation sessions for anyone that has fears about it- this allows you to develop your confidence and form a trusting bond with your therapist.
It's normal to have worries about this experience, and we welcome you to reach out to us and discuss any concerns that you may have.
Each person responds a little bit differently in how fast they metabolize the medicine. Typically the entire session lasts 2.5-3 hours, sometimes a bit less or more.
Because of the dissociative effect of Ketamine, we require that you have transportation set up after your appointment. We ask that you provide us with the name and contact information for the friend or relative that will be driving you home.
There's many ideas being proposed and the deeper we look, the more questions we have.
When assessing a question such as this, we can look at it from many angles, including with the pharmacological/biological, psychological, relational and transpersonal lenses (to name a few).
"Psychedelics" describes a class of substances that are actually quite different from each other, in their effects and the experiences they produce. The word psychedelic means "mind manifesting" and most of the substances that retain this label are related through their ineffible, powerful and non-ordinary impact on consciousness. Psychedelics cause signficant changes to ones perceptions, sense of self and experience of reality. They are truly out of this world.
In terms of the pharmacology, most typical psychedelics impact the 5HT2A receptors in the brain, although atypical ones like Ketamine impact other systems. To learn more about the pharmacology, Wikipedia is a great resource.
Researchers have recently discovered a network of activities in our brain that’s referred to as the “default mode network”. This is a technical term that refers to some complex happenings, but to simplify the idea: we tend to engage in patterns of behavior and can feel stuck in a certain story of who we are, and what our life means. Challenging life experiences can distort our thinking; we can often feel insecure, unsafe, and want to remove ourselves from daily life.
Psychedelics may offer a “break” by helping one to access non-ordinary states of consciousness, which can help give them an opportunity to reflect more deeply on their struggles and sense of purpose and place in the world. Uncovering our values, meaning, and sense of self may help us to find freedom from the patterns we feel trapped in.
Having a “break” from our normal ways of being, in combination with therapy can help to identify alternative narratives to our life. We believe the stories we tell ourselves about our lives can lead to deeper meaningful interactions or keep us stuck in patterns that are destructive. Creating a new narrative requires an interruption to unhelpful stories we tell ourselves; psychedelic psychotherapy aims to help promote such a break.
Additionally, psychedelics can produce strange experience that may be referred to as "transpersonal", meaning "beyond the individual". For some, the psychedelic experiences is felt as a deep connection to "the world" and reality itself, which some may describe as feeling sacred. This does not mean "spiritual" or "religious" or "woowoo" but instead a felt sense of belonging with and inseparableness from the Universe itself- A sense of "rightness" with reality. This transpersonal experience can have lasting, sometimes lifelong effects as it sits as a reference point for future life, intention and purpose.
Psychedelics were primarily used in the clinical setting before they were co-opted by the counterculture revolution of the 1960s. By 1951, over 100 articles on LSD had been published in medical journals. The drug was capable of inducing a new level of self-awareness that had enormous therapeutic potential compared to other modalities of the day. Studies on LSD and alcoholism reported that between 40 and 45% of patients given the drug had not experienced a relapse after a year. Bill Wilson, co-founder of Alcoholics Anonymous, believed LSD could be used to cure alcoholics and credited the drug with helping his own recovery from depression.
Psilocybin (mushrooms) and LSD psychotherapy peaked in the late 1950s and early 1960s, and was widely considered to be “the next big thing” in psychiatry.
Between the years of 1950 and 1965, some 40,000 patients had been prescribed one form of LSD therapy or another under the trade-name Delysid. Research into the potential therapeutic effects of LSD and other hallucinogens had produced over 1,000 scientific papers and six international conferences.
Preliminary findings were very positive and warranted further study, but the research abruptly stopped. It came to a halt not for safety or efficacy issues, but primarily for political reasons. The Nixon administration heavily restricted further research despite some politicians and researchers speaking out against the government’s actions. Nixon and his fight against anti-war protestors eventually led to the Controlled Substances Act of 1970 as a tool to jail and imprison dissidents of the Vietnam War.
