The peer-reviewed research that focuses on ketamine as an intervention for treatment-resistant depression, or as a tool in managing depression, points in a promising direction: ketamine can be an effective and viable treatment option.

But what factors contribute to making ketamine an effective tool in the treatment of depression?

Ketamine’s Dissociative & Psychedelic Properties

Ketamine’s properties make it both a dissociative and psychedelic compound. At certain doses, people can experience both the physical and psychological dissociative effects, as well as the subjective psychedelic effects.

This is a two-part experience quite unique to ketamine, and drives many of the reasons ketamine is effective in managing/treating depression.

Dissociative Properties

There is science demonstrating that the dissociative effect itself, has a direct effect on the antidepressant qualities of ketamine.

“Antidepressant effects can occur in patients who do not experience even transient dissociative effects, and vice-versa.

It is worth considering that dissociation is part of the unique effect of ketamine that is not shared by conventional antidepressants: an altered sense of self that can also lead to a new state of contentment.”

Wolfson M.D., Phil. The Ketamine Papers: Science, Therapy, and Transformation (pp. 393-394). Multidisciplinary Association for Psychedelic Studies. Kindle Edition.

Some subjective markers of dissociation, according to the CADSS scale include: 

  • A feeling of moving in slow motion
  • Experiencing sensations as if in a dream-like state
  • A sense of being separated from the direct experiences
  • An out-of-body perspective
  • Feeling disconnected from the body
  • Events happening at a perceived faster pace
  • Disconnection from the sense of time

For someone living with depression, the felt experience of dissociation in this context can provide a respite, or the ‘breathing room’ to rest, reflect, and begin taking control again.

Psychedelic Properties

As a compliment to the dissociative effects, ketamine at certain doses can produce or give rise to an experience which also contains psychedelic properties.

“If your eyes are closed, then it’s a different visual experience. If you close your eyes even right now and actually look at what you’re seeing, it’s not just darkness or nothing—you see lights, and shapes, and colors. Most of us tend not to sit around on a daily basis with our eyes closed just watching the show, but during a ketamine infusion, you may watch the show, and it will likely be more colorful, brighter, it can have a texture to it, and you can feel like you’re travelling around in it. You’re not hallucinating—it’s really there, and it just takes on a different meaning. But this is why people sometimes describe it as psychedelic or “trippy.”

Wolfson M.D., Phil. The Ketamine Papers: Science, Therapy, and Transformation (p. 499). Multidisciplinary Association for Psychedelic Studies. Kindle Edition.

Some properties of ketamine/psychedelics include:

  • Novel or altered ways of thinking or feeling, perhaps accessing alternate or mystical states of consciousness
  • Visual imagery: including colors, shapes, visualizing the movement of energy, archetypal images, or watching clips of your life play back on a film real as an observer,
  • New sensory patterns: including alterations in touch, smells, and physical sensations
  • Increased connections in regards to memories and present circumstances

By providing a potential avenue for new insights, experiences, and connections, the ketamine experience can also provide a therapeutic compliment to the neurochemical benefits.

The dissociative and psychedelic properties of ketamine manifest themselves in the experience primarily in two ways: providing biological and phenomenological benefits, and helping generate experiential and emotional insights.

“When looking at the tools we have out there to treat depression, we have typically had to rely on the medicine to do the work. This aligns with the medical model in understanding that we take something, something happens in our mind or body, and we hopefully feel better. We are a passive participant,” Kristin Arden, Lead Clinician at Mindbloom, said. “Ketamine works in that way too, but also affords us a whole other avenue of healing potential. We are able to gain insights, perspectives, and find peace on the medicine. All in a time where our brain is primed to heal and grow thanks to the neurobiological effects of the ketamine. We can, in a way, take back a degree of self-agency in our healing process.”

Neurobiological Benefits & Experiential Insights

Biological/Neurochemical Benefits

There are a number of biological (specifically neurochemical) effects from ketamine that are helpful in treating the underlying neurobiology associated with depressive symptoms.

One of the ways depression and its symptoms manifest is through neural pathways and certain synaptic connections becoming “cemented,” promoting patterns of thinking with strong momentum carrying them. This makes depressive thoughts or feelings both routine and frequently recurring. Over time, this damages the health of the neurons themselves.

Mindbloom’s Science Director, Dr. Casey Paleos, summarizes it as such:

“The end result of all these glutamate-related neuronal changes is a brain much more predisposed to manifesting the constellation of subjective phenomena we call depression and anxiety.”

In order to address this predisposition, ketamine has 3 neurochemical benefits in particular that are beneficial:

  1. Upregulating Neuronal Production: Ketamine increases the production of new neurons, supplying the brain with healthy and vital neurons, the basis for more effective and harmonious connections in the brain.
  2. Upregulating Release of BDNF (brain-derived neurotrophic factor): BNDF, colloquially referred to as ‘fertilizer for the brain’ helps promote neuron growth, overall health, and ongoing maintenance. Providing both short and long-term benefits.
  3. Stimulating mTOR: mTOR regulates many processes involved in cell growth and healing worn out synaptic connections, and also stimulates activity/growth in the prefrontal cortex and hippocampus, essential areas for emotional regulation.

From the biological perspective, ketamine produces a cascade of effects that are beneficial for short and long-term repair and flourishing of the cells, neurons, and synaptic connections that healthy, balanced brains need. 

These neurobiological effects create an environment primed for new programed responses to triggers, new understandings of ourselves and the world around us and emotional regulation.

The biological effects of ketamine are generally dose-dependent, and will often occur when ketamine enters the body. Although we have a great amount of science that has helped us understand how ketamine works as an antidepressant, there is still a lot to that is unknown and being actively explored.

Subjective/Experiential Benefits

Alongside its dissociative properties, at certain doses ketamine can also induce novel subjective experiences or classic psychedelic phenomenology. This sense of experience or journey can provide important insights and felt experiences that can help us manage depression in the short and long-term.

“A ketamine psychedelic experience tends to offer up the possibility for transformation of the self by isolating the mind to some extent from external sensations, altering body consciousness toward an experience of being energy without form, and by amplifying and scrambling the contents of mind in unpredictable ways—all of this generating the potentiality for changes in consciousness that may be beneficial and persistent. Coming back from a ketamine journey as a somewhat different being is quite predictable.”

