For Canadians dealing with anxiety who have tried various treatments with limited success, ketamine therapy presents a powerful alternative. In this guide, we’ll explore this treatment option. We’ll explore its legal status in Canada, and I’ll walk you through what you can expect if you are eligible for treatment. We’ll get into the science behind it, how it works in your brain, and why it’s been such a breakthrough for some patients with anxiety and depression. We’ll look at the good, the bad, and everything in between. From its effectiveness compared to other treatments to potential side effects.
Understanding Ketamine Therapy for Anxiety
I’ve dedicated my career to mental health and developing innovative therapies. I believe that by sharing my understanding of ketamine therapy for anxiety with those who haven’t found relief through traditional anxiety treatments will have a positive impact on mental health in Canada.
What is Ketamine and How Does it Work?
Ketamine, originally developed as an anesthetic, has become increasingly prominent in medical settings due to its exceptional safety profile. Approved by the US Food & Drug Administration in 1970 as a safer alternative to existing anesthetics, it continues to be a preferred choice in operating rooms and clinical environments today. At the turn of the 21st century, a groundbreaking discovery revealed ketamine’s remarkable effectiveness as an antidepressant when administered in low doses. This discovery opened up new possibilities for mental health treatment.
Over time we’ve come to learn that ketamine works by triggering neuroplasticity. This state enhances the brain’s capacity to learn, change, and adapt, fostering new neural connections and breaking away from entrenched thought patterns that often contribute to mental health issues. This process creates a temporary window of opportunity for establishing fresh habits, thought patterns, and perceptions.
Additionally, ketamine acts on the glutamate system in the brain, particularly on NMDA receptors, which are involved in learning, memory, and synaptic plasticity. It is also thought to influence other neurotransmitter systems, including serotonin and dopamine, which play crucial roles in mood regulation. This multi-dimensional mechanism of action contributes to ketamine’s rapid and potentially long-lasting effects on anxiety and other mental health conditions.
Finally, neuroimaging studies show that ketamine reduces activity in the default mode network of the brain. In patients with mental health conditions, this network may be responsible for the repetitive fixed patterns of thinking and behaving, like excessive worry in patients with anxiety.
Ketamine’s Safety Profile for Anxiety Treatment
Ketamine demonstrates a favourable safety profile, with minimal effects on breathing and blood circulation, which is a critical consideration when evaluating novel therapies in general. Ketamine’s long-standing use as an anesthetic agent has yielded extensive clinical data supporting its safety.
Clinical Studies on Ketamine for Anxiety Relief
Recent clinical studies have demonstrated ketamine’s potential in alleviating anxiety symptoms. Our patients at Field Trip Health often experience rapid anxiety relief within hours of ketamine administration (see whitepaper). Ketamine’s rapid onset of action can be welcome relief for patients experiencing acute anxiety. This swift relief can be life-altering, especially when compared to SSRIs or benzodiazepines that may take weeks to reach full effect.
Other studies have shown that ketamine can be particularly effective for treatment-resistant anxiety disorders. A 2020 study published in the Journal of Psychopharmacology found that ketamine significantly reduced anxiety symptoms in patients with treatment-resistant generalized anxiety disorder and social anxiety disorder. The study reported that 50% of participants showed a significant reduction in anxiety symptoms after just one ketamine infusion, with effects lasting up to two weeks.
Furthermore, a meta-analysis of multiple studies has shown that ketamine can effectively reduce symptoms across various anxiety disorders, including social anxiety disorder, panic disorder, and post-traumatic stress disorder (PTSD). This data supports that ketamine’s potential as an anxiety treatment extends beyond generalized anxiety disorder, offering hope for individuals with diverse anxiety-related conditions.
The ketamine -assisted psychotherapy approach may have even further benefit than ketamine alone, as evidence suggests combining ketamine with psychotherapy makes the treatment more tolerable and the effects more profound and enduring.
Benefits and Limitations of Ketamine Therapy
For some patients, ketamine therapy for anxiety may provide significant relief. It can offer rapid relief, which can be life-changing for those struggling with debilitating anxiety. Moreover, ketamine’s ability to promote neuroplasticity means it can help break the cycle of anxious thoughts and behaviours.
