We prescribe oral ketamine as a lozenge or troche, for home use for treatment of depression, anxiety, PTSD, OCD, and chronic pain. Patient dosing schedules are fully tailored to the individuals needs and the medication is titrated based on symptomatology and follow-up with the Midwest Alternative Treatment Clinic’s medical team. The medication, compounded at a local pharmacy, dissolves in your mouth, is a much smaller dose than IV ketamine and can help increase the time between booster infusions and maintain positive outcomes.
Oral ketamine, also known as oral ketamine hydrochloride, is an alternative form of ketamine administration that is becoming increasingly popular for mental health and chronic pain management.
While most research on ketamine has focused on intravenous (IV) administration, oral ketamine may offer several advantages over IV administration, such as ease of administration, reduced risk of adverse effects, and improved patient convenience.
However, not all patients are ideal candidates for oral ketamine administration.
Oral ketamine is typically used to manage low to moderate pain severity. Patients with severe pain may not be suitable candidates for oral ketamine, as higher doses and longer infusion times may be required to relieve pain, which can increase the risk of adverse effects.
Patients receiving oral ketamine should have a stable medical condition, as ketamine can have significant cardiovascular effects. Patients with uncontrolled hypertension, congestive heart failure, or other cardiovascular conditions may not be suitable candidates for oral ketamine.
Patients with active psychosis or mania may not be suitable candidates for oral ketamine, as ketamine can exacerbate these conditions. Patients should be screened for active psychosis or mania before receiving oral ketamine.
Patients with active substance use disorder may not be suitable candidates for oral ketamine, as ketamine can have the potential for abuse and dependence. Patients should be screened for active substance use disorder before receiving oral ketamine.
Patients receiving oral ketamine should be willing to comply with the treatment plan, which may include regular monitoring, medication adjustments, and follow-up appointments. Patients should be informed of the potential risks and benefits of oral ketamine and should be willing to participate in shared decision-making with their healthcare provider.
Oral ketamine is typically used to manage chronic pain conditions, such as neuropathic pain, fibromyalgia, complex regional pain syndrome (CRPS), trigeminal neuralgia, and chronic headaches. Patients with these conditions may be suitable candidates for oral ketamine if they have not responded well to other treatments.
Oral ketamine can be a valuable option for mental health and chronic pain management in the vast majority of patients. Ideal candidates for oral ketamine include patients with chronic pain conditions, low to moderate pain severity, stable medical conditions, no active psychosis or mania, no active substance use disorder, and a willingness to comply with the treatment plan. However, patients receiving oral ketamine should be closely monitored for potential adverse effects and advised to seek medical attention if they experience any unusual symptoms. As with all medications, the decision to use oral ketamine should be made on a case-by-case basis, with careful consideration of the patient’s individual needs and circumstances.
At Midwest Alternative Treatment Clinic, we work closely with our patients to create a ketamine program best suited to their needs. Always rooted in the human experience and relationships, we strive to understand where you are in your journey to wellness. Contact us today and begin your consultation if you are an ideal candidate for oral ketamine.
Following your consultation with your provider, your oral ketamine will be shipped directly to you for safe and effective use at home. Once you are ready to take the next step toward personal wellness, the next step will be to establish an environment of comfort and safety within your home environment. As set and setting are instrumental in achieving a positive experience and optimal outcomes, the providers at Midwest Alternative Treatment Clinic will assist you in preparing your set and setting so that you can fully relax during your sessions to focus on your wellness.
Ketamine is a revolutionary development in antidepressants. Anxiety, depression, PTSD, OCD, and other illnesses that used to be more challenging to address are now within sight of a fast-acting adjunct with a growing reputation in the medical community. People who use oral ketamine tend to experience quick symptom relief, sometimes within an hour or two.
The effects of even a single low dose of ketamine can linger for up to a week and often continue to grow much longer once a few more doses have been administered. Furthermore, significant emotional and psychological discoveries often result from the subjective impacts on consciousness and the psyche.
Cortical neurons degenerate under chronic stress. Neurons can atrophy (shrink and die) when exposed to chronically high doses of the stress hormone cortisol. Dendrites go from having many short, spreading branches that link to many neurons to having a few long, stubby branches that attach to fewer neurons. The axons attenuate and become less robust. Extreme stress can alter glutamate signaling and reduce cell responsiveness and connectivity. Imaging studies reveal a smaller prefrontal cortex in sad persons. Reduced cortical connectivity impairs the efficiency of the brain’s memory, decision-making, emotion, and focus circuits.
All these alterations in glutamate-related neurons culminate in a brain significantly more inclined to exhibit the constellation of subjective events we term depression and anxiety.
Although ketamine is known to affect other receptor types, it appears to have its greatest impact on glutamate receptors. Glutamate is a powerful neurotransmitter, known to play a part in nervous system regulation. Overstimulation of glutamate is linked to anxiety, depression, restlessness, difficulty concentrating, fatigue, and increased sensitivity to pain. At higher dosages, ketamine blocks glutamate receptors making it a useful anesthetic. However at lower doses (such as those used for treatment in mental health), ketamine enhances glutamate production, which may be responsible for stimulating new neuronal connections and regenerating existing synapses.