Wolfson M.D., Phil. The Ketamine Papers: Science, Therapy, and Transformation (p. 646). Multidisciplinary Association for Psychedelic Studies. Kindle Edition.

There are a few ways the ketamine experience can do this:

  1. Novel Insights: With dissociation comes a sense of being separate from yourself. With this perspective individuals can spot certain behavioral patterns, environmental triggers, or see how they act in a new way. These insights can catalyze short-term respite or long-term positive behavior/mood change.
  2. Embodied Feelings: The ketamine experience can induce a number of embodied emotions/feelings. For those with depression, having an embodied experience of calm, joy, contentment, or elation can be a powerful reminder or positive reinforcement that these states are possible for them. This can change long term outlooks and actions.
  3. Cognitive Distancing: Both during and for a brief window after a ketamine session, it’s possible that individuals may notice more ‘space’ between an external stimulus and their internal reaction to it. This space can provide the room to change behavior, remove automatic self-sabotaging habits, all of which are valuable in managing depression.

Acute Responsiveness & Long-Term Durability

Acute Responsiveness

Unlike other traditional treatment options for depression (namely psychotherapy, pharmacology, or a combination of the two), ketamine is fast-acting and acutely responsive.

Ketamine is classified as a RAAD (rapid-acting antidepressant) providing felt relief from major symptoms within hours or days, rather than weeks or months that traditional psychotherapeutic or pharmacological methods can take to demonstrate effects.

With this immediate response, it provides a foundation or “breathing room” for the patient and clinician to begin working on longer-term behavior/mood change.

Long-Term Durability

Complimentary to the acute responsiveness of ketamine are the lasting effects after a session. This is known as the “durability” of the effects.

There are a few factors that contribute to the long-term durability of ketamine therapy:

  • Insights gained from the psychedelic properties can allow for long-term positive behavior/mood change with effective integration
  • Insights are gained during a time the brain is primed to process these new insights thanks to things like neuroplasticity and synaptogenesis. Through integration, we work on reinforcing the new pathways and connections; helping them fire and wire together. 
  • Through a series of treatments “stacked” or placed close together, we aim to build up a solid foundation of the substance in your system. This also reinforces the phenomenon of incremental and compounding improvements in baseline mood, attitude and perspective over a period of time.

Ketamine is a unique treatment in this regard, as single sessions have the potential to provide both short-term, rapid-acting relief, but also build toward long-term elevations in mood, brain health, and overall symptomatology.

These are some reasons we understand ketamine’s unique role to play in the treatment of depression, and why it is showing such promising results already. 

Given its ability to address both neurobiological and phenomenological experiences, and providing both short and long-term benefits — ketamine is uniquely positioned, and uniquely effective, to be a valuable treatment for depression.

If you’ve been looking into ketamine treatment, or are currently familiar with the space, you might have noticed there are several different methods of receiving the medicine: ketamine infusions (intramuscular or intravenous), tablets (or “troches”), or nasal spray. 

What isn’t as immediately evident is what the differences are, what the benefits may be, and why you would choose one over the other. Below is a brief history of ketamine treatment, three common methods of administering ketamine, and how each fits into the best course of therapeutic treatment.

A Brief History of Ketamine’s Medical Use

Ketamine’s first FDA-approved use was as a dissociative anesthetic and is used for this purpose in medical and surgical procedures. Ketamine is a special medicine in this class as it does not suppress respiratory rate and is a generally safe tool for anesthesia. It has also been used for years for its rapid acting analgesic (pain reducing) effects from battlefields to emergency care.

To achieve the dissociation and sedation required, doctors needed a direct and effective way to provide and regulate larger amounts of ketamine to the patients. This is where IV and IM injections of ketamine began.

At anesthetic levels, patients often come back from an experience with little to no recollection of what happened while they were sedated. During an invasive procedure this is the preferred outcome. However, when working with mental illnesses, some level of subjective or conscious experience may be preferable, particularly when ketamine’s psychedelic medicinal effects are desired.

IV/IM administration allows dosing of the medicine at amounts that can produce full dissociation and sedation. There is scientific evidence supporting the mental health benefits of dissociation, and more research is being conducted. These are typically the longest sessions, ranging anywhere from 1-3 hours, and are the most expensive, with individual sessions running around $800-1200+USD, with psychotherapy afterward as an available option.

Methods of Administering Ketamine

Ketamine infusions and injections aren’t the only method of delivery used in mental health treatments. Here’s a quick overview of the different methods one can expect when working with ketamine.

Sublingual Tablets or Troches 

Tablets or troches (pronounced “tro-keys”) are compounded tablets from a pharmacy that are absorbed into the brain/bloodstream sublingually, or held in the mouth. Dosing can vary from 10-200 milligrams (mg) per tablet on average, depending on the compounding pharmacy and the order from the clinician.

Tablets are the method utilized by Mindbloom clinicians, allowing for a greater flexibility in treatment based on the client’s response to the medication. Tablets also provide an identical delivery mechanism as IV/IM, but without the risk of infections or introducing harmful agents into the bloodstream — contributing to an increased safety profile.

A secondary benefit is there is a ceiling, an upper limit, to how much medicine an individual can absorb sublingually, making it nearly impossible to take larger doses than necessary.

IV Infusion or IM Injection 

Intravenous (IV) infusions or Intramuscular (IM) ketamine injections have similar effects. The difference is that IV is typically infused into a vein with a bag that drips the substance in while IM is injected directly into the arm with a needle (similar to a flu shot).

Nasal Spray 

Ketamine nasal sprays are a synthesized mist stored in a spray bottle that is applied according to the delivery timeline outlined by the clinician. This is the latest delivery method to gain FDA approval with the introduction of Spravato. 

The bioavailability and desired effect (sub dissociative, sub psychedelic, anesthetic) of each delivery method, which is the proportion of the compound that enters the body’s circulation, is what determines the typical dosing ranges. You can apply the highest doses (several thousand milligrams) with infusions, a mid-range with sublingual tablets (around 1000-1500mgs) and the lowest doses with nasal sprays (

Determining Which Method is Right for Your Ketamine Treatment

It’s important to distinguish the two ways in which ketamine treatments provide therapeutic value, as this will help you make a decision as to which one is right for you, and when.

