Many medical professionals and mental health providers refer patients to Dr. Ascani for assessment and evaluation regarding Ketamine treatment. Dr. Ascani has extensive and varied experience with the use of Ketamine within a mental health context. Through his roles as an educator and consultant, he keeps up with the latest research in Ketamine treatment and its clinical applications. He has been working with Ketamine since 2018 and is a published author in the field of Ketamine Assisted Psychotherapy (KAP). (link to KAP article)

Ketamine was created in 1956 as a pharmaceutical anesthetic. It was placed on the World Health Organization’s list of “Essential Medicines” in 1985. Researchers in the 1990s discovered that this medicine can be a valuable tool for use in mental health treatment, especially in people who have not responded to other measures and have exhausted most avenues of treatment.

Ketamine is a legal medicine which is currently being used off-label by doctors to treat treatment-resistant depression (TRD), Bipolar Depression, Suicidal Ideation, Post Traumatic Stress Disorder (PTSD), Substance Use Disorders, Anxiety and Panic Disorders, Anxiety related to chronic or life-threatening illness, and other psychological conditions. It is distinguished from other psychotropic medications that treat mental illness by its rapid action, often producing transient relief in as soon as a few hours to days.

Biologically, Ketamine acts to enhance healing in the brain through multiple pathways. One is through the NMDA receptors in the brain, where it increases the activity of a neurotransmitter called glutamate. This can elevate your mood, decrease anxiety, and assist in changing patterns of thought.

Ketamine can be used in a variety of ways: intravenously (IV), intramuscular injection (IM), through a nasal spray (IN), sublingually (SL), subcutaneously, and orally (PO). Sublingual and Intramuscular Ketamine treatments take place in the office and are medically monitored and supervised by Dr. Ascani.

Psychologically, Ketamine has dissociative effects that create a time-out from our ordinary mind. It disrupts well-established and conditioned patterns of thinking and repetitive thought loops characteristic of depression, chronic trauma and anxiety (i.e. Default Mode Network or DMN). Ketamine also promotes nerve growth in the brain. This neuroplastic effect promotes new learning, especially when psychotherapy and lifestyle interventions are leveraged as essential elements that create opportunities to explore novel ways of being.

It is well-established that ketamine has antidepressant effects. Studies specifically looking at ketamine used without psychotherapy are numerous and well established. Other studies looking at the synergy between ketamine and psychotherapy modalities are less numerous, but readily emerging (see more).

Similar work with psychedelic compounds that create shifts in consciousness – such as MDMA, LSD, and psilocybin – suggest that altered state experiences combined with psychotherapy can have benefits beyond the use of the medicine alone.

Ketamine is unique among anesthetic medications because it is extremely safe, having been used in various settings for more than fifty years, from pediatric emergency treatment to the battlefield. Ketamine has a higher margin of safety when used to treat depression because the doses used are much lower than those used in anesthesia.

Health conditions that might make someone not be eligible for ketamine include a recent heart attack, stroke, uncontrolled high blood pressure, poor cardiovascular health, recent history of mania, history of psychosis or thought disorder (hallucinations, delusions), untreated thyroid dysfunction and recent bladder inflammation.

If you are interested in learning more, or reading some of the science behind this treatment, see our Resources section.

The experience of Ketamine varies from person to person but in general patients report feelings of disconnection from their bodies, deep peace and equanimity. Many see colors or shapes and find the music being played during the session to be mesmerizing and deeply moving. Some have the experience of meeting with elders that have passed, offering them support and care. Some visit past traumatic events but with the distance that the medicine offers, find they are able to process the memory without feeling so much fear. Some find the experience to be spiritual or mystical. The intensity of the experience can vary depending on the dose, route of administration, and on the individual response to the medicine.

In some people, Ketamine can cause mild nausea, dizziness, derealization (a sense of detachment), and drowsiness. These are usually mild and don’t last very long, however, we ask that you arrange for someone to pick you up after your treatment sessions. Patient’s receive a full preparatory session reviewing various effects and side effects of Ketamine to be fully prepared for what may emerge.

Every person is different, but we find that most people get the maximum benefit from around four to six sessions of KAP. Most people will have some improvements after one to two sessions. Additional sessions allow the brain to continue changing and solidifying new neural pathways and patterns of thought during integration sessions.

Some people need more than six sessions to get the maximum benefit, and some need fewer. Some people with chronic or Treatment-Resistant Depression find that they need an occasional “booster” or maintenance dose once they finish their main course of treatment. During your initial intake sessions, you will discuss your situation and goals with your provider, and make a personalized plan. That plan can be adjusted depending on how you respond. You do not have to commit to any specific number of sessions and you can stop at any time if you feel you are ready, or if you are not getting what you need out of it.