Safety of ketamine in addiction treatment
Colleagues from all over the world met again this year at the International Ketamine Conference in Oxford to exchange scientific experiences.
From my point of view, it was important that it was confirmed once again that ketamine has no addictive potential in psychiatric use. The increasing use of ketamine as a party drug arises independently of this and can cause serious damage, particularly in the urological area (ketamine bladder) and also in the brain (neurotoxic effect). Animal experiments have shown that a pronounced craving typical of the development of addiction only occurs with esketamine, but not with the R-enantiomer. Opiate antagonists can then be used therapeutically; in our clinic in Palma de Mallorca we also use transcranial magnetic stimulation in combination with ketamine assisted psychotherapy in the treatment of depression, PTSD, anxiety, OCD, Addictions and other psychosomatic pathologies.
Video: Ketamine for chronic pain
In our ketamine therapy, very small amounts of ketamine are administered intravenously in a controlled manner, with the patient under the constant supervision of a qualified therapist. Approximately 30 minutes after the end of the ketamine infusion, the ketamine has already been metabolized in the body. The effect that ketamine has on the brain is long-lasting and usually leads to an immediate improvement in symptoms; thoughts of addiction can disappear after just one ketamine infusion.
We also use ketamine infusions with good results in the treatment of depression, anxiety disorders, obsessive-compulsive disorder, PTSD, long Covid, chronic pain and other psychosomatic illnesses.
Possible side effects of ketamine
Side effects from ketamine infusions are very rare and if they do occur, they usually subside quickly. Approximately 30 minutes after the end of the ketamine infusion, the ketamine is metabolized in the body and the effects are usually gone. However, the effect on the neuronal connections and the neuroplasticity of the brain remains.
The described effects usually subside within 15 to 30 minutes after the end of the infusion. Unpleasant side effects occur in less than 5% of cases in our setting (IV infusion, always accompanied by a therapist).
Ketamine for PSTD
Another focus was on the use for traumatized patients. The improved efficacy of trauma-specific brief therapies in combination with ketamine has been impressively demonstrated in various studies. It is interesting to note that ketamine can also be given prophylactically before possible trauma (this only plays a role in war medicine) or as secondary prevention directly afterwards.
Overall, the combination of ketamine with psychotherapy is becoming increasingly popular. Pure ketamine clinics, hundreds of which have sprung up in the USA, are becoming less important or are closing, as the sustainability of the treatment results is not guaranteed. When combined with psychotherapy, it once again became clear how important it is for the therapy session to take place at the same time as the ketamine intake.
The use of oral ketamine was discussed controversially. In the USA, lozenges are commonly used and there is at least some control by the prescribing doctor. On the other hand, this form of prescription can also lead to misuse and patients forgo useful psychotherapeutic support out of convenience. However, even difficult access regulations do not prevent people from abusing substances, as can be seen with all drugs.
