Psychedelics continue to show excellent results in treating depression, anxiety and PTSD. Ketamine is available for administration in clinical settings. Does the psychedelic experience matter during an infusion, or is it simply important to get the drug?
The many different psychedelics:
A variety of novel and ancient psychedelic substances have been examined in clinical research programs for their effects on severe treatment-resistant depression, terminal-illness related depression, end-of-life anxiety, severe treatment-resistant anxiety, generalized anxiety, and PTSD. These medications include: LSD, MDMA, ayahuasca, peyote, DMT, datura, jimson weed, magic mushrooms or psilocybin, and phencyclidine (PCP). Ketamine, which was originally developed as a safer version of PCP, has been the most widely studied and is the only one currently being employed for regular clinical treatments.
Ancient people in many different cultures found a way to spirituality and meaning through the psychedelic pathway. Fasting in the desert, enforced stays in complete darkness and other physical pathways forced the body into hallucinations and spiritual visions. Along the way, shamans found that plant based mixtures like mushrooms, Datura, jimson weed, ayahuasca worked, as well. Pharmaceutical researchers developed modern drugs that have these same, or similar, effects like MDMA, ketamine, PCP and LSD. Unlike PCP, MDMA, and LSD, however, ketamine is commonly used and has a very predictable course through its “trip”.
The psychedelic drug used by doctors:
Ketamine is the only psychedelic drug available for clinical use today. It has a well-known safety profile, a long history of use, and an increasingly significant body of research supports its use for other conditions, especially mood disorders including depression, anxiety and post-traumatic stress disorder (PTSD), and for pain conditions such as CRPS.
Ketamine is sometimes referred to as a psychoactive drug because it produces psychoactive effects or symptoms in a patient, although these may or may not be related to the results the doctor seeks.
Does the psychedelic experience matter?
When treating many pain conditions the dose of ketamine is so high that the patient must be sedated to avoid uncomfortable experiences. At the lower doses used for the treatment of mood disorders, patients often do experience psychedelic “side effects.”
There is debate over the usefulness of the experience during a ketamine infusion and drug makers are trying to eliminate these experiences as they develop new drugs that capitalize on the success of ketamine. Many clinicians and researchers, however, believe that the dissociative effect of psychedelics, including ketamine, may be important in achieving good results:
“the quality of the psychedelic trip was directly linked with how much someone’s depressive symptoms decreased. In other words, the more connected someone felt during and immediately after the trip, the longer those feelings lasted and the less depressed they felt. That said, a high quality (sic) trip should not to be confused with “good” or “bad” feelings, since some highly therapeutic trips can involve a fair amount of anxiety.”
Discussing, in part the results of:
Roseman L, Nutt DJ and Carhart-Harris RL (2018) Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression. Front. Pharmacol. 8:974. doi: 10.3389/fphar.2017.00974
This is consistent with the information we have, including the results we see with our patients. We find that getting an appropriate, individualized dose of medication (carefully, incrementally changed – increased or decreased – based on a patient’s response) appears to impact the quality of the results patients see. Whether the experience is perceived as good or not, we tailor dosing to find the range that appears best suited for the patient.
What do patients experience during a ketamine infusion:
The experience can be different from patient to patient and for each patient from one treatment to the next. But, in general, patients describe feeling “floaty” or like they are floating. Patients may experience mild visual hallucinations, such as seeing colors. Sometimes patients will think about important life events or subjects. Sometimes patients will focus on the calming or happy music they are listening to.
Here’s more information: What is a Ketamine Infusion Like?
About Me, Dr Allison Wells: I started Lone Star Infusion, here in Houston, to provide ketamine infusions for depression, anxiety, PTSD, CRPS and other mood disorders and pain conditions. I am a licensed, board-certified anesthesiologist. I am super passionate about being a partner in helping people feel their best with evidence-based medicine.
An Important Disclaimer: The information in this and other blog posts represents my informed opinion or the opinion of others, and does not constitute medical advice and should not be relied upon to make decisions regarding medical care. To address the specific details of your medical conditions and treatments please speak with your doctors.