Ketamine In-Depth

Since its discovery in the 1960s, ketamine has been extensively studied and used in a number of ways. While initially classified as an anesthetic, ketamine produces different effects at lower doses. Recent research has focused on exploring its antidepressant, anti-inflammatory, pain-relieving, and psychedelic properties.

Though ketamine is known for its veterinary use, it was first discovered and developed for humans before being adapted for veterinary practice. Its reputation as a "horse tranquilizer" or "cat anesthetic" is undeserved—it is generally very safe and is used extensively in hospitals, clinics, and outpatient settings.

Over the last sixty years, numerous studies have demonstrated ketamine's safety and positive effects for various conditions. While ketamine has an excellent safety profile, your well-being remains our priority. You will be carefully screened to ensure that low-dose ketamine treatment is a safe choice for you.

At low doses, such as those offered at Raven Feathers Health Services, ketamine provides relaxation, pain relief, and lowered psychological defenses. Patients receiving low doses remain alert, oriented to their surroundings, and generally remember their entire treatment session. Side effects at this dose are typically mild and short-lived, potentially including nausea, headache, increased blood pressure, and increased heart rate.

At higher doses, usually administered through intravenous infusion, ketamine can create complete dissociation from experience and result in an anesthetized state. A full profile of potential side effects is provided below.

Raven Feathers Health Services uses ketamine only in the low-dose sublingual route. During your appointment, you will remain conscious and oriented to your surroundings.

How is ketamine used

Ketamine has demonstrated significant effects on both body and brain. At Raven Feathers, we use ketamine to produce a relaxed, comfortable, and pro-neuroplastic state. Neuroplasticity is the process in which the brain grows new connections and pathways. Three main factors make ketamine useful in creating this state.

First, ketamine drives neuroplasticity through its effect on the brain's glutamate and GABA neurotransmitter systems. Second, its analgesic and anti-inflammatory properties may improve your pain during treatment. Third, psycholytic (low-dose) ketamine creates a state combining an alert, oriented mind with lowered unconscious psychological defenses. This creates ideal conditions for new insights into your chronic pain and life experiences.

By combining these three factors, psycholytic ketamine treatment allows you to experience your body in a novel way and create a deeply meaningful mental "image" of your brain with less pain signaling. During treatment, we'll work together to identify experiences that help build this new map. These include guided imagery—where you'll visualize changes to your brain or specific experiences related to decreased pain—meditation such as mindfulness and breath awareness, and even simple experiences like listening to music. With dedicated practice over time, you can train your brain to easily enter this state and rewire its pain signaling, resulting in fewer pain signals reaching your conscious mind. Some users have reported complete elimination of their pain using neuroplastic pain approaches.

Conditions That Might Make Ketamine Unsafe

Several conditions might make ketamine treatment unsuitable for you. Some medical conditions may pose cardiovascular risks, while certain psychiatric or mental health issues might make ketamine's subjective effects challenging for your mental well-being. Some mental health concerns may be better addressed through psychedelic-assisted or traditional therapy. If this is the case, I can refer you to a psychologist or other therapist.

Contraindications for Ketamine Treatment:

• Cardiovascular: History of stroke, recent heart attack, uncontrolled high blood pressure, unexplained arrhythmia (irregular heart beat), angina or chest pain

• Neurological: Increased intracranial pressure, current brain tumor, increased intraocular pressure

• Advanced liver or kidney disease

• A personal or family history of schizophrenia, psychosis or mania

• Active or recent suicidality

Potential Positive Effects of Ketamine Treatment:

Ketamine treatment may help change how your brain processes and presents pain signals. Some patients report significant improvements in their pain experiences and, over time, resolution of their pain using neuroplastic techniques. During treatment, you may experience pain relief due to ketamine's analgesic (pain-killing) effects. Many patients report new insights or an ability to experience their pain from a fresh perspective. Studies show, and patients report, that ketamine has antidepressant effects, improving depressive symptoms.

Potential Negative effects of Ketamine Treatment

At low doses, ketamine's side effects are generally short-term and resolve on their own by the end of the treatment session. During a low-dose ketamine session, you might experience:

• Disorientation, confusion, impaired motor coordination (referred to as K-legs)

• Dizziness, nausea or vomiting, headache

• Increased blood pressure, heart rate, breathing rate, body temperature

• Changes in your sensory perception

• A sense of detachment from yourself or your own experiences - "looking at yourself from a distance"

Psychological Side Effects of Ketamine Treatment

While ketamine treatment for chronic pain aims to create a pro-neuroplastic environment for addressing pain-related goals, you may encounter psychologically distressing memories or realizations during treatment. By lowering your psychological defenses, you may recall painful or traumatic memories and experience challenging insights about yourself or your life experiences. While we provide emotional support, I am not qualified to provide psychotherapy. This approach isn't intended to address concerns such as depression, post-traumatic stress, or other psychological issues. If needed, I can refer you to a psychologist or therapist for assistance with these issues.

Serious reactions

Serious reactions to ketamine are unusual, especially at lower doses. However, the following reactions are possible:

• General - sedation, impaired consciousness

• Head, Ear, Eyes, Nose, Throat - horizontal, vertical or rotary nystagmus (eye twitching), mydriasis (abnormally dilated pupils), and excessive salivation

• Cardiovascular - hypertension, hypotension, tachycardia, bradycardia, palpitations, arrhythmias, chest pain, myocardial infarction

• Abdominal - abdominal pain, abdominal tenderness, nausea, vomiting

• Neurological - altered mental status (disorientation), paranoia, dysphoria, anxiety, confusion, slurred speech, dizziness, ataxia, dysarthria, trismus, muscular rigidity, psychomotor reactions, psychomimetic reactions, acute dystonic reactions, seizure, stupor, coma

• Respiratory - respiratory depression, laryngospasm

• Genitourinary - lower urinary tract symptoms

Please note, at Raven Feathers Health Services, your safety is our utmost concern. We have protocols in place to minimize risks and support you should any adverse events occur. These side effects are unusual in patients undergoing low-dose ketamine treatment. Your medical history and suitability for ketamine treatment will be thoroughly assessed by myself and a psychiatrist during your intake process. However, all risks associated with ketamine treatment remain with you, the patient.

Psychedelic versus Psycholytic Ketamine dosing

Raven Feather Health Services uses "psycholytic" (low-dose) doses of ketamine. The word psycholytic comes from the Greek psyche- (mind) and -lysis (opening, or breaking a barrier). Psycholytic dosing differs from psychedelic ketamine experiences, where users typically become disoriented to place and time, may experience mystical or deep spiritual insights, and may experience ego death or a dissolving of the self. A psycholytic experience helps you explore elements of your inner self and world while maintaining your orientation, insight, and ability to participate in therapeutic interventions such as mindfulness, guided imagery, or meditation.

Alternatives to Ketamine Treatment

Several alternatives exist to low-dose ketamine treatments for chronic pain. These include conventional or psychedelic-assisted psychotherapy, mindfulness, guided imagery, movement and breath practices, and meditation. Many meditative and breathwork-related practices have been shown to enhance neuroplasticity. Raven Feathers Health Services acknowledges that ketamine treatment might not be right for everyone and supports informed consent, encouraging you to explore all avenues that support your care and well-being.