Ketamine rapidly upregulates neuronal synthesis and release of BDNF (brain-derived neurotrophic factor) by raising the level of glutamate transmission and altering the balance of glutamate activation from NMDA to AMPA receptors. BDNF is a protein that aids in the development, maintenance, and survival of neurons; in other words, it increases neuroplasticity, hence the adage that it helps “fertilize” the brain.
Ketamine also promotes the synthesis of proteins important in long-term memory by activating a major cell pathway called mTOR (mammalian target of rapamycin), which controls numerous processes related to cell growth.
Stimulating mTOR increases the production of brain-derived neurotrophic factor (BDNF), which in turn improves the hippocampus and prefrontal cortex (two brain regions crucial to emotional regulation) and reverses synaptic damage in these regions caused by chronic stress.
Precisely because of these neuroplastic effects, dendritic spine regrowth can occur within a few hours of a therapeutic dose of ketamine. Anxiety and depression symptoms subside when damaged neurons can recover and forge new connections.
Ketamine appears to lose its discriminatory effect and block both NMDA and AMPA receptors at greater dosages.
Neuroplasticity and BDNF upregulation are inhibited when any or both receptor subtypes are blocked.
Perhaps this is why the antidepressant effects of ketamine weren’t discovered until recently.
Its antidepressant effect was accidentally found when researchers at Yale began using it in much lower dosages as a psychiatric treatment.
The drug has been used as a surgical anesthetic since the 1970s.
New information on how ketamine works is emerging from ongoing studies. Parvalbumin interneurons are a type of neuron that include NMDA receptors, which could be another mechanism for ketamine.
These neurons are small and uncommon but crucial in coordinating the brain’s electrical activity. They perform their function by suppressing the activity of neighboring neurons. Ketamine blocks a subunit of the NMDA receptors on these neurons, resulting in less glutamate entering the cells and a diminished inhibitory action. The parvalbumin interneurons slow down the brain’s processing speed. When you let up on the brake, activity in all regions of your brain increases. The mind becomes alert and more active.
Dopamine and noradrenaline are two of the neuromodulators ketamine can additionally stimulates. It also weakly binds to opioid and nicotinic receptors. It is still unclear, and sometimes conflicting, the specific functions these receptors have in the antidepressant action. Continued research and data collection will allow for increased understanding and increasingly better treatment options for individuals in need.
Ketamine’s application in management of pain, mental health, and substance use disorders has gradually become more accepted and has increased research in the area of psychedelics over the last decade. Although ketamine alone has demonstrated positive antidepressant and anxiolytic effects, current literature suggests incorporation of psychotherapy to promote an increase in success and possibly prolong the positive effects of ketamine. Building a trusting relationship with your healthcare provider and/or therapist is essential for the success of ketamine integration. Regular talk therapy sessions most frequently fulfill this need for processing and integration of insights and experiences that occur during ketamine sessions.
KAP is a distinctly unique therapy modality in which individuals simultaneously participate in psychotherapy and experience a trance or psychedelic transformation. Although variability of KAP exists due to its relative novelty, its ability to increase psychotherapy engagement in conjunction with rapid reduction in anxiety and depression is creditable and worthy of further research and standardization.
KAP is an excellent option for those seeking additional support throughout their ketamine experience, including personalized and thorough preparation sessions, connection and safety during the dosing session(s), and space to process and integrate after the dosing experience.
Regular exercise is an effective way to manage anxiety symptoms. It can help reduce stress, boost mood, and improve physical health. Exercise also releases endorphins, which are natural mood-boosting chemicals in the brain.
Sleep is essential for overall health and well-being. Aim for 7-9 hours of sleep per night and establish a regular sleep routine to promote restful sleep.
A healthy diet of fruits, vegetables, lean protein, and whole grains can help manage anxiety symptoms. Avoid or limit caffeine and alcohol, which can exacerbate anxiety symptoms.
Anxiety often involves negative thoughts that can be irrational or distorted. Challenging and replacing these thoughts with more realistic and positive ones can help manage anxiety symptoms. This technique is called cognitive restructuring.
Social support from friends, family, or support groups can help manage anxiety symptoms. Social support can provide a sense of comfort, validation, and perspective.
Mindfulness involves being present at the moment and non-judgmentally observing one's thoughts and emotions. Mindfulness-based techniques are effective in managing symptoms related to mental health and wellness.
Whether ketamine is right for you depends on various factors, including your specific medical history, the condition you are seeking treatment for, and the advice of a qualified healthcare professional. Midwest Alternative Treatment clinic will provide a thorough assessment of your individual circumstances and make appropriate recommendations.
Like any treatment, not all patients will have positive results. It’s also important to know that ketamine isn’t a cure, but rather an adjunct to improve your current therapy; it’s a better way to help you overcome your unique challenges.