The Biological Effects of Ketamine

There are the neurobiological effects and benefits when receiving ketamine. Through these effects, we would expect a general improvement in overall mood, an increase in brain-derived neurotrophic factor (BDNF),  and bolstering of neurons that have been worn down over time by the body’s physiological response to things like anxiety and depression.

The biological effects are dose-dependent, and happen regardless of an individual’s subjective experience with the medicine.

Learn more about the neuroscience of ketamine here.

The Subjective Effects of Ketamine

There are also subjective or phenomenological healing effects that ketamine can provide at medium/high doses. These effects include novel ways of thinking, disconnection from thoughts or emotions, dilation of time or space, out-of-body experiences, and more. These experiences vary between each individual and each treatment, but can be essential catalysts for deep transformation when treating mental health conditions such as depression or anxiety with ketamine.

The subjective effects have a ‘sweet spot.’ They need a certain dosage to surface, and can be overtaken by the dissociative or sedative effects at higher doses.

This ideal range for the subjective or phenomenological effects of ketamine is an important point to consider when looking at methods of treatment, and the results you want to achieve. An experienced clinician can help you make the right choice in this regard.

Ketamine’s Role as a Psychedelic Therapy Catalyst

As off-label treatments for ketamine are increasingly researched, ketamine’s subjective and psychedelic effects should be considered.

When looking at long-term, enduring benefits and personal transformation, ketamine’s psychedelic effects play an important role.

Individuals in treatments have the potential to experience more classically ‘psychedelic’ experiences: novel ways of thinking or feeling, immersion in new experiences, time or space dilation, out-of-body experiences, hallucinations, and visual imagery. 

Not to be discounted, these experiences and insights can provide the scaffolding for long-lasting changes, especially if properly integrated back into their lives. 

Which Ketamine Treatment Method is Right for Me?

By Cost

If you’re considering overall cost of treatment:

  1. Infusions: Each infusion session can range from $400 to $1000-plus, often sold in 4-6 session packs.
  2. Nasal Spray: Monthly nasal spray use can cost $4000-5000 based on recommended dosages. There are some insurance coverage options here to help manage costs.
  3. Sublingual Tablets: Depending on the recommended dosage, these can run from $500-1500 per month. Mindbloom offers six medicinal sessions for $89/week billed monthly for three months.

Subjective or Psychedelic Benefits

If you want a compliment of biological benefits and subjective, experiential insights:

  1. Infusions: Have the potential to provide a higher degree of dissociation as dissociation is dose dependent and higher doses can be provided via IV or IM.
  2. Nasal Spray: Little to no dissociation.
  3. Sublingual Tablets: Has the potential to produce mild to moderate levels of dissociation which is generally supportive of a deep meditative state or a trance-like state which can include some psychedelic properties.

When speaking with your clinician or provider, you can use this information to help determine the best method for your unique circumstances.

Ketamine is currently prescribed and used to treat a number of unique medical and clinical situations: from general anesthesia for surgical procedures, to sublingual doses in the treatment of mental health conditions.

Of particular interest is ketamine’s use as an “off-label” medicine for the treatment of mental health conditions. Regarding its applications in medical and surgical procedures, it is so effective and well-supported by medical professionals that the World Health Organization designates it as an essential medicine.

Support for Ketamine’s Off-Label Efficacy

As it was originally approved as an anesthetic in medical procedures, the use of ketamine for therapeutic outcomes in the treatment of mental health conditions are classified as “off-label” use: using a medicine for something other than the original scenario it was approved for.

The existence of off-label uses for ketamine are the first indicator of its efficacy. A potential treatment must demonstrate reasonable and remarkable proof of its ability to treat other symptoms and conditions to be considered for off-label use.

Ketamine is used off-label to treat a variety of treatment-resistant mental health conditions, demonstrating particular efficacy in depression and anxiety treatments.

Ketamine’s Mental Health Use-Cases

Ketamine use in the treatment of mental health conditions is still an emerging area of research and study. More trials are underway to demonstrate the depth and breadth of ketamine’s applications and potential.

There are a few core areas of research underway:

  • Ketamine as a treatment for major depressive disorder (MDD) / treatment-resistant depression
  • Ketamine as a novel treatment for general anxiety and social anxiety disorders
  • Using ketamine to manage bipolar disorder (BPD), obsessive-compulsive disorder (OCD), and substance use disorders (SUD)
  • Ketamine as an early treatment for managing suicidal ideation

As more studies emerge, the results are promising: From the rapid onset of results, to long-lasting effects, ketamine as a novel treatment in the mental health space is showing to be highly effective.

Core Benefits of Ketamine Therapy for Mental Health

There are a number of features that make ketamine therapy remarkable and effective as a medicine for the mental health field.

Rapid onset and visibility of results and positive outcomes 

Unlike some traditional pharmacological interventions, which can take up to 6 weeks to begin showing positive outcomes, some clients working with ketamine therapy report seeing results within hours of their first treatment.

Long-tail endurance and durability of its outcomes 

The second core benefit is what is called the durability of the benefits — those that extend beyond just the dosing session or the immediate hours following administration.

Early research has highlighted enduring effects from a single treatment that remain noticeable weeks after the dosing session.

Addresses and heals underlying drivers of the conditions

Along with the immediate mood-regulating effects of a ketamine session, there may be longer-term neurochemical and biological benefits from ketamine.

Some of these benefits may include increasing the presence of brain-derived neurotrophic factor (BDNF) in the brain, which can help create new, healthy neural connections. 

The dissociative and psychedelic subjective experiences ketamine induces can provide new behavioral insights, clarity into life circumstances, and surface deep-embodied emotions or feelings. Integrating and addressing what comes up in ketamine therapy can lead to more resiliency, positive affect, and brighter futures for clients.

It fits into your life 

Convenience is an important factor that makes ketamine therapy a useful and appealing treatment option. 

The experience itself lasts around 90 minutes when using sublingual tablets, so it’s not a full-day commitment for those whose schedules don’t allow.

Because ketamine’s benefits and durability can be long-lasting, you aren’t required to take a pill every day to see benefits. 

Any side-effects are minimal and subside quickly

With programs like Mindbloom, you can receive psychedelic therapy from the comfort of your own home, monitored by a close friend or loved one, while under the guidance of experienced clinicians and highly-trained guides.

The “felt” or physiological effects last around one hour, and short term side effects such as altered sense of time, nausea, restlessness, and elevated blood pressure or heart rate typically subside shortly following the treatment experience.