Another psychedelic medication, MDMA, was patented by Merck in 1914 and has a long history of use in relationship therapy. It gained notoriety in the 1980s as the illicit drug “ecstasy”, but it was originally known as “empathy”. Therapists found that it had the extraordinary ability to make their patients more willing to communicate and participate in the psychotherapy process. It also eliminated the typical fear response in patients with histories of trauma. Anecdotally, psychotherapists reported that it greatly accelerated therapy, which made it an important adjunct not an alternative to traditional therapy. Unfortunately, underground use in clubs and bars became more widespread prompting the DEA to investigate by the early 1980s.
There were no links to deaths or violent crimes, but under the banner of the War on Drugs it was placed in the Schedule 1 category under the Controlled Substances Act despite its history of therapeutic use. The DEA acted against the recommendation of the administrative law judge who presided over the scheduling hearings, while also disregarding opposition from the medical profession and researchers.
In the early 1990s limited research was started using MDMA that eventually confirmed its safety for human use. Additional studies have confirmed that it does not deplete the brain of important neurotransmitters or cause permanent brain injury. The Multidisciplinary Association for Psychedelic Studies (MAPS) has led the way in fundraising and spearheading groundbreaking studies. Clinical trials at some of the nation’s leading institutions has ensured that this new era of psychedelic research will be of the highest caliber. Placebo-controlled, double-blinded trials (the gold standard) using MDMA-assisted psychotherapy for PTSD in a sample of law enforcement and military veterans were so successful that the FDA classified it as a “Breakthrough Therapy”.
This designation fast tracked MDMA into Phase 2, which has supported the safety and efficacy demonstrated in the previous Phase. Long-term follow-up results show that for a majority of participants, the benefits of MDMA-assisted psychotherapy for PTSD extended at least 12 months after the treatment sessions. Two months following their last session, 56% of 100 participants no longer met diagnostic criteria for PTSD. Twelve months later 67% did not qualify for a PTSD diagnosis. Remarkably, all patients received a maximum of three sessions over a three month period. Phase 3 trials are expected to be completed in 2022, meaning that the FDA could approve the treatment by the end of 2022 or early in 2023.
Despite its long history of therapeutic use, LSD is not currently receiving the same renaissance. Its negative perception in the general public makes it difficult to receive adequate support. However, a Phase 2 pilot study in 12 subjects found positive trends in the reduction of anxiety associated with life-threatening illness following LSD-assisted psychotherapy.
Psilocybin has received much more attention than LSD likely because it does not carry the same baggage. The structure and effect are very similar to LSD, which makes it an adequate substitute. Notably, psilocybin therapy has received the FDA’s Breakthrough Therapy status twice, one for treatment resistant depression and later for major depressive disorder. The weight of evidence continues to support that psilocybin may offer a substantial clinical improvement over existing therapies.
Psychedelic medicine has more legitimacy now through rigorous scientific studies conducted by highly reputable institutions. What was once thought to be a career killer has now become cutting edge. Leading the way is Johns Hopkins School of Medicine, who raised over $15M to create the Center for Psychedelic and Consciousness Research. Shortly after their launch the Medical University of South Carolina announced that a new Psychedelic Research Center would be open by 2022. With more science comes more evidence. With more evidence comes more hope. Hope that our leaders will realize that these medicines do indeed hold therapeutic value.
Current off-label use of Ketamine has been shown to be effective in many people suffering from many conditions, including major depression, bipolar depression, postpartum depression, anxiety, post-traumatic stress disorder, obsessive compulsive disorder, pain syndromes such as neuropathic pain, fibromyalgia and complex regional pain syndrome (CRPS).
Once a medication is approved by the US Food and Drug Administration (FDA) for an indication a provider may be able to use it for other indications (off-label) if there is evidence that supports that use. Ketamine has been around for so long that it is now a generic drug. It takes millions of dollars to seek FDA approval for a drug. As a result, pharmaceutical companies do not have any incentive to invest in the study of a generic drug that they cannot recoup the cost. This is why Ketamine’s use to treat conditions such as treatment-resistant depression remains off-label.
