What is ketamine?
Ketamine has been safely used in medical settings around the world for more than 50 years. Originally developed as an anesthetic, researchers have since discovered that at much lower doses it can have powerful effects on mood and awareness.
Ketamine is included on the World Health Organization’s List of Essential Medicines, recognizing it as one of the most important and reliable drugs needed in the health care system and reflecting its safety and effectiveness when used properly.
In recent years, ketamine has been studied for its ability to reduce symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD), especially in people who have not responded well to other treatments. The effects usually begin within hours and can create a temporary state where people feel more open to reflection and new perspectives.
When used in a therapeutic setting, ketamine is not meant to “erase” problems, but rather to help people step outside their usual patterns of thought and gain insight. This can support therapy by creating space for deeper exploration of life story, values, and meaning.
What is ketamine-assisted therapy, and how does it differ from ketamine therapy?
“Ketamine therapy” usually refers to the medical use of ketamine alone to help relieve symptoms of depression, anxiety, or chronic pain. In these settings, ketamine is administered under supervision and patients often rest quietly during the session. While many people experience mood improvements, there is little or no structured talk therapy involved during or after the medicine.
Ketamine-assisted therapy, on the other hand, combines ketamine with therapeutic conversation. The medicine helps open a temporary state of increased awareness and flexibility in thought. A trained provider then helps the person explore personal meaning, life events, and patterns of thought during the session as well as afterward in integration sessions.
While ketamine therapy focuses primarily on symptom relief, ketamine-assisted therapy aims to connect the experience to personal growth, insight, and lasting change. Research and clinical experience suggest that therapeutic support adds depth, helping people mine the ketamine experience for great meaning and autonomy in carrying its benefits forward.
How does ketamine work?
Ketamine works differently from traditional psychiatric medications. Instead of focusing on serotonin or dopamine, it primarily influences the glutamate system, the brain’s main messenger involved in learning, memory, and mood regulation.
One of ketamine’s most important effects is increasing levels of brain-derived neurotrophic factor (BDNF), a natural protein that helps brain cells grow and form new connections. This process, called synaptogenesis, may allow the brain to “reset” unhealthy patterns and develop more flexible, resilient pathways.
Researchers believe that this combination of rapid chemical changes and new neural connections explains why ketamine can relieve symptoms of depression and anxiety much faster than traditional medications—sometimes within hours instead of weeks.
But again: it’s the therapeutic setting and integration work that help turn these brain changes into lasting personal growth.
References: Duman & Aghajanian, 2012; Abdallah et al., 2016; Reiff et al., 2020
How do I know if I’m a candidate for this treatment?
The best way to find out is to begin a conversation. At Transcendent Medicine, we offer a free initial phone consultation to learn something about you, your goals and the challenges you’re facing. This first step allows us to share more about how ketamine-assisted therapy works and see if you are a match for our approach.
Ketamine therapy may be most helpful for people who are experiencing:
- Depression or anxiety that has not improved with standard treatments
- End-of-life distress, including fear, loss of meaning, or spiritual suffering
- Post-traumatic stress disorder (PTSD) or unresolved trauma
- Major life transitions, such as grief, illness, or other periods of change where support for reflection and perspective is needed
There are times when ketamine may not be the best choice—for example, in individuals with certain medical conditions, active substance misuse, or who are not ready to enter a profound and challenging reflective process. If you choose to move forward after the free consultation, we’ll review your medical and psychological history, answer any questions, and customize your treatment plan.
Is ketamine addictive?
Ketamine does have the potential for misuse when it is taken repeatedly in high doses outside of medical settings. In those situations, people can develop dependence or problems with bladder health and memory.
However, in a medical setting with careful dosing and supervision, the risk of addiction is very low. Treatment is typically given intermittently, not daily, and always with clinical oversight. Patients are also screened before treatment to make sure ketamine is appropriate and safe for them.
In our practice, ketamine is not used as a stand-alone quick fix, but as a tool within a larger therapeutic process that emphasizes meaning, life story, and integration. This careful, intentional approach further reduces risks of misuse.
References: Morgan et al., 2012; Sanacora et al., 2017; Reiff et al., 2020.
Do I need a referral from my doctor?
Not necessarily. You can contact us directly to learn whether ketamine-assisted psychotherapy may be appropriate for you.
As part of our intake process, we carefully review each patient’s medical and psychological history. In most cases, this is sufficient. However, if questions or concerns arise during that review—for example, about a heart condition, medications, or other health issues—we may recommend consulting with your primary care physician or another specialist before moving forward.
Our goal is to make sure treatment is both safe and appropriate, and when needed, we coordinate with your existing doctors to ensure the best care.
How is ketamine administered?
Ketamine can be given in several different ways, including:
- Intravenous (IV) infusion – directly into the bloodstream
- Intramuscular (IM) injection – into a muscle
- Oral lozenges (troches) – slowly dissolved in the mouth
- Intranasal spray – absorbed through the nasal passages
- Topical application – applied to the skin (used less commonly)
Different clinics may emphasize different methods. At Transcendent Medicine, our primary approach is with oral lozenges, which allow for a gentle and flexible experience. In certain cases—such as when a more precise or rapid effect is desired—we may also use intramuscular injections.
What happens during the ketamine experience?
Each person’s journey is unique, but there are some common features you can expect. The session begins in a quiet, comfortable setting where you are invited to relax and let go of ordinary concerns. You may choose to recline, use an eye mask, and listen to carefully selected music, all of which help create a safe container for the experience.
As the medicine takes effect, most people notice a shift in perception. Thoughts, images, or memories may arise in new ways, often with a sense of distance or openness that allows for reflection. Some describe a dreamlike state, while others feel a gentle detachment from ordinary patterns of thinking. Emotions can surface—sometimes difficult, sometimes uplifting—but always with the possibility of a new perspective.
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