Common Concerns and Objections to Ketamine-Assisted Psychotherapy (KAP): A Q&A Overview
1. Is ketamine safe for mental health treatment?
Concern: Many people worry about the safety of ketamine, especially given its history as an anesthetic and recreational drug.Response: Research has shown that ketamine, when administered in controlled, therapeutic settings, is generally safe and well-tolerated. Unlike traditional antidepressants, which can take weeks to take effect, ketamine has been found to provide rapid relief for symptoms of depression and PTSD (Dore et al., 2019). However, like any medical treatment, it does have potential side effects, including dizziness, nausea, and transient dissociation, which are carefully managed by trained professionals (Bonaventura et al., 2021).Additionally, studies have indicated that ketamine is particularly effective for treatment-resistant depression, where conventional therapies have failed. This makes it a valuable tool for individuals who have struggled with long-term mental health challenges. That said, patients should undergo thorough screening and monitoring to ensure that ketamine is an appropriate treatment for their specific condition (Grunebaum et al., 2017).
References:•Dore, J., Turnipseed, B., Dwyer, S., Turnipseed, A., Andries, J., Ascani, G., & Monnette, C. (2019). Ketamine-assisted psychotherapy (KAP): Patient demographics, clinical data, and outcomes in three large practices administering KAP. Journal of Psychoactive Drugs, 51(2), 189-198.•Bonaventura, J., et al. (2021). Neuropsychiatric safety and mechanisms of ketamine treatment in depression. Nature Reviews Neuroscience, 22, 497–511.•Grunebaum, M. F., et al. (2017). Ketamine for rapid reduction of suicidal thoughts in major depression. International Journal of Neuropsychopharmacology, 20(3), 227-232.
2. Is ketamine addictive?
Concern: Some people fear that ketamine could lead to addiction, particularly because of its use as a recreational drug.Response: While ketamine has been misused recreationally, the risk of addiction in a therapeutic setting is low. Medical professionals administer ketamine at controlled doses and frequencies that minimize the risk of dependence. Studies indicate that ketamine, when used under supervision, does not exhibit the same addictive properties as opioids or stimulants (Krystal et al., 2019). However, individuals with a history of substance use disorder should be assessed carefully before undergoing treatment. Furthermore, research shows that ketamine interacts with the brain’s glutamate system, rather than dopamine pathways typically associated with addiction (Morgan et al., 2012). In fact, some emerging studies are exploring its potential to help treat substance use disorders, including alcohol and opioid dependency (Dakwar et al., 2014).
References:•Krystal, J. H., Sanacora, G., & Duman, R. S. (2019). Rapid-acting antidepressants and the neurobiology of resilience. Nature Reviews Neuroscience, 20(8), 480-490.•Morgan, C. J., et al. (2012). The enduring effects of ketamine on addiction. CNS Neuroscience & Therapeutics, 18(2), 70-74.•Dakwar, E., et al. (2014). The effects of a sub-anesthetic dose of ketamine on motivation to quit and cue-induced craving in cocaine-dependent research volunteers. Biological Psychiatry, 76(1), 40-46.
3. Will I lose control or have a "bad trip" during ketamine therapy?
Concern: Some worry that ketamine’s dissociative effects might cause anxiety or a loss of control.Response: Ketamine can induce altered states of consciousness, but in a therapeutic setting, these experiences are guided and integrated into the healing process. KAP is conducted in a safe, supportive environment with trained professionals who help clients process their experiences. Studies suggest that the dissociative effects of ketamine contribute to its antidepressant benefits by disrupting maladaptive thought patterns (Zarate et al., 2018). Proper preparation and post-session integration further help clients navigate these experiences constructively.Additionally, research shows that the degree of dissociation a patient experiences can correlate with better treatment outcomes (Luckenbaugh et al., 2014). Trained clinicians help patients approach the experience with intention and guidance to maximize therapeutic benefit while minimizing distress.
References:•Zarate, C. A., et al. (2018). Ketamine and rapid-acting antidepressants: A window into a new neurobiology for mood disorder therapeutics. Annual Review of Medicine, 69, 437-451.•Luckenbaugh, D. A., et al. (2014). Do the dissociative side effects of ketamine mediate its antidepressant effects? Journal of Affective Disorders, 159, 56-61.
4. How long do the benefits of KAP last? Do I have to do it forever?
Concern: Some worry that ketamine provides only temporary relief, requiring continuous sessions.Response: The duration of ketamine’s effects varies by individual, but research suggests that a series of treatments can lead to sustained improvements, especially when combined with psychotherapy (Wilkinson et al., 2018). Many individuals experience symptom relief for weeks or even months, and booster sessions may be scheduled as needed. KAP is not necessarily a lifelong treatment but can be part of an integrated mental health strategy.Furthermore, ketamine’s impact on neuroplasticity suggests that it may facilitate lasting changes in brain function that help individuals make long-term progress (Duman & Aghajanian, 2019). Patients who integrate lifestyle changes, ongoing therapy, and self-care practices tend to experience longer-lasting benefits.
References:•Wilkinson, S. T., et al. (2018). A clinical review of ketamine in depression. JAMA Psychiatry, 75(2), 139-150.•Duman, R. S., & Aghajanian, G. K. (2019). Neurobiology of rapid-acting antidepressants: Role of BDNF and GABAergic interneurons. Nature Reviews Neuroscience, 20, 247-262.
5. Is ketamine therapy just another "quick fix"?
Concern: Some believe that ketamine is simply a shortcut, rather than addressing the root causes of mental health issues.Response: Unlike traditional psychiatric medications that only manage symptoms, ketamine’s unique mechanism fosters neuroplasticity, potentially helping individuals form new, healthier thought patterns (Duman et al., 2019). When used in conjunction with psychotherapy, ketamine can provide both immediate symptom relief and long-term emotional and cognitive changes, supporting deeper healing.Additionally, the therapy component of KAP is designed to help individuals explore and resolve underlying emotional trauma or maladaptive thought patterns, making it more than just a symptom-management approach. Many clinicians emphasize the importance of integrating insights gained during ketamine sessions into daily life through therapy and personal reflection.
Conclusion
Concerns about Ketamine-Assisted Psychotherapy are valid and deserve careful consideration. However, extensive research supports its safety, efficacy, and therapeutic benefits when used appropriately. As with any medical treatment, discussing individual risks and benefits with a qualified provider is essential to making an informed decision.