Off-label does not mean it is illegal or not advised to use. Several medications that are prescribed for one indication are used for completely different indications. The blood pressure medications Prazosin and Clonidine are used off-label for nightmares and ADHD, respectively. Off-label medications should be prescribed by a provider that understands the weight of evidence, risks, and benefits for its use.
The doses used in KAP are significantly less than those used for anesthesia, because our goal is not for you to be completely sedated. Our desired effect can be achieved with a dose of approximately 1.5 mg/kg (IM) versus an anesthetic dose of at least 6.5 mg/kg (IM). We also only use sublingual (SL) and intramuscular (IM) routes of administration. These routes decrease the amount of the medicine actually in your system compared to intravenous (IV).
You will receive a complete medical examination before cleared for treatment. Generally, there are few absolute contraindications. These include a history of allergic reaction to ketamine, pregnancy, alcoholism, history of brain bleed, stroke within the last 3 months, significant uncontrolled high blood pressure, heart attack within the last 3 months, untreated thyroid disease, and known or suspected schizophrenia.
Relative contraindications will not necessarily exclude patients from treatment. These conditions will be evaluated in the context of the patient’s overall health to determine suitability. The most common conditions being increased pressure in the eye, decreased lung function (requiring home oxygen), sudden and serious symptoms of heart failure called acute decompensated heart failure, failure of the heart to maintain adequate circulation (ejection fraction < 40%), history of tracheal stenosis, tracheal surgery, or airway instability, and urinary retention.
Outpatient use of Ketamine is very different from inpatient use. The doses are low enough that the patient is still conversant, therefore there is no risk of respiratory depression like with opioids. The most typical effects are nausea, increased blood pressure and heart rate. Vital signs will be checked before your encounter and during if there are signs of physical distress. It is normal for patients that work through their trauma to have moments of distress that do not pose a physical danger to themselves. The therapist will aid in your journey and guide you through those difficult moments. For nausea, you will be offered anti-nausea medication before your session. You can minimize this risk by eating a light meal that day and not eating 4 hours prior to therapy.
1. Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy. Journal of Psychoactive Drugs (2019) Jennifer Dore, Brent Turnipseed, Shannon Dwyer, Andrea Turnipseed, Julane Andries, German Ascani, Celeste Monnette, Angela Huidekoper, Nicole Strauss & Phil Wolfson
This study explores KAP within an analytical framework examining three distinct clinical practices that use similar methods. The authors present demographic and outcome data from 235 patients. Their findings suggest that KAP is an effective method for decreasing depression and anxiety in a private practice setting, especially for older patients and those with severe symptom burden.
2. Augmenting the Treatment of PTSD with Ketamine—a Review Current Treatment Options in Psychiatry (2019) Duek, O., Kelmendi, B., Pietrzak, R.H. et al.
Ketamine may affect memory reconsolidation, learning and more specifically, and extinction learning. Small studies suggest that it may act as an enhancer for extinction-based psychotherapies for PTSD.
3. PTSD Augmented Psychotherapy With Ketamine (KPE) - First Results Biological Psychiatry (2019) Duek, O ; Levy, I ; Li, Yt ; Gordon, C ; Kelmendi, B ; Harpaz-Rotem, I
A small study that divided PTSD patients into two groups, one receiving Ketamine, the other Midazolam. The treatment protocol consisted of 7 daily sessions of prolonged exposure therapy with Ketamine or Midazolam. After 90 days follow-up, ketamine PTSD symptoms were lower than midazolam.
4. Single Versus Repeated Sessions of Ketamine-Assisted Psychotherapy for People with Heroin Dependence. Journal of Psychoactive Drugs (2007)Krupitsky, Evgeny M ; Burakov, Andrei M ; Dunaevsky, Igor V ; Romanova, Tatyana N ; Slavina, Tatyana Y ; Grinenko, Alexander Y
A prior study found that one ketamine-assisted psychotherapy session was significantly more effective than active placebo in promoting abstinence (Krupitsky et al. 2002). In this study of the efficacy of single versus repeated sessions of ketamine-assisted psychotherapy in promoting abstinence in people with heroin dependence. At one-year follow-up, survival analysis demonstrated a significantly higher rate of abstinence in the multiple KAP group.