However, it’s important to note that ketamine therapy isn’t without limitations. The effects, while powerful, can be temporary, often lasting a few weeks. This means that ongoing treatment may be necessary for long-term anxiety relief. Additionally, as with any medical treatment, individual responses can vary, and not everyone will experience the same level of benefit.
To address these limitations Field Trip Health clinics apply personalized, science-backed protocols in ketamine-assisted psychotherapy (KAP). Patients may experience enhanced and prolonged anxiety-reducing effects and maintained improvements in their anxiety symptoms over time.
Combining Ketamine Therapy with Psychotherapy for Enhanced Results
In my experience, the most effective approach to ketamine therapy for anxiety involves combining it with psychotherapy. This combination helped our clients enhance and prolong the benefits of ketamine treatment.
The neuroplasticity induced by ketamine creates a window of opportunity where psychotherapy can be particularly effective for reshaping thought patterns and behaviours. During the window of neuroplasticity, patients are more receptive to therapeutic interventions, allowing for deeper exploration and resolution of underlying anxiety issues. This combination can lead to more sustained improvements in anxiety symptoms compared to either treatment alone.
Field Trip Health clinics offer integrated treatment plans that combine ketamine treatments with targeted psychotherapy sessions. Ketamine-assisted psychotherapy (KAP) leverages the rapid anxiety-relieving effects of ketamine while using psychotherapy to help patients develop coping strategies and healthy thought patterns.
Legal Status and “Off-Label” Use of Ketamine for Anxiety in Canada
In Canada, ketamine’s use for mental health conditions like anxiety is considered “off-label.” This means that while it’s not officially approved for this purpose, doctors can prescribe it based on their professional judgement.
It’s important to understand that this off-label status doesn’t mean it’s illegal or experimental – many medications are used off-label when there’s evidence to support their efficacy. Low dose ketamine’s effects in creating an altered state of consciousness have lead some to include it in the category of psychedelic compounds. As the only legally available psychedelic substance requiring a prescription in Canada, ketamine occupies a unique position. This legal status makes it more accessible than other psychedelics being researched for mental health treatments, such as MDMA or psilocybin.
Ketamine Administration Routes
Ketamine can be administered through various routes, each affecting its bioavailability and, consequently, its effectiveness. Intravenous (IV) administration offers the highest bioavailability, making it the most potent option. Intramuscular injections and nasal sprays follow in effectiveness, while oral administration has the lowest bioavailability.
Our clinics use a personalised and flexible approach when deciding how to administer ketamine based on the patient’s individual needs. For instance, IM ketamine might provide more rapid and intense effects, which could be beneficial for severe anxiety. On the other hand, oral or sublingual ketamine, while less potent, might be more suitable for maintenance therapy or for those who prefer a less invasive method.
Ketamine Therapy vs Other Anxiety Treatments
A comprehensive comparison table based below outlines key aspects of various anxiety treatments highlighting differences in onset of effects, mechanisms of action, efficacy, and side effect profiles. This will help you in understanding how ketamine therapy fits into the broader landscape of anxiety treatments.
| Treatment | Onset of Effects | Mechanism of Action | Efficacy | Side Effects |
| Ketamine Therapy | Rapid (within hours) | Increases glutamate activity, promotes neuroplasticity, NMDA receptor inhibition, reduction in default mode network | Effective for treatment-resistant anxiety; significant reduction in symptoms within hours; effects can last up to two weeks. May be more effective when paired with psychotherapy | During medication experience – Nausea, vomiting, lightheadedness, dissociation, increased blood pressure, visual and perceptual changes that stop approximately one hour after administration |
| SSRIs (e.g., Fluoxetine) | Several weeks (typically 4-6 weeks) | Increases serotonin levels by inhibiting its reuptake | Effective for generalized anxiety disorder and other anxiety disorders; requires consistent use for full effect | Nausea, insomnia, sexual dysfunction, weight gain, increased risk of suicidal thoughts in young adults |
| Benzodiazepines (e.g., Diazepam) | Rapid (within minutes to hours) | Enhances the effect of the neurotransmitter GABA at the GABA-A receptor | Effective for short-term relief of acute anxiety symptoms; not recommended for long-term use | Drowsiness, dizziness, dependency, withdrawal symptoms, cognitive impairment |
| Cognitive Behavioral Therapy (CBT) | Several weeks to months | Addresses dysfunctional thoughts and behaviours through structured therapy sessions | Effective for various anxiety disorders; can lead to long-term improvement in anxiety symptoms | Minimal side effects; may include temporary discomfort from confronting anxiety-inducing situations |
| SNRIs (e.g., Venlafaxine) | Several weeks (typically 4-6 weeks) | Increases levels of serotonin and norepinephrine by inhibiting their reuptake | Effective for generalized anxiety disorder and other anxiety disorders; requires consistent use for full effect | Nausea, dry mouth, dizziness, insomnia, increased blood pressure |
Potential Side Effects and Safety Considerations
As a leading expert in ketamine therapy for anxiety with years of clinical experience, I can assure you that ketamine has an excellent safety profile. Still it’s important to be aware of potential side effects and safety considerations.
