Menu

the science

Of ketamine

A TOOL FOR YOUR WELLNESS

Research has shown that in the right set and setting, ketamine
can be a powerful tool for transformation. It offers new hope on the path to a life well lived.

what is ketamine?

Ketamine has recently entered the world of mental health, primarily for the treatment of what is known as “treatment resistant depression” (though we’re not into labels). For the last 50 years it’s been used as an anesthetic, because of its impressive safety profile. Ketamine is on the World Health Organization’s list of essential medicines. Starting in the early 2000’s, due to its dissociative properties and effect on consciousness, the healthcare field began researching ketamine’s efficacy on other illnesses, including a multitude of psychiatric and pain disorders. In 2019, it received its first FDA approval for “treatment resistant depression”, through a specific enantiomer (esketamine) – known as Spravato, in the United States.

what is depression and TRD?

Major Depression is a universal illness that effects people of all different demographics. It’s a chronic illness, meaning there is no “cure” and approximately 1/3 of the world’s population will have at least one episode of major depression in their lifetime, with many people having multiple episodes of depression throughout their lives. Though it is defined by certain criteria by the leading diagnostic manuals in the international classification of diseases and Diagnostic and Statistical Manual of Mental Disorders, in clinical practice it is known as being a fairly heterogenous disease, meaning it may present differently and individually in those suffering from depression, making it difficult to have a standardized treatment plan that is a one size fits all model. Although there is no absolute definition of treatment-resistant depression, most expert consensus and the field of mental health have agreed on an arbitrary definition of treatment-resistance being defined as failure of two failed trials of first-line antidepressants, in which the individual has taken an adequate dose for an adequate period of time, usually anywhere from 6-8 weeks, and have no shown a response based on validated clinical scales for depression.

why is ketamine important?

Ketamine represents an additional tool in our toolbox to attempt to alleviate one of the most disabling diseases in the modern world; depression. Though first-line treatments like SSRIs (selective serotonin re-uptake inhibitors) have been somewhat effective, roughly only 30% of people show response to these interventions, leaving many without solutions. The current trial and error method often causes individuals to be on multiple medications at once, leading to higher potential for adverse reactions and side effects. Not only that, but healthcare has shifted primarily to a biological model of treatment, often ignoring various therapy models, psycho-education, and alliance building that has been shown to be just as effective as medication. The human psyche and human experience is complex, and too often is reduced to a “chemical imbalance.” Psychological suffering can’t be explained simply by either deficits or over-abundance of chemicals, and there is still a lot to understand fully.

Ketamine provides a novel mechanism of action that is very different from the current first-line treatments. It’s been touted as a significant clinical breakthrough in the world of mental health in the last several decades. We’re not pitching Ketamine as a “miracle drug” that will cure the world of Major Depressive Disorder, Bipolar disorder, PTSD, and others, but as an additional treatment modality that can help ease the immense suffering that these diseases cause worldwide.

That’s why at Set/Setting we are combining a curated therapeutic and educational process in coordination with novel medications such as ketamine. We’re approaching psychological suffering from all angles. Ketamine to help with neuro-modulation and acute alleviation of depressive symptoms, to help retain and sustain response; and training our clients in expanding their tool box to better understand the root causes of their suffering, so they may decrease the burden of symptoms and improve their overall quality of life and functionality in their day-to-day lives.

how does ketamine work?

Although we are still unsure of the actual mechanism of action and how ketamine leads to anti-depressive properties and alleviation of acute suicidal ideation, the primary proposed mechanism of action is found to be through the reduction of the central nervous system’s primary excitatory neurotransmitter, referred to as glutamate. Ketamine, is referred to as an NMDA – antagonist, which means that it blocks this particular receptor in two distinct ways that reduces the excitation of the central nervous system. But this is not the only manner in which ketamine effects the brain. It also inhibits several “channels” that we have in our bodies, which lead to a multitude of other effects such as smooth muscle relaxation and decrease activation in one’s parasympathetic nervous system. Furthermore, while it may “antagonize” the NMDA receptor, it is known that it also leads to activation of other receptors in our brain’s including the opioid, AMPA, and GABA receptors, all of which lead to various clinical effects. For example, although the dissociate effects and inhibition of one’s sensory perception may arise from the inhibition of the NMDA receptors, it’s primary anti-depressive effects are thought to be due to the activation (or agonism) of AMPA receptors.

