Unlock Freedom By HUDSON MIND
A new era of psychedelic possibility has arrived.
The power of psychedelics have long been recognized by researchers, but only recently have their potential for transformative mental health care been legitimized. Ketamine was cleared as a safe anesthetic by the FDA in 1970. But in the decades that followed, its recreational reputation overshadowed its medicinal purpose. Because perception is everything, ketamine has had to walk a long road to shed its party persona.
But a new dawn for ketamine has finally arrived. Today, interest in the psychedelic as an antidote for depression, anxiety, and even PTSD has sparked a burgeoning industry, and more importantly, new hope for people living under a constant cloud of depression and anxiety symptoms.
Medicinal psychedelics are not a new phenomenon. Indigenous cultures have relied on psychedelic substances for thousands of years. But it took modern medicine, and the public at large, a bit more time to catch up to the physical and mental benefits.
Psychedelics, including ketamine, psilocybin, and MDMA, are known for their ability to influence consciousness through altered thoughts and sensory perceptions. While each drug within this psychedelic class can induce slightly different effects, they share common ground in their ability to open the mind to a new conscious experience.
In the second half of the 20th century, psychedelics became nearly synonymous with tripping. People who dabbled in psychedelics reported the mental (and in many cases, spiritual) journeys—both good and bad—that they experienced as their brains and bodies responded to the drug. And while psychedelics do activate dreamlike responses, their transformational power extends beyond a temporary trip.
The FDA is currently reviewing studies citing the psychotherapeutic benefits of psilocybin and MDMA. Though not currently under review by the FDA, more psychedelics, including LSD and Ayahuasca, are gaining momentum across the mental health landscape through promising clinical trials.
While there is no given timeline as to when more psychedelics might receive FDA clearance, it is apparent that we are on the brink of psychedelics being widely accepted as effective antidotes to mental health conditions.
Ketamine operates on two levels: the physiological and the experiential.
The brain is not a fixed organ–it’s changeable, or plastic, and ketamine taps into this plasticity.
A depressed brain develops some deficiencies over time, including changes in synapses, which can hurt the interconnectedness of the brain’s neurocircuitry and make it more difficult for regions of the brain to communicate with one another. This decrease in synaptic proficiency can especially impact the prefrontal cortex, which is a region of the brain that helps to regulate mood. But ketamine has the power to strengthen what depression has weakened.
The ability to form new neural connections is integral to fighting–and overcoming–symptoms of depression. When our brain forms new connections it creates new opportunities for changes in thought and behavior patterns.
When administered in low doses, ketamine triggers the production of Glutamate, a neurotransmitter that sparks increased production of BDNF, a protein that promotes the brain’s neuroplasticity.
Simultaneously, ketamine stimulates pathways in the brain (specifically the prefrontal cortex and hippocampus) that repair synaptic connections and regulate emotion.
The biological reactions of ketamine in the brain are rapid. Whereas it may take Selective Serotonin Reuptake Inhibitors (SSRI medications) several weeks, if not months, to affect chemical change, synaptic transmitters may begin to repair and regrow new neural connections within hours of a low-dose ketamine treatment.
While ketamine influences the structures of your brain at the cellular level, it also opens your mind. The substance sparks a dissociation from recurring thought patterns—granting you respite and the chance to experience your life in a new (and, sometimes, more colorful) light.
During a ketamine treatment, patients often note how they feel disconnected from their bodies, life experiences, and typical thought patterns. Essentially, they are able to experience themselves from a slight distance, and it is this different vantage point that can open the door to new insights.
New insights, supported by an increase in neural connectivity, can influence lasting cognitive changes and freedom from the weight of depressive and anxious thoughts
Ketamine is an especially effective solution for anyone who has what is known as treatment-resistant depression—or have not felt improvements after trying chemical medication or talk therapy.
It’s also a great option for people who don’t want to tether themselves to common side effects of Selective Serotonin Reuptake Inhibitors (SSRI) medication. Some of these side effects include: insomnia, weight gain, nausea.
Ketamine may be a good option if you are looking for faster relief. There are many benefits to talk therapy (and we encourage patients to continue talk therapy after beginning ketamine treatment) but it can take a long time for relief from talk therapy or changes from cognitive behavioral therapy to kick in. Ketamine therapy can initiate fast responses like reducing suicidal thoughts as quickly as two hours after a single-dose infusion.
The beauty of ketamine is that the journey is completely unique to you. Some people’s experiences are more driven by auditory sensations while others have visual experiences.