Common Side Effects of Ketamine Therapy for Anxiety
Ketamine therapy for anxiety may cause temporary side effects such as mild dissociation, dizziness, or nausea. These effects typically subside quickly after treatment. Of our patients who experience these short-term discomforts, most of them find it manageable, especially when weighed against the potential for significant anxiety relief. For some patients the altered state of consciousness can be anxiety provoking initially, and at the discretion of the prescribing clinician, a lower dose may be used initially. The mindset and setting of the patient may further reduce negative experiences for the patient.
Long-Term Safety and Efficacy of Ketamine Treatment
Long-term studies on ketamine for anxiety are ongoing. Current evidence suggests that ketamine therapy, when administered properly in clinical settings, is safe and effective for extended use. At Field Trip Health clinics we monitor and conduct follow-ups as an essential part of the treatment process to ensure continued safety and efficacy.
Contraindications and Precautions for Ketamine Therapy
Ketamine therapy isn’t suitable for everyone. Certain medical conditions, such as uncontrolled high blood pressure or a history of psychosis, may preclude its use. At Field Trip Health we provide a thorough medical assessment that is crucial before starting treatment to ensure your safety.
The Process of Ketamine Therapy for Anxiety
As someone who’s developed this process at Field Trip Health clinics, I can provide insight into what you can expect. The process of ketamine therapy can be quite complex but over the years working with anxiety patients in Canada at our clinics we’ve developed a streamlined approach for our clients. Here’s how it works:
Step 1: Consultation
The intake process for our Ketamine-Assisted Psychotherapy program is comprehensive, ensuring it’s the optimal treatment for your specific needs and goals. Our thorough intake procedure consists of three key steps:
- Discovery Call: An initial conversation to discuss your concerns and explore how our program might benefit you.
- Questionnaire: A detailed form gathering information about your medical history, current symptoms, and treatment goals.
- Medical Consultation: A thorough evaluation with a Field Trip Health healthcare professional to assess your suitability for ketamine therapy and address any questions or concerns.
This meticulous approach allows us to tailor the treatment to your individual circumstances, maximizing the potential for positive outcomes in your anxiety management journey.
Step 2: Preparation
During your Ketamine-Assisted Therapy journey, you’ll be paired with a dedicated Field Trip Health therapist who will provide support and guidance every step of the way. This experienced professional will be there to assist you through your ketamine sessions, helping you process your experiences and integrate any insights gained.
Step 3: Experience
During your ketamine session, you’ll enter an altered state of consciousness in a safe, comfortable, and controlled environment. This experience is a key part of the therapeutic process. As your mind opens up, you may gain new perspectives on your anxiety and life challenges.
Our experienced therapists will be there to guide you, providing support if you encounter any difficult moments during your journey. We create a calm, nurturing space where you can fully embrace the transformative potential of ketamine therapy. Remember, these altered perceptions are temporary and contribute to the anxiety-relieving effects of the treatment.
Many of our patients report feeling a sense of detachment from their usual anxious thoughts during the ketamine experience. This dissociation can offer a valuable opportunity to observe your mental patterns from a new vantage point. Some describe vivid imagery or insights that emerge during the session.
While everyone’s experience is unique, our team is trained to help you navigate this altered state and maximize its therapeutic benefits for your anxiety. We encourage you to approach the experience with an open mind, knowing you’re in a safe environment designed to foster healing and personal growth.