With a relatively proven and promising efficacy profile for mental health treatment, coupled with the flexibility and adaptability of the treatment programs themselves, ketamine therapy can be a life-changing experience that doesn’t require you changing your life for it. It meets you where you’re at.

What Results Do Clients Commonly See?

The results summary from a 2019 study on individuals with major depressive disorder explains the potential for powerful results:

“There was a significant improvement in depression, anxiety, and the severity of illness after 2 weeks and 1 month of the last dose of ketamine. Significant improvement at 1st [hour] of the first dose was seen in depression and anxiety and not for illness severity. There were transient adverse effects observed in some patients which subsided within 1 [hour].”

In more direct terms, this indicates: 

  • Significant improvements in depression and anxiety symptoms, and illness severity, lasting at least one month after the last dose.
  • Significant improvement noticeable within the first hour of the first dose, which did not make the illness more severe.
  • Some adverse effects subsided within the hour.

Ketamine can be a powerful medicine, and a breakthrough therapy for those with depression and anxiety.

Mindbloom clients who respond well to treatment report outcomes across the spectrum:

  • Reduction in symptoms for anxiety and depression diagnoses.
  • No longer displaying objective symptoms or meeting criteria for mental illness.
  • Subjective reports of feeling completely changed or revitalized.

Here’s what one client had to say about their progress:

“I 100% recommend Mindbloom to anyone who has been stuck with anxiety, depression, or stress and wants to try something new. I’ve come to see old problems in new ways and feel like I have a better perspective on the world.” — Mattan G.

Is Ketamine an Effective Mental Health Treatment?

In short, yes! Ketamine is shown to be effective in treating those with depression and anxiety and the corresponding symptoms, and this is backed by research.

Mindbloom will continue developing and providing therapeutic experiences with ketamine. It’s shown to be fast-acting, long-lasting, safe, well-tolerated, and effective. Consult your mental health provider or take the assessment on our website to see if Mindbloom could be a fit for you.

Ketamine can be a powerful tool for mental health clinicians because of its remarkable safety profile across medical and therapeutic modalities. 

In fact, the World Health Organization (WHO) lists it as an essential medicine and advocates for its widespread availability globally. However, like any medication, patients should be well-informed about ketamine’s contraindications and potential side effects, along with alternative treatments available, to determine if ketamine therapy is right for them.

Is Ketamine a Safe Drug?

Ketamine is considered safe when used in a clinical setting under the supervision of medical professionals. We strongly advise against recreational use of ketamine since the strength and quality are uncertain and widely variable (it can be cut with a handful of substances). Further, long-term damage to the body is sometimes seen among recreational users who consume at higher doses or higher frequencies than would be advised in a clinical setting. 

Why Ketamine is Considered Safe

Ketamine was first approved by the Food and Drug Administration (FDA) for use as an anesthetic in the 1970’s. It has been widely used by anesthesiologists during surgeries with young children to aging seniors since. It is used in many socio-economic environments, and continues to be used because it is generally safe, well-tolerated, and effective in what it does.

A factor indicating the safety profile of ketamine as a medicine is that it is used in a variety of medical settings to treat a broad (and growing) number of symptoms and conditions.

Some of these applications include:

  • Anesthesia for surgery
  • Analgesia for a wide variety of painful conditions, traumas, or procedures
  • Combating major depression and anxiety symptoms

Ketamine’s use in a variety of medical and therapeutic indications, with relatively positive safety outcomes, supports its safety profile in many age groups

An important note: Anesthetic dose ranges —those used in surgical procedures— are much higher than those that are used for treating mental health conditions, such as treating depression, anxiety, OCD, and other conditions. When thinking about the safety profile of ketamine at an anesthetic dose, which can be 4-8x and higher a dose used in mental health, it helps us understand how safe ketamine can be in a treatment model like Mindbloom’s.

Is Ketamine Safe for Depression and Anxiety?

With the emergence of science that has validated other therapeutic indications for ketamine treatments (depression, anxiety, OCD, PTSD) more and more clinicians have begun to follow the science and treat conditions with ketamine, off-label. 

This, along with a paradigm shift in emerging mental health treatments, has helped drive ketamine from the hospital into outpatient clinics. Outpatient clinic models vary greatly and you can receive treatment from anesthesiologists, licensed clinicians, and in some settings a psychotherapist paired up with a prescriber.

Results of emerging science continue to be promising. We continue to learn about how ketamine works in the body to treat mental health conditions, and its safety profile in this context. This learning has lead to continued evolution of treatment models that aim to increase access to care (such as in-home treatments) and enhance its therapeutic potential (such as coupling up with therapy).

A true testament to the safety of ketamine is that with professional guidance, it can be taken by clients in their homes. This ensures it’s dosed properly and with proper education around developing a safe environment and mindset. Throughout these sessions, there are few, if any, adverse events that arise —demonstrating the tolerability of ketamine as a therapeutic medicine as well.

Ketamine’s Risk Profile & Contraindications

No medicine available is without risks and contraindications —symptoms or conditions that an individual may be experiencing that indicate treatment may not be suitable. This is why ketamine is a regulated medicine, used in structured procedures and administered by medical professionals. 

Ketamine does not require the use of supplementary tools or procedures such as external oxygen sources, electricity supplies, or large clinical teams — further simplifies the procedures, and this reduction in complexity serves to reduce the potential for adverse effects or events.

Some of the contraindications include:

  • Uncontrolled high/low blood pressure, heart problems, glaucoma or intracranial pressure.
  • Active and unstable substance use disorder
  • Psychotic disorders
  • Active mania

There is also potential for adverse events through the dissociative effects of ketamine, such as grogginess, drowsiness, or disorientation leading to an accident or confusion during/after use.

This is why using ketamine as prescribed, in a medical or therapeutic context with trained practitioners, is important. If done in this manner, as has been proven over the past decades, ketamine is a safe and effective medical and psychedelic therapy treatment.

One of the advantages of ketamine as a clinical and therapeutic treatment is that it can lead to desired treatment outcomes within shorter timescales — for some within 24 hours, others after weeks of therapeutic work— while maintaining the efficacy and beneficial effects of longer-acting therapeutic and psychedelic experiences.