You’ll still be awake, but will see and feel on a new plane of consciousness.It’s common to feel completely detached from your usual perspectives and thoughts, which may give you the space to see your life differently. You might feel as though you are moving through a dream or you might find yourself replaying memories that have been buried in your consciousness.
Before the Journey
Before scheduling your first appointment you’ll have the chance to participate in a Complimentary Education Screener with one of our Physician Assistants. During this time you can learn more about ketamine, ask questions, and review your personal history.
The day before you’ll receive a pre-treatment checklist with some tips to follow like what to bring, how to set your intentions, and what to avoid.
After you get acclimated in our space, a member of our team will set you up with an optional curated playlist before leading you through some breathwork exercises and a simple, guided meditation.
During the Journey
The entire journey typically lasts around 45 minutes. After our team sets up the IV infusion they will periodically check in on you. There is also a call button you can use if you need any assistance or support during your treatment session.
If you ever need to take a break, you can simply remove your eye mask and headphones.
After the Journey
We give you as much time as you need to relax and reacclimate in our serene Recovery Lounge. During this time you can enjoy tea and light snacks, and also journal any thoughts you may have had during the experience.
We encourage you to take the rest of the day to unwind and reflect on the experience.
If you are working with a psychotherapist, we recommend scheduling a session within 48 hours. This ensures that any insights you may have had are still fresh for the two of you to explore.
We want you to sit back and relax during your treatment, but there are some things you can bring and do beforehand to maximize your own comfort:
- Have a favorite eye mask? Bring it! If not, we’ve got you covered (literally). Wearing an eye mask will block out light and help you focus on your journey.
- Try not to eat or drink for four hours before your journey, as an empty stomach will reduce nausea.
- Wear comfortable, loose-fitting clothes so that you feel as relaxed as possible. Non-restrictive clothing will also help with IV accessibility.
- Set your intentions beforehand. Carve out some time to think about what you are hoping to get out of treatment and the changes you want to prompt in your life.
- Avoid violent media. Watching TV shows and movies with excessive amounts of violence can have a negative impact on your ketamine experience
- Avoid alcohol, marijuana, and other mind-altering substances or stimulants as they can influence your experience.
How much does it cost?
For information on pricing, please contact our Patient Services Representative team at: email@example.com. If you think you may be eligible for financing options or assistance because you have documented financial hardship, please fill out the eligibility form and a member of our Patient Services Representative team will contact you shortly.
Does insurance cover ketamine therapy?
Unfortunately, insurance does not cover low-dose ketamine infusions for depression, because it is still considered an off-label medication.
Will I have a bad trip?
Bad trips are rare, but it is always possible that your journey may not feel pleasant. For some people, bad trips can feel like being trapped in a dark space, while others relive their past traumas. If you feel at all anxious about your journey, rest assured that you will not be left alone. We regularly check in during your infusion and there is a call button available if you need assistance. Stopping or slowing the infusion is also always an option.
How long will ketamine stay in my system?
Traces of ketamine may be detected in your urine sample for about two weeks, in your blood for four days, and in your hair follicles for up to 90 days. It’s important to note that a chemical trace is not the same as chemical activity. The dissociative feelings induced by the treatment will wear off after about two hours.
Do I need a referral?
Our team prefers to receive referrals before beginning treatment, but they are not required. We find that we are able to help people achieve the best results when we are able to work with a mental health provider to better understand your history and develop a post-treatment plan. If you are not currently seeing a psychotherapist or psychiatrist, our physicians will perform a comprehensive screening. We work with hundreds of ketamine-assisted-psychotherapists and are happy to refer you.
Are there any contraindications?
There are very few contraindications to ketamine, however patients with a recent history of Traumatic Brain Injury, History of Psychosis, and ketamine allergy should NOT receive ketamine.
How does ketamine compare to Psychiatric Medicines (SSRI’s) for depression?
Antidepressants challenge chemical imbalance in the brain by replacing neurotransmitters that have broken down. While this can be effective, antidepressants also come with side effects.
Ketamine challenges the breakdown in the brain’s information synthesis capability by resetting brain structures and creating new neural connections.
Can I still receive ketamine treatment if I’m currently on antidepressants?
We always recommend discussing dosage changes or continuation with your psychiatrist. But it is safe to continue taking antidepressants once you’ve begun ketamine treatment, as ketamine does not interact with the majority of antidepressant medications. Although it is safe to continue, many people actually are able to lower their antidepressant dosage following ketamine therapy.