Step 4: Integration
After your ketamine session, there’s a crucial phase of processing and integration. With guidance from our experienced therapists, you’ll have the opportunity to transform your insights into lasting healing. These integration sessions play a vital role in enhancing the long-term benefits of ketamine therapy.
By working closely with your therapist, you’ll be able to unpack your experiences, gain deeper understanding, and develop practical strategies to apply your newfound perspectives to daily life. This collaborative approach helps solidify the positive changes initiated during ketamine treatment, paving the way for sustained anxiety relief and personal growth.
Through thoughtful reflection and expert support, you’ll be empowered to find greater balance and inner peace, maximizing the transformative potential of your ketamine therapy experience.
Step 5: Reconnect and Reassess
Our evidence-based treatment protocols typically involve 6 to 9 ketamine-assisted psychotherapy sessions, which include supportive integration sessions before and after the ketamine experience. This structured approach allows us to provide effective anxiety relief while ensuring proper support throughout the process.
After completing the initial treatment series, you have the option to extend your therapeutic journey or apply your new insights with ongoing support tailored to your unique needs. We recognize that everyone’s path to healing is different, so we offer flexibility in continuing care to help you maintain and build upon the progress you’ve made.
Ready to explore ketamine therapy for your anxiety? Take the first step towards relief. Book your free discovery call to learn if ketamine-assisted therapy is right for you. Our compassionate professionals will guide you through the process, answer your questions, and help you make an informed decision about your mental health journey. Don’t let anxiety control your life any longer – reach out today and discover a new path to healing.
FAQs
Ketamine therapy uses low doses to treat anxiety by enhancing brain neuroplasticity and reducing activity in the default mode network. It disrupts anxious thought patterns by affecting glutamate transmission, leading to rapid symptom relief. This approach offers a promising alternative for Canadians who haven’t found success with conventional anxiety treatments.
Ketamine therapy for anxiety typically begins with six treatments over 3 weeks. Maintenance treatments are tailored to individual needs. The number of sessions varies, ensuring the treatment plan addresses anxiety symptoms effectively. This approach aims to provide lasting relief through a customized treatment regimen.
Ketamine can offer rapid anxiety relief for some patients, often within hours, unlike traditional medications that take weeks. It targets the glutamate system, a different approach than oral medications which may make it effective for treatment-resistant cases. By promoting neuroplasticity and reducing default mode network action, ketamine can break entrenched thought patterns, providing both immediate and long-term benefits.
Ketamine therapy for anxiety is not covered by public health insurance in Canada. Some private plans may offer partial coverage. Out-of-pocket costs vary based on the clinic, number of sessions, and treatment plan. Some clinics offer financing options. Patients should discuss coverage with their insurance providers.
Ketamine therapy isn’t suitable for those with uncontrolled hypertension, certain heart conditions, psychosis history, active mania or during pregnancy. Liver issues may require careful evaluation. A thorough medical assessment is essential before treatment to ensure safety and appropriateness.
Ketamine therapy can be combined with psychotherapy. This combination may enhance treatment effectiveness for anxiety disorders. Ketamine-assisted psychotherapy (KAP) integrates ketamine with psychotherapeutic techniques, potentially offering synergistic effects in treating anxiety and other mental health conditions.
Long-term effectiveness of ketamine for anxiety varies. Many patients experience sustained relief with an initial series in combination with psychotherapy, some describing it as a reset for the nervous system. Others may require maintenance treatments, but individual responses differ. Some may need periodic “booster” sessions. A patient centred approach to care seeks to match patient needs with a tailored long term approach to care.
About the Author
Dr. Mario Nucci MD CCFP is a licensed Family Physician with a passion for mental health and the development of new therapies. He is actively engaged in research with a faculty associate professorship at Northern Ontario School of Medicine, and research collaborations with the University of Ottawa, University of Calgary, Lakehead University, Concordia University and Vancouver Island University.
Dr. Nucci is the founder of Bay and Algoma Health Centre in 2019, a walk-in and addiction medicine clinic. He founded the Canadian Centre for Psychedelic Healing in 2019, now operating as Field Trip Health, providing cutting edge mental health care in 6 cities across Canada and growing.
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