There are two ways to address the question “how long does ketamine last?”: How long do the “felt effects” —immediate physiological effects— of the medicine persist in the short-term, and how long do its lasting antidepressant and antianxiety effects persist.

How Long Do the Short-Term, Physical Effects of Ketamine Last?

How long ketamine’s immediate physical effects last depends on multiple factors, with the key factor being method of administration. There are a number of ways ketamine can be received, and each one has its own timing for onset of effects, duration of experience, and noticeable effects after the experience.

The duration of the felt effects or “felt experience” depends primarily on the methods of administration.

Methods of Ketamine Administration

Ketamine is administered, or taken, in the following ways: intravenous (IV) infusion, intramuscular (IM) infusion, sublingual tablets, or intranasal spray. 

Treatment sessions using each of these methods are typically set for one hour, with immediate effects subsiding around one to three hours.

Intravenous (IV) infusion 

IV infusion takes the medicine directly into the bloodstream. It has a very rapid onset, and how long the felt experience lasts is dependent on the half-life of ketamine — the time it takes to be processed in the body and leave its system fully— and other psychological factors. Infusion sessions typically last one hour, but can be extended up to five hours based on clinician’s recommendation.

Intramuscular (IM) infusion 

Intramuscular infusions are administered through a syringe, which is injected into a muscle (usually the shoulder or thigh). This method’s onset typically takes 2-4 minutes, and its full duration ranges from 1-3 hours.

Sublingual Tablets or Troches

Tablets or troches (pronounced “tro-keys”) are another way of receiving the medicine. Mindbloom uses rapid dissolving tablets (RDTs), which are held in the mouth for direct oral absorption and removed after a point of maximum absorption. 

By not swallowing the medicine, the gastrointestinal tract is bypassed avoiding metabolization in the liver, which extends the duration of the experience. If not swallowed, the average onset is around 5-10 minutes, with the dissociative effects lasting for around 30-60 minutes, and a return to physical baseline around 1-3 hours after treatment. If swallowed, half-life is increased and the effects last longer, around 4-5 hours.

Intranasal (IN) Spray 

Intranasal spray options, administered through the nose, are also emerging. There are two types of ketamine-based nasal spray: S-ketamine (esketamine) and R-ketamine (arketamine), also known as “racemic” or “generic” ketamine.

This method’s onset typically takes five to ten minutes, and its full duration ranges from one to three hours.

How Long Does Ketamine Stay in Your System?

As with any compound, it’s easiest to consider this in terms of the half-life of ketamine. A half-life is how long it takes for 50% of the compound to be excreted from the body.

Ketamine metabolizes quickly in the body, with a half-life of around 2.5 hours. This means that after 2.5 hours, 50% of the ketamine has been excreted from the bloodstream. For comparison, coffee has a half-life of five hours. Ketamine’s metabolites can remain in the body for almost two weeks.

Given this, after about 10-12 hours since the initial dosing, a majority of the ketamine is out of your system. This is independent of the subjective experience, which subsides after about an hour.

Overall, this is one of the advantages to work with ketamine: it’s very well tolerated across a large population, it has a fast onset and manageable total duration, and is metabolized and processed through the body quickly as well.

How Long do the Antidepressant Effects of Ketamine Last?

One of the most remarkable aspects of ketamine therapy are the benefits that an individual can experience during, after, and between each dosing session. This is called the “durability” of the experience.

After a single session, it would be reasonable to expect a general improvement in mood/outlook, and increased mental flexibility and openness lasting for about seven days. This can vary from person to person. Some effects are noticeable immediately after the session.

A 2019 study on individuals with major depressive disorder demonstrates the potential for longer-term positive effects:

“There was a significant improvement in depression, anxiety, and the severity of illness after 2 weeks and 1 month of the last dose of ketamine. Significant improvement at 1st [hour] of the first dose was seen in depression and anxiety and not for illness severity. There were transient adverse effects observed in some patients which subsided within 1 [hour].”

Given the 1-2 week window of increased openness, flexibility, and general mood brought on by a single session, another opportunity presents itself when “stacking” or adding on multiple sessions through the course of treatment.

Integration’s role in ketamine therapy’s effectiveness

It’s worth noting that ketamine as a compound alone isn’t a “magic pill.” Its short and long-term effects are meant to open an individual up to action and behavioral changes that will help them reach their full potential. Ketamine therapy as a holistic experience promotes setting and working on intentions or goals that promote personal growth. These insights gained are taken with us but the physiological effect may not last.

Mindbloom’s program includes four sessions, spaced 1-2 weeks apart. This treatment methodology is referred to as “stacking.” By continually renewing this general baseline improvement, paired with effective integration work in-between, clients report improvement and maintenance of their baseline moods for many months after completing their last session.

Overall, we can see there are acute effects from a single session that can last for weeks. If sessions are combined into a comprehensive and holistic program, the enduring effects can last for months, or provide enduring and robust baseline improvements.

How Long Do Ketamine Treatments Last?

In general, the subjective experience tends to follow a standard direct dosing arc: An initial period for the effects to come on, a period of full experience with an associated ‘peak’, and a gradual decline back towards normal waking consciousness — though with some lingering physical effects that subside 1-2 hours after the session.

Each individual will have a unique experience, and each session may slightly vary from these exact markers, though the general trend tends to remain the same. Here is a common overview of the experience:

  • 0 to 15 minutes: dosing and initial effects begin to arise.
  • 15 to 45 minutes: full effect onset, peak of subjective experience.
  • 45 minutes to 1 hour: gradual decline back to waking consciousness.
  • 1 hour +: residual effects (grogginess, mild dizziness, etc.) begin to subside.

Most treatments are designed to last roughly one hour, with a recovery window of up to three hours.

Clients should plan to have a restful day after a ketamine session, regardless of the delivery method used. It’s helpful to stay with the medicine and the experience rather than jumping back into work or stressful exercise.

If you’d like to learn more about the psychedelic therapy experience, read about how the Mindbloom journey works.

“Is Ketamine legal?” is a common, and legitimate question from those looking to explore psychedelic medicine for therapeutic treatment of their depression and anxiety.

Ketamine is legal for use by registered practitioners, and historically has a high safety profile in surgical and therapeutic use since its synthesis in the 1960’s. Its scope of treatment and potential use-cases continue to grow and develop as ketamine is studied further

More and more we are seeing promising areas that ketamine is uniquely suited to help with, in everything from surgical procedures to relieving treatment-resistant depression and anxiety symptoms.

