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Ketamine-Assisted Therapy (K-AT)

What is Ketamine?

Ketamine is a dissociative anaesthetic with a few very different uses—as a medical anaesthetic, as a treatment for pain, and as a fast-acting treatment for certain mental health conditions. It can also be used as a recreational drug. Ketamine mainly works by blocking the NMDA receptors in the brain, which are part of the glutamate system – the brain’s main excitatory neurotransmitter.

  • By blocking NMDA receptors, ketamine disrupts normal signalling between neurons.
  • This leads to a temporary “disconnect” between brain regions—what’s often described as a dissociative state (feeling detached from your body or reality). 

Frequently Asked Questions

How is ketamine used in mental health? 

Clinically, ketamine may be prescribed for: 

  • Treatment-resistant depression  
  • Suicidal thoughts  
  • PTSD or anxiety  
  • Other uses currently being researched include eating disorders and obsessive-compulsive disorder 

Ketamine’s antidepressant effects are complex and still being studied, but possible means include: 

  • A surge of glutamate after the initial NMDA blockade 
  • Leading to:  
  • Increased synaptic plasticity (the brain’s ability to rewire itself)  
  • Rapid strengthening of neural connections, especially in mood-related areas like the prefrontal cortex  

Ketamine therapy is a newer approach used mainly for people whose depression has not responded to standard treatments. It’s not a first-line option, but it can work much faster than typical antidepressants. 

  • Ketamine is administered under the supervision of a healthcare provider. 
  • The most common administration method at Ecdysis is subcutaneous injection.  
  • The patient is monitored during the entire treatment session. 
  • The effect of the drug lasts 45-60 minutes. 
  • The patient remains in the clinic until cleared for discharge (typically 2 hours after administration of the drug). 

During the session, people often experience: 

  • A “detached” or floating feeling  
  • Changes in perception (visual distortions, altered sense of time)  
  • Reduced emotional intensity around painful thoughts  
  • Memories and even re-experiencing of life events including traumas 

Beyond the biology (rapid brain rewiring), there’s also a psychological effect: 

  • It can interrupt rigid negative thinking loops  
  • People may gain new perspectives on problems or trauma  
  • When paired with therapy (often referred to as integration) those insights can be used to make constructive changes in one’s life  
  • Some people feel improvement within hours  
  • Most people notice improvement within a few days up to a fortnight 
  • Effects can last days to weeks after even a single session  
  • Usually done as a series of treatments (e.g., 6 sessions over 3 weeks) 
  • Depending on the length of the series and number of sessions, some people can feel benefit for months after treatment completion 
  • Others, however, experience a relatively rapid return of symptoms after completing their treatment course 
  • We currently have no way of predicting who will have sustained benefit and who will have rapid  return of symptoms after the treatment course 
  • It is important that ketamine therapy takes place in a larger care plan to optimize benefit. 
Further reading on the science behind ketamine therapy in mental health
  • Albott CD, Lim KO, Forbes MK, Erbes C, Tye SJ, Grabowski JG, Thuras P, Batres-y-Carr TM, Wels J, Shiroma PR. Efficacy, Safety, and Durability of Repeated Ketamine Infusions for Comorbid Posttraumatic Stress Disorder and Treatment-Resistant Depression. Journal of Clinical Psychiatry (2018). doi: 10.4088/JCP.17m11634 
  • Batievsky D, Weiner M, Kaplan SB, Thase ME, Maglione DN, Vidot DC. Ketamine-assisted psychotherapy treatment of chronic pain and comorbid depression: a pilot study of two approaches. Frontiers in Pain Research (2023). doi: 10.3389/fpain.2023.1127863 
  • Galuszko-Wegielnik M, Wlodarczyk A, Cubala WJ, Wilkowska A, Gorska N, Slupski J. Case Report: Repeated Series of Ketamine Infusions in Patients with Treatment-Resistant Depression: Presentation of Five Cases. Frontiers in Psychiatry (2021). doi: 10.33898/fpsyt.2021.705190 
  • McInnes LA, Qian JJ, Gargeya RS, DeBattista C, Heifits BD.  A retrospective analysis of ketamine intravenous therapy for depression in real-world care settings. Journal of Affective Disorders (2022). doi: 10.1016/j.jad.2021.12.097 
  • Murrough JW, Perez AM, Pillemer S, Stern J, Parides MK, Rot MAH, Collins KA, Mathew SJ, Charney DS, Iosifescu DV. Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions on Treatment-Resistant Major Depression. Biol Psychiatry (2013). Aug 15; 74(4): 250-256 
  • Rosenblat JD, Lipsitz O, Di Vincenzo JD, Rodrigues NB, Kratiuk K, Subramaniapillai M, Lee Y, Arekapudi AK, Abrishami A, Chau EH, Szpejda W, Wong L, Mansur RB, McIntyre RS. Real-world effectiveness of repeated ketamine infusions for treatment resistant depression during the COVID-19 pandemic. Psychiatry Research (2021). doi: 10.1016/j.psychres.2021.114086 
  • Sakopoulos S & Todman M. The Effects of Psychotherapy on Single and Repeated Ketamine Infusion(s) Therapy for Treatment Resistant Depression: Convergence of Molecular and Psychological Treatment. International Journal of Molecular Sciences (2025). doi: 10.3390/ijms26146673 
  • Yermus R, Bottos J, Bryson N, De Leo JA, Earleywine M, Hackenburg E, Kennedy S, Kezemidis M, Kratina S, McMaster R, Medrano B, Mina M, Morisano D, Muench M, Pillai S, Scharlach R, Setlur V, Verbora M, Wolfson E, Zaer N, Lo C. Ketamine-Assisted Psychotherapy Provides Lasting and Effective Results in the Treatment of Depression, Anxiety, and Post-Traumatic Stress Disorder at 3 and 6 months: Findings from a Large Retrospective Effectiveness Study. Psychedelic Medicine (2024). doi: 10.1089/psymed.2023.0021

What should I do in case of an emergency?

Ecdysis Clinical Psychedelic Therapy does not offer crisis or after-hours support. In the case of an emergency, please phone 111, go to your nearest emergency department, or phone your local Te Whatu Ora – Health New Zealand (formerly DHB) mental health crisis team which can be located here:  https://www.healthnz.govt.nz/health-topics/mental-health/crisis-assessment-teams.

The Wellington, Hutt, and Kapiti crisis phone number is 0800 745 477 

The Wairarapa crisis phone number is 0508 432 432  

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