How will I feel after?
Everyone’s experience is different. But you’ll likely feel calm and uplifted following a treatment. You might feel the dissociative effects of the ketamine for up to two hours after the infusion. Some people report feeling a bit light-headed and nauseous—especially when they are new to ketamine. Feel free to take as much time as you need to readjust and re-acclimate in our recovery lounge.
Should someone accompany me?
We recommend bringing along a friend if this is your first time receiving ketamine treatment. It’s not a requirement, but sometimes knowing that a familiar face is waiting can put you at ease.
Who is administering the treatments at Hudson?
Our ketamine treatments are administered by physicians and ICU-trained physician assistants who are supervised by board-certified anesthesiology physicians.
How long is the treatment?
The infusion portion of your ketamine treatment may last anywhere from 45 minutes to one hour. You may continue to feel dissociative effects for 30 minutes following the infusion—some people even report lingering effects for a few hours. We give you as much time as you need to relax and readjust in the room.
How many sessions should I schedule?
Research shows that significant healing breakthroughs typically occur around the fourth or fifth ketamine treatment. We recommend completing six sessions over the course of three to four weeks.
What are the different ways ketamine is administered?
We offer two types of ketamine treatments The first is an infusion drip administered intravenously. The second is an injection, administered intramuscularly. We recommend new patients begin with infusions as this mode of administration gives our team more control over the speed at which the ketamine is delivered to your system, ultimately delivering a more gradual journey.
Admin. “FDA Approves First Ketamine-Based Antidepressant.” Science in the News, 13 Mar. 2019, https://sitn.hms.harvard.edu/flash/2019/fda-approves-first-ketamine-based-antidepressant/
Williams, K., Romero, O.S.G., Braunstein, M. and Brant, S. (2022), Indigenous Philosophies and the “Psychedelic Renaissance”. Anthropol Conscious, 33: 506-527. https://doi.org/10.1111/anoc.12161.
Marks, M., Cohen, I.G. Psychedelic therapy: a roadmap for wider acceptance and utilization. Nat Med 27, 1669–1671 (2021). https://doi.org/10.1038/s41591-021-01530-3
“How Depression Affects the Brain.” Yale Medicine, Yale Medicine, 17 June 2021, https://www.yalemedicine.org/news/neurobiology-depression.
Hudson Medical. “About Us.” Hudson Mind, 14 Mar. 2022, https://hudsonminds.com/blog/intravenous-ketamine-infusions/.
“Yale Scientists Explain How Ketamine Vanquishes Depression within Hours.” YaleNews, 22 Jan. 2018, https://news.yale.edu/2012/10/04/yale-scientists-explain-how-ketamine-vanquishes-depression-within-hours.
Hudson Mind research: Ketamine IV Infusions—The Science
- Mandal, Suprio et al. “Efficacy of ketamine therapy in the treatment of depression.” Indian journal of psychiatry vol. 61,5 (2019): 480-485.
- Marcantoni, Walter S et al. “A systematic review and meta-analysis of the efficacy of intravenous ketamine infusion for treatment resistant depression: January 2009 – January 2019.” Journal of affective disorders vol. 277 (2020): 831-841. doi:10.1016/j.jad.2020.09.007
- Orhurhu, Vwaire et al. “Ketamine Infusions for Chronic Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.” Anesthesia and analgesia vol. 129,1 (2019): 241-254. doi:10.1213/ANE.0000000000004185
- Taylor, Samantha-Su et al. “Complex Regional Pain Syndrome: A Comprehensive Review.” Pain and therapy, 10.1007/s40122-021-00279-4. 24 Jun. 2021, doi:10.1007/s40122-021-00279-4
- Zhao, Jianli et al. “The Effect of Ketamine Infusion in the Treatment of Complex Regional Pain Syndrome: a Systemic Review and Meta-analysis.” Current pain and headache reports vol. 22,2 12. 5 Feb. 2018, doi:10.1007/s11916-018-0664-x
- Niciu, Mark J et al. “Overview of glutamatergic neurotransmission in the nervous system.” Pharmacology, biochemistry, and behavior vol. 100,4 (2012): 656-64. doi:10.1016/j.pbb.2011.08.008