5. Ketamine psychotherapy for heroin addiction: immediate effects and two-year follow-up. Journal of Substance Abuse Treatment (2002)Evgeny Krupitsky M.D.,Ph.D. Andrey Burakov M.D. Tatyana Romanova M.A. Igor Dunaevsky M.D. Rick Strassman M.D. Alexander Grinenko M.D.
Seventy detoxified heroin-addicted patients were randomly assigned to one of two groups receiving ketamine psychotherapy (KAP) involving two different doses of ketamine, psychedelic and sub-psychedelic. High dose KAP produced a significantly greater rate of abstinence in heroin addicts within the first two years of follow-up, a greater and longer-lasting reduction in craving for heroin, as well as greater positive change in nonverbal unconscious emotional attitudes than did low dose KAP.
1. Efficacy and Safety of Ketamine in Bipolar Depression: A Systematic Review Revista de Psiquiatría y Salud Mental - Journal of Psychiatry and Mental Health (2017) Alberich S., Martínez-Cengotitabengoa M., López P., et al.
This a systematic review of 10 studies on the efficacy and safety of ketamine as treatment of bipolar depression. According to data, ketamine appears to be an effective and safe treatment for bipolar depression. Adverse effects observed tended to completely disappear within the first hour of therapy.
2. Efficacy of Ketamine in the Rapid Treatment of Major Depressive Disorder: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Studies Neuropsychiatric Disease and Treatment (2016) Han Y., Chen J., Zou D., et al.
Nine high-quality studies that included 368 patients were selected to compare the efficacy of ketamine to placebo. The therapeutic effects at 24 hours, 72 hours, and day 7 were found to be significantly better than placebo.
3. Ketamine Administration in Depressive Disorders: A Systematic Review and Meta-Analysis Psychopharmacology (2014) Fond G, Loundou A, Rabu C, et al.
This meta-analysis confirms ketamine's efficacy in depressive disorders based on 9 studies with a total of 192 patients. Depression scores were significantly decreased in the ketamine groups compared to those in the control groups. Three of four studies found a significant decrease of suicidal thoughts.
4. Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial The American Journal of Psychiatry (2013)Murrough J.W., Iosifescu D.V., Chang L.C., Al Jurdi R.K., Green C.E., Perez A.M., et. al.
This was a high quality, well-designed randomized controlled trial. Patients with treatment-resistant major depression experiencing a major depressive episode were randomly assigned under double-blind conditions to receive either ketamine or midazolam. The primary outcome was change in depression severity 24 hours after drug administration, as assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS). The ketamine group had greater improvement in the MADRS score than the midazolam group 24 hours after treatment.
1. Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress DisorderA Randomized Clinical Trial JAMA Psychiatry (2014)Feder A, et al.
A single dose of ketamine resulted in the rapid reduction of symptoms of posttraumatic stress disorder in a proof-of-concept, randomized, double-blind study of 41 patients with chronic PTSD. Scores of PTSD symptom severity 24 hours after receiving Ketamine were significantly improved compared with midazolam.
2. Impact of oral ketamine augmentation on hospital admissions in treatment-resistant depression and PTSD: a retrospective study Psychopharmacology (2017) Hartberg, John; et al.
This was a retrospective review of patients receiving long-term oral ketamine for treatment-resistant depression and post-traumatic stress disorder. Hospital records of 37 patients who received oral ketamine treatment were reviewed to compare the number and duration of psychiatric hospital admissions before and after treatment. Following treatment, inpatient hospital days were reduced by 70%, and hospital admissions were reduced by 65%.
3. Repeated ketamine infusions for antidepressant-resistant PTSD: Methods of a multicenter, randomized, placebo-controlled clinical trial Contemporary Clinical Trials (2019) Abdallah CG, Roache JD, Averill LA, et al.
This ongoing study is the only trial of therapeutic effects of ketamine for PTSD and the first placebo-controlled trial to determine the dose-related effects of repeated ketamine on PTSD.
Institute of Integrative Therapies
1370 Mendota Heights Road Suite 123
Mendota Heights, MN 55120