Is Ketamine Legal?

Ketamine is legal for medical use in the United States and select countries across the world. 

The use of ketamine is regulated, meaning it can only be administered or prescribed by licensed clinicians with the authority and expertise to support its effective use.

When used within the context of a surgical procedure or as prescribed by a licensed clinician, it is perfectly legal to use. Any other use of this medicine outside of these guidelines is currently illegal and unregulated.

Ketamine’s FDA and DEA Scheduling

Ketamine is an FDA-approved anesthetic, and is available for “off-label” prescription by a licensed clinician.

Ketamine has been approved by the Food and Drug Administration (FDA) for medical use as an anesthetic since 1970. In addition to off-label ketamine prescriptions, the FDA recently approved derivatives such as esketamine for treatment of adults with treatment-resistant depression.

“Off-label” prescription is when a medicine is used to treat another condition outside of its original medicinal intent. More on this below.

Ketamine is currently listed as a Schedule III compound under DEA guidelines. 

This means it is generally accepted to have medical value for specific purposes, and must be administered by a licensed provider to be distributed effectively.

The Drug Enforcement Administration (DEA) schedules controlled substances or compounds 1 through 5. Any compound receiving a 2, 3, 4, or 5 rating is designated as having viable medical uses, and is legal to administer so long as it is through a licensed provider to treat a specific condition.

When is Ketamine Illegal?

Ketamine is illegal when used outside of a clinically-prescribed setting.

Ketamine is known to be used as a “club drug.” It’s often referred to as special k, vitamin k, ket, kit kat, cat valium, and other street names. 

Side effects can include elevated blood pressure, increased heart rate, nausea, dizziness, and other symptoms. When used unsupervised recreationally, and in high doses, users can experience extreme dissociative effects, often called a “k-hole.”

This is why it’s important for users seeking medical and therapeutic benefits of ketamine to do so under medical supervision. When using the calculated dosage, in a clinically-supervised setting, ketamine therapy is safe and well-tolerated, allowing individuals to receive the intended benefit of the treatment.

Is “Off-Label” Ketamine Legal as Well?

Ketamine is able to be prescribed “off-label”, which can, understandably, be a confusing term. A common misconception about “off-label” prescribing is that it’s potentially illegal or otherwise untrustworthy. 

Generally, when a drug or compound is approved for medical use, it is approved to treat a very specific ailment or serve a very particular purpose. Originally, ketamine was approved for use as a general anesthetic in surgeries that do not require skeletal muscle relaxation. This is the labelled use.

If the compound or medicine is prescribed and used to treat something other than the original designation, this is considered off-label use. This is a relatively common practice, with studies showing that one in five prescriptions are given off-label. Fully labeling a medicine for FDA-approved use is a time and cost-prohibitive process, and is typically sought out by pharmaceutical companies looking to apply the medicine for a specific consumer use case.

Fortunately, new science and research is emerging showing that ketamine can be highly effective in treating treatment-resistant depression, anxiety, PTSD, OCD, chronic pain, and a growing list of other applications.

If prescribed for any of these use-cases, this is considered off-label use, and it is completely legal — so long as it is prescribed by a licensed practitioner for this particular use.

What are the Legal Uses of Ketamine?

Ketamine for General Anesthesia

Ketamine was originally synthesized for use as a general anesthetic in medical and surgical procedures. 

To this day it continues to be used in emergency rooms and in surgeries across the country to help manage pain and induce sedation. Due to its safety and efficacy, it has become an essential asset to the medical community, being used to treat a range of cases from young children, military members and veterans, and seniors. 

Ketamine for Depression & Anxiety

As research continued and scientific interest explored the uses of ketamine further, new applications and areas of efficacy were discovered.

Evidence from peer-reviewed, double-blind research over decades has shown that lower doses of ketamine prescribed in a clinical and therapeutic setting can provide benefits for depression and anxiety symptoms, among other mental health considerations.

Ketamine’s antidepressant and antianxiety benefits are related to enhanced neuroplasticity, or the ability of brain cells to form new connections with one another. The effects of ketamine therapy can be long-lasting, and often require shorter courses of treatment than medications like antidepressants.

Legal Ketamine-Assisted Therapy

One of the potential, and most illuminating, applications of ketamine is its use as a catalyst and treatment in managing or relieving depression and anxiety symptoms in patients actively suffering from these symptoms or who have been found to resist other possible treatments.

Therapeutic ketamine sessions, when prescribed and monitored by a licensed clinician, have the potential to facilitate incredible breakthroughs in the mental health of clients and patients who go through these treatments.

Ketamine is legal, safe, well-tolerated, and effective. This is due to decades of history in clinical and surgical environments, structures and systems in place for quality control, prescription and clinician regulations.

If you’re interested in learning how ketamine can help with anxiety and depression symptoms, take our assessment to see if you’re a candidate today.

Psychedelics, when used thoughtfully, can help induce life-changing experiences. In a 2006 Johns Hopkins study of psilocybin (the psychedelic chemical in magic mushrooms), over half of the participants rated the experience as “among the five most personally meaningful” of their lives… 14 months later!

For the past half-century, expert psychedelic clinicians and researchers have employed methods that commonly produce profound therapeutic benefits. But what are these methods, and how can you incorporate them into your Mindbloom journey?

The first step is setting your intentions.

Why it’s important to set intentions

Intention setting has always been an essential component of psychedelic therapy, employed by early psychedelic therapists in the mid-20th century and in today’s groundbreaking psychedelic research centers at prestigious academic institutions such as Johns Hopkins University and Imperial College London.

You may have heard the terms “set” and “setting” used in relation to a psychedelic experience. The psychedelic experience is rooted in the user’s character, expectations, and intentions, which are referred to as “set” (mindset, abbreviated). The social and physical surroundings in which the event takes place are referred to as “setting”.

Establishing intentions prior to a psychedelic experience can help cultivate the right “set” by priming your mind with your objectives, or what you hope to gain or learn from the experience. When combined with the right setting, this dramatically increases the likelihood of having a positive, therapeutically valuable experience.

How to set your intentions

What are the right intentions? Just about anything! An intention can be something serious, such as understanding the root of your depression or anxiety or learning how to deal with a loss. But it can also be something lighter, such as how to find more joy in your daily routine.