Am I a candidate
for treatment?

Complete our short assessment to determine if you’re eligible for treatment.

Begin / Today

LEARN MORE

There is a substantial amount of evidence for the safety of Ketamine over the years of its use. But no medication comes without potential adverse consequences. Some common side effects of ketamine include dizziness, nausea, vomiting, most of which are dose dependent and self-resolving upon metabolization. More serious issues such as increased heart rate and blood pressure, palpitations, are primarily due to its effects on our cardiopulmonary system. With that said, ketamine is known as a medication that has a wide therapeutic range, and rarely do individuals overdose on ketamine. In long term use, recent evidence has displayed some lower urinary tract issues, as well as gastrointestinal symptoms such as epigastric pain and liver injury, but with discontinuation and abstinence, these too resolve over the course of time.

From a psychological perspective, it may lead to perceptual changes including but not limited to visual, auditory, time distortion, and depersonalization and derealization, which fall under the category of dissociation, a known common side-effect, or primary effect of ketamine.

Our highest priority is your safety. We have created a comprehensive assessment and evaluation to make sure you’re a suitable candidate for ketamine, both physical and psychological. During the administration of ketamine you’ll will be supervised by a licensed RN to assure that the experience is safe as possible.

There isn’t enough evidence nor a lack of evidence to give a straightforward answer. When a substance is introduced to a person’s body in combination with our complicated psyche, there’s always a chance of physiological and psychological dependence. Ketamine has not been studied enough to say whether or not it can lead to a dependence. At Set/Setting we’re not focused on only biological modalities of treatment. Our proprietary protocol is designed to take advantage of the effects of the medication to synergize true neuro-plasticity, and not relying solely on the medication. We’ve made it our mission to be as transparent as possible with our clients about the reality of drugs. They can be an incredible tool for healing, but need to be handled with respect and thoughtfulness.

Ketamine administration comes in many forms, each with its own unique benefits. At Set/Setting, we offer prescrbed sublingual tablets designed to dissolve under the tongue for a simple yet effective way to dose from home. Our method is often easier and more accessible than infusions, and best of all, no needles.

Additional methods include IV, IM, PO, subdermal, and intranasal. Speak with our team to determine if sublingual administration is right for you.

“

When the mind is still, tranquil, not seeking
any answer or any solution, neither resisting
nor avoiding—it is only then that there can
be a regeneration, because then the mind is
capable of perceiving what is true; and it
is truth that liberates…”

J. Krishnamurti

MENU

The Experience
The Science
Pricing
Take the First Step

RESOURCES

FAQ
Blog
About Us
Research Papers we Love
Contact Us

LEGAL

Terms of Use
Privacy Policy
Notice of Privacy Practices
Electronic Communications Policy
Docs

STAY IN TOUCH

Tune In. We’ll keep you informed about the state of psychedelic medicine, mental wellness tips and advice, and suggestions for a live well lived.

Set and Setting Health Inc is a platform that provides services to affiliated psychiatric medical practices which are independently owned and operated, and in no way owns, directs, or controls the mental healthcare clinicians providing care.

This website has been reviewed by the affiliate medical group and should not be used as medical advice in place of a licensed psychiatric clinician.

If you are in a life-threatening situation, don’t use this site. Call, text, or chat   988   or   1-800-273-TALK (8255)   to get immediate help.

© 2022 Set and Setting Health Inc. All rights reserved.