What is KAP (Ketamine Assisted Psychotherapy)

Ketamine is the ONLY legal psychedelic medication currently (excluding cannabis).

Ketamine is classified as an Analgesic and Anesthetic.

Ketamine at lower doses to treat psychiatric conditions such as depression, suicidality and anxiety is considered an off-label use.

Ketamine can be administered via IV, IM, rectal, intranasal, oral and sublingual routes.

Clinical studies have generally detected no long-term impairment of behavior or personality functioning as a result of repeated ketamine use. Ketamine has been shown to be useful as a neuroprotective agent to prevent brain damage from head trauma, strokes, heart attacks, epileptic seizures, low oxygen levels and low blood sugar levels. There has been recent concern about toxicity to the urinary system. Ketamine was approved in 1970 (anesthesia) for children, adults and elderly. Ketamine is included in the World Health Organization model list of essential medications. (The Ketamine Papers, 2016).

About 20 years ago, researchers discovered that a low dose of ketamine (about one-tenth the amount used for anesthesia) worked as a fast-acting antidepressant.

Ketamine works on glutamate, the most common chemical messenger that regulates much of the nervous system and also plays an important role in the brain’s response to experiences. Neuroimaging studies have shown that ketamine increases glutamate release in the prefrontal cortex, a surge that is likely associated with its rapid antidepressant effects as well as its dissociative side effects. 

But scientists still don’t know exactly what initiates the glutamate release, or whether it’s even the main driver behind the relief of depression and anxiety.

“We believe that this rapid burst of glutamate activates downstream receptors, which can trigger new synapses to grow,” says Lace M. Riggs, a neuroscience Ph.D. candidate at the University of Maryland School of Medicine who co-authored a recent review of ketamine’s use as an antidepressant. “While we’ve made a lot of progress to understand this process, it probably only scratches the surface of ketamine’s full mechanism of action as an antidepressant.”

https://www.discovermagazine.com/mind/how-ketamine-helps-alleviate-depression

Brain Derived Neurotrophic Factor (BDNF) and Increased Neuroplasticity

Ketamine and three types of commonly prescribed oral antidepressants bind directly to a receptor for the brain derived neurotrophic factor (BDNF), a protein that encourages growth and differentiation of new nerve cells. Ketamine, however, binds to the BDNF receptors within minutes instead of days, which may be why patients experience relief immediately.

As for increasing the brain’s plasticity, this is not in and of itself a good thing, but rather a neutral process. If someone experiences stressful situations during a period of increased neuroplasticity, it could translate into negative emotions.

The first 72 hours post treatment are crucial for successful integration.

https://www.discovermagazine.com/mind/how-ketamine-helps-alleviate-depression

The KAP model includes calming practices for patients during treatment, like wearing an eye mask, focusing on breathing and listening to specific music.

Since ketamine increases neuroplasticity and can temporarily induce an altered state of consciousness, some practitioners believe that it’s critical to administer the medicine in a safe, supportive setting. Research is validating that breakthroughs come more quickly when ketamine is paired with therapy.

“It helps to have a therapist process the experience with you and integrate any insights from ketamine treatment into your daily life, that’s how people can make lasting changes in how they react to depression triggers in the future.”

https://www.discovermagazine.com/mind/how-ketamine-helps-alleviate-depression–

Even though ketamine has been around for 50 years, we don’t know that repeat dosing is safe. One reason the FDA hasn’t approved off-label ketamine as a treatment for depression is because of a lack of long-term, formal data that proves it’s safe. But since ketamine is already widely available, there’s less incentive for pharmaceutical companies to fund testing that provides that data.

Contraindications for Oral Ketamine Treatment administered in the home setting:

•History of ketamine abuse or dependence

•Active psychosis or mania

•Diagnosis of Schizophrenia or Schizoaffective disorder

•Active suicidal ideations or suicide attempt in past year

•Glaucoma

•Increased intracranial pressure

•Pregnant/Nursing

•Medical clearance required for:

•Uncontrolled hypertension

•Congestive Heart Failure

•COPD

•Hyperthyroidism