A great first step for setting your intentions is to think about what brought you to Mindbloom and what you’re hoping to change in your life. Your intentions work best when they are personal, specific, and focused.

Here are some questions you might ask yourself as you get started:

  • Where am I stuck in life?
  • What’s holding me back? 
  • How does my behavior compare to my goals, values, and self-beliefs? 
  • What would I like to change about my life?

Pro tip: don’t just think through these questions… close your eyes and try to feel them!

Next, write down your intentions. Writing them down is crucial for solidifying these goals in your mind. Prepare 1-2 intentions per session (never more than three).

Common themes include:

  • Improving awareness of strengths, weaknesses, blindspots, roadblocks, etc.
  • Exploring creative problems and inspirations
  • Healing from past traumas
  • Improving relationships
  • Overcoming bad habits
  • Cultivating gratitude

Here are some examples below. You can think of these statements, requests, or questions as the beginning of a dialogue you are initiating with a special part of your subconscious mind – your Inner Healing Intelligence.

  • What are the causes of my depression or anxiety?
  • Show me how I can be a better partner to my significant other
  • Help me understand what’s holding me back at work
  • I will be more patient and empathetic
  • How can I overcome my bad habit?

Need some expert guidance? Before your first session, you’ll also have the opportunity to discuss and reinforce your intentions with your Mindbloom clinician.

Putting your intentions into practice

At Mindbloom, we advise clients to set intentions – not an agenda. This means going into each session with thoughtful objectives, while being open to wherever the medicine and your subconscious decide to take you (remember to trust, let go, be open). Use each session as an opportunity to collect (but not direct) your experiences. You may be surprised by the profound insights you discover!

After your session, reflect (and journal!) on how the insights and observations that arose during your experience related to your intentions. Discuss these discoveries with a friend, family member, or therapist and see how this contributes to a new perspective.

In subsequent experiences, your intentions may completely change or you might find yourself going deeper into your original intentions. Intentions can (and often will) build on each other – let them!

Update: We’re no longer accepting in-person appointments at our NoMad space. Mindbloom now offers fully virtual treatment! For a list of states Mindbloom is available in, click here.

Mindbloom remains operational

COVID-19 has skyrocketed past mental healthcare as the #1 public health crisis in the United States. The conditions for anxiety and depression have never been higher, and our clinicians and team feel called to service in this time of crisis.

We will remain operational as long as we are safely able in order to continue increasing access to effective, science-backed mental health and wellbeing treatments for the people who need it most, with some minor changes.

Virtual visits

Mindbloom’s priority is the health and safety of our clients and partner clinicians. As a result, we are indefinitely lifting the requirement to begin your journey with an in-person visit to one of our locations. Now, you can enjoy your first session from the comfort and safety of your home through an online psychedelic therapy visit. Your Mindbloom provider will help you prepare beforehand and integrate afterwards through video. As was previously practiced, subsequent sessions will continue to be remote. Our NoMad space is now closed.

What do I do next?

If you’re an existing client or new to Mindbloom and experiencing symptoms of anxiety or depression related to COVID-19 or for any other reason, send questions to support@mindbloom.co. We’re here to guide you through these challenging times as best we can.

As you approach your first Mindbloom visit, you may be asking yourself:

  • “What will happen during my first Mindbloom session?”
  • “After I take the medicine, what do I do?”
  • “What should I think about?”
  • “Will I be talking with my clinician during my treatment?”

In this article, we’ll cover exactly what to expect heading into your first treatment and how the “TLO” mantra will help you navigate the experience.

What you should know going into your first treatment

In our article, we talked about setting intentions before treatment. Even with your thoughtful focus on intentions, psychedelics can still unlock unexpected subconscious material. That’s why we ask our clients to set intentions, not an agenda, and cultivate a positive and open mindset heading into treatment. Here are some more important points to keep in mind for your first experience:

You’re entering uncharted territory

You’ll work with your clinician to find an appropriate therapeutic dose during your first couple of sessions. Even with a conservative initial dose, the medicine (ketamine) causes changes in your physical and mental perception and allows you to explore sometimes hidden parts of your consciousness. Read our article, “How will I feel during treatment,” if you want to learn more.

You’re here to learn

You’re doing this to learn and gain insights into your thoughts, emotions, and behaviors. Approach the experience with an attitude of curiosity and exploration. We advise clients to use their session to collect experiences that you can reflect upon and start to decode while journaling for integration after your session, and in the days and weeks that follow.

If you encounter anything during your exploration that causes fear, sadness, anger or any other uncomfortable emotion, remember that anything that is coming up in your mind is there not to harm you, but to enlighten you. Treat these ‘guardians of the threshold’ with openness and curiosity – they’re not monsters, they’re teachers. Have compassion for the fact that they have carried the burden of these difficult emotions for so long, and thank them for bringing them into the light of your awareness for healing and integration.

You’re safe

Your Mindbloom Guide and a professional clinician are there to support you throughout your journey. Before and after your initial session, your Guide and clinician will ensure your medication dosage is right, and help you work with your set intentions. During treatment, you’ll be comfortable in your own at-home setting, with an eye mask and hand-selected meditations and music for your journey. Your Peer Treatment Monitor (PTM) —a loved one or close friend— is with you during your sessions to check in on your safety and comfort.

How to navigate your experience

Even if you’re familiar with psychedelics, you may feel uneasy or excited for your first Mindbloom session. Don’t worry – your Guide will help you prepare both your intentions and expectations during your initial video consultation and at the start of your Mindbloom session.

In your preparation call before taking the medicine, your Guide will help you prime your mind for the experience. Immediately after, you’ll use journaling to help develop and solidify your insights and new perspectives and then debrief your session with your Guide and clinician. This helps to ensure your safety, provides support with integration, and helps make a suitable plan for treatment moving forward. Your guide is also available for unlimited text support throughout the journey.

Your Mindbloom psychedelic therapy sessions are designed to facilitate inner exploration, where you’ll dive into your own mind. The goal isn’t to focus on anything specific, but to embrace what comes up.

Your Guide and clinician work very closely as a team to support you every step of the way. In addition to unlimited text support, you will have 1:1 support with your Guide, meeting virtually both before and after your first and second treatment session. This includes a deep dive integration session following the second treatment. You’ll receive a Wrap-up call at the end of your journey, which is a space to reflect on and integrate The Basics Program with your Guide.