- Adell, Albert. “Brain NMDA Receptors in Schizophrenia and Depression.” Biomolecules vol. 10,6 947. 23 Jun. 2020, doi:10.3390/biom10060947
- Abdallah, Chadi G et al. “The effects of ketamine on prefrontal glutamate neurotransmission in healthy and depressed subjects.” Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology vol. 43,10 (2018): 2154-2160. doi:10.1038/s41386-018-0136-3
- Marsden, W N. “Stressor-induced NMDAR dysfunction as a unifying hypothesis for the aetiology, pathogenesis and comorbidity of clinical depression.” Medical hypotheses vol. 77,4 (2011): 508-28. doi:10.1016/j.mehy.2011.06.021
- Gaynes, Bradley N et al. “Defining treatment-resistant depression.” Depression and anxiety vol. 37,2 (2020): 134-145. doi:10.1002/da.22968
- Phillips, Jennifer L et al. “Single, Repeated, and Maintenance Ketamine Infusions for Treatment-Resistant Depression: A Randomized Controlled Trial.” The American journal of psychiatry vol. 176,5 (2019): 401-409. doi:10.1176/appi.ajp.2018.18070834
- Singh, Jaskaran B et al. “A Double-Blind, Randomized, Placebo-Controlled, Dose-Frequency Study of Intravenous Ketamine in Patients With Treatment-Resistant Depression.” The American journal of psychiatry vol. 173,8 (2016): 816-26. doi:10.1176/appi.ajp.2016.16010037
- Chater, Thomas E, and Yukiko Goda. “The role of AMPA receptors in postsynaptic mechanisms of synaptic plasticity.” Frontiers in cellular neuroscience vol. 8 401. 27 Nov. 2014, doi:10.3389/fncel.2014.00401
- Lazarevic, V., Yang, Y., Flais, I. et al. “Ketamine decreases neuronally released glutamate via retrograde stimulation of presynaptic adenosine A1 receptors.” Mol Psychiatry. (2021): https://doi.org/10.1038/s41380-021-01246-3
- Sen, Srijan et al. “Serum brain-derived neurotrophic factor, depression, and antidepressant medications: meta-analyses and implications.” Biological psychiatry vol. 64,6 (2008): 527-32. doi:10.1016/j.biopsych.2008.05.005
- Guilloux, JP., Douillard-Guilloux, G., Kota, R. et al. Molecular evidence for BDNF- and GABA-related dysfunctions in the amygdala of female subjects with major depression. Mol Psychiatry 17, 1130–1142 (2012). https://doi.org/10.1038/mp.2011.113
- Tripp, Adam et al. “Brain-derived neurotrophic factor signaling and subgenual anterior cingulate cortex dysfunction in major depressive disorder.” The American journal of psychiatry vol. 169,11 (2012): 1194-202. doi:10.1176/appi.ajp.2012.12020248
- Marchi, Mario et al. “Effects of adenosine A1 and A2A receptor activation on the evoked release of glutamate from rat cerebrocortical synaptosomes.” British journal of pharmacology vol. 136,3 (2002): 434-40. doi:10.1038/sj.bjp.0704712
- Yang, Tao et al. “The Role of BDNF on Neural Plasticity in Depression.” Frontiers in cellular neuroscience vol. 14 82. 15 Apr. 2020, doi:10.3389/fncel.2020.00082
- Fukumoto, Kenichi et al. “Activity-dependent brain-derived neurotrophic factor signaling is required for the antidepressant actions of (2R,6R)-hydroxynorketamine.” Proceedings of the National Academy of Sciences of the United States of America vol. 116,1 (2019): 297-302. doi:10.1073/pnas.1814709116
- Autry, Anita E et al. “NMDA receptor blockade at rest triggers rapid behavioural antidepressant responses.” Nature vol. 475,7354 91-5. 15 Jun. 2011, doi:10.1038/nature10130
- Höflich, A., Kraus, C., Pfeiffer, R.M. et al. Translating the immediate effects of S-Ketamine using hippocampal subfield analysis in healthy subjects-results of a randomized controlled trial. Transl Psychiatry 11, 200 (2021). https://doi.org/10.1038/s41398-021-01318-6
- Xiong, Jiaqi et al. “The acute antisuicidal effects of single-dose intravenous ketamine and intranasal esketamine in individuals with major depression and bipolar disorders: A systematic review and meta-analysis.” Journal of psychiatric research vol. 134 (2021): 57-68. doi:10.1016/j.jpsychires.2020.12.038
- Gill, Hartej et al. “The Effects of Ketamine on Cognition in Treatment-Resistant Depression: A Systematic Review and Priority Avenues for Future Research.” Neuroscience and biobehavioral reviews vol. 120 (2021): 78-85. doi:10.1016/j.neubiorev.2020.11.020