Throughout your journey, we encourage you to practice a classic psychedelic mantra that will help guide you: trust, let go, be open.

TLO – Trust, Let Go, Be Open

“Trust, Let go, be Open” or TLO, is a mantra that is widely used in psychedelic therapy. From pioneers such as Stan Grof and Betty Eisner to today’s sessions at Johns Hopkins and NYU, the TLO mantra helps voyagers get the most out of their experiences.

Trust

Trust that you’ve been prepared by expert Clinicians to dive deep into the issues that are holding you back from living your best life, without compromising your physical or psychological well-being. Trust that the medicine will serve its purpose.

Trust your own Inner Healing Intelligence, and trust that you have the skills and natural abilities to achieve profound insights and healing from this experience.

Let go

Letting go is crucial to psychedelic therapy. Let go of expectations about what should or shouldn’t happen to your mind or body. Let go of concerns and judgments, as well as the inevitable urge to control the experience. Whatever happens, happens – let it unfold. Your mind will give you what you need.

If the experience is challenging, confront whatever frightens you. Betty Eisner, a psychedelic therapy pioneer, explains:

Then there was the most important information for a therapeutic session, the suggestion that the subject should allow IT (whatever) to happen… “Move toward the problem!” In other words, one should go into the fire, toward the dragon, into the vortex, toward the void, toward that which is frightening. In a psychedelic session (as in life?), it is confronting the seemingly life-threatening situation that allows the problem to be solved and/or transcended… Life – or the deep unconscious – knows better than we do.

Be open

Be open and curious about whatever comes along in your journey. Your experience may be centered on your intentions – or it may not, and that’s okay. You may experience epiphanies or breakthroughs during your first experience, but don’t be disappointed if they don’t come right away. Benefits will compound over each session.

Be open to the events that are unfolding, whether profound or confusing, pleasant or challenging–there will be plenty of time to process and make sense of things later, if they don’t make sense right away. Stay open to the fundamental truth that everything happening is completely and utterly OK.

How will I feel during my treatment? This might be one of the first questions that springs to mind if you’re new to psychedelic therapy.

The short answer is that ketamine produces a sense of dissociation from one’s ordinary reality. But of course, it’s a lot more complex than that.

That’s why in this post, we’ll (try our best to) explain what you’ll experience during your treatment, and also, what happens during your first visit to Mindbloom.

Introduction to psychedelic ketamine experiences

Ketamine is the only clinician-prescribed psychedelic medicine currently available to mental health professionals. Ketamine is fast-acting and has shown impressive clinical efficacy across many conditions. This is likely because ketamine increases neuroplasticity (the ability to create new neural connections) and suppresses the default mode network (DMN), which is often the culprit of negative and ruminating thought patterns. Learn more in The Neuroscience of Ketamine.

Ketamine creates a unique experience due to its biological, experiential, and psychological impacts. Ketamine is dissociative, which means it alters your perception of reality. In other words, it can open you up to seeing yourself, and the world, in a whole new light, thereby opening up new possibilities for change.

The spectrum of ketamine experiences range from very mild to complete dissociation (typically only targeted in anesthesia), and Mindbloom’s clients most frequently achieve moderate levels of dissociation described as “trance” or “transformational” states, described below. While every journey is different, there are common mental and physical effects, which we’ll now explore in greater detail.

How Mindbloom clients typically feel during treatment

Our clinicians at Mindbloom collaborate with clients to find the right dose. The right dose is important because it will help the client achieve a therapeutic state that best meets their psychotherapeutic needs. For the initial session, the dosing is typically light to moderate.

The initial session

Mindbloom clients typically enter a trance state during their initial session. When in a trance state, people often report positive feelings such as reduced mind chatter, relaxation, euphoria, love, and empathy.

Explaining the trance state further, Dore et al. say that, “Depending upon dose, ketamine promotes a time-out from ordinary, usual mind, relief from negativity, and an openness to the expansiveness of mind with access to self in the larger sense.”

Depending on a client’s psychotherapeutic needs, clinicians might target a transformational state for clients. This is a deeper psychedelic state that is accessed with higher sublingual dosing or intramuscular (IM) injections. The transformational state is characterized by the reduction of body and sensory awareness of an ego. Clients can also have experiences that help to liberate their conceptions of themselves and the world from rigid societal norms, and sometimes these experiences are described as highly spiritual. Using IM dosing, a full out-of-body experience can be reached.

The 2014 paper, “Do the dissociative side effects of ketamine mediate its antidepressant effects?” suggests that the level of dissociation that takes place during treatment is actually correlated with more robust antidepressant effects.

Although each person’s experience is different, it’s often comforting and insightful to read about others’ experiences, including those of Mindbloom clients and this writeup by Dilan Dane.

How long does it last?

Each person’s ketamine experience will be different. You’ll start to feel the effects of the dose within 10-15 minutes, and the peak experience will last approximately 30-45 minutes. Most clients return to their ordinary level of awareness within 1-2 hours following administration and can resume normal activities. However, we suggest you clear your day to reflect and take advantage of your fertile brain state!

In some cases, mild side effects may linger until you’ve had a full night’s rest, so our clients agree not to operate a vehicle or heavy equipment until the next day.

Side effects and safety tips

Anyone taking a mind and body altering drug should always take extra care to remain safe. Side effects of ketamine can include confusion, disorientation, dissociation, loss of coordination, agitation, nausea, and elevation in heart rate and blood pressure. We require our clients to take these side effects very seriously, since disorientation and lack of balance can lead to accidents if Mindbloom guidance is not carefully followed during every session.

At Mindbloom, we’ve put some extra measures in place to ensure the safety and comfort of our clients. We carefully monitor the safety of our clients during virtual treatments, and can also prescribe anti-nausea medication as needed for future sessions. We also require that all our clients have a peer monitor close at hand whenever they do a remote treatment at home.

Will I feel the same way each time?

Ketamine is slightly different for everyone and experiences may vary from session to session based on your mindset and setting. The preparation for the treatment and the work you do between treatments, such as intention setting and journaling, will influence your experiences and help you achieve greater therapeutic benefits.

Your subjective experience, such as how dissociated you feel, might not always be an indicator of therapeutic results. That’s because even a mild experience could significantly impact your mood, feelings, and perspective in days to come.