Ketamine Assisted Therapy versus Psilocybin Assisted Therapy
Comparing Emerging Mental Health Treatments
Novel, alternative treatments for mental health disorders have been gaining momentum in recent years, with both psilocybin and ketamine emerging as promising therapeutic options.
Psilocybin is a naturally occurring compound found in “magic mushrooms,” and Psilocybin Assisted Therapy (PAT) involves administering psilocybin in a controlled setting, guided by a trained facilitator, to access deep psychological insights and emotional breakthroughs.
Ketamine is an FDA-approved dissociative anesthetic that has been adapted for Ketamine Assisted Therapy (KAT), legal to administrate in a medical model. As a dissociative agent, inducing a sense of detachment from reality. It’s been found to provide rapid relief from depressive symptoms.
While both treatments are often grouped together as psychedelic therapies, it is important to understand the differences. Both offer hope to those who have not found success with traditional treatments.
What is Ketamine?
Ketamine was initially developed in 1962 and approved for medical use as an anesthetic in 1970 by the FDA. It was widely adopted in surgical and emergency settings for its effectiveness in inducing anesthesia and pain relief. Unlike other anesthetics, it has the advantage of maintaining cardiovascular stability, which makes it particularly useful in trauma care and with patients with heart issues.
Ketamine's primary mechanism of action involves modulating the neurotransmitter glutamate, the most abundant excitatory neurotransmitter in the central nervous system. Glutamate plays a critical role in synaptic plasticity, the process by which neurons adapt and change in response to new information and is essential for cognitive functions such as learning and memory and has a rapid impact on brain function. Because of it’s mechanism of action, ketamine additionally gained popularity for treating mental health disorders, particularly depression which has led to its use in specialized clinics across the US.
The drug also has a history of recreational use owing to its hallucinogenic and dissociative effects. It often goes by the street name “Special K,” and users can be said to enter a “K-hole” at higher doses.
Ketamine is a synthetic compound administered in a medical setting.
It may be taken intravenously, via intramuscular injection, or may be available in nasal spray or pill form as a derivative, esketamine.
How Ketamine Assisted Therapy Works
Ketamine is classified as a Schedule III controlled substance in the US, which means it has recognized medical uses but also a potential for abuse and dependence. As a result, its administration is strictly regulated and Ketamine must be prescribed by a medical doctor and should be administered under the supervision of a licensed medical professional, often a licensed nurse practitioner, often in a controlled clinical environment.
The process typically includes a series of intravenous (IV) infusions, although other routes of administration, such as intramuscular injections, nasal sprays, and oral lozenges, are also used. The exact number and frequency of these sessions vary depending on the patient’s condition and response to treatment, but a typical course might involve three to six sessions over the course of a few weeks.
Each infusion session lasts about an hour, during which the patient remains seated and in a relaxed, semi-conscious state. The effects typically wear off enough for the patent to leave within 2 to 3 hours.
The dissociative state induced by ketamine allows patients to experience a temporary detachment from their usual thought patterns, which can help them access and process difficult emotions and memories that are typically challenging to confront. This altered state of consciousness is seen as a window of opportunity for deeper psychological work with a therapist, if available and present.
In most KAT protocols, the patient’s existing therapist collaborates with the medical team administering ketamine, often conducting a follow-up therapy session shortly after the infusion to help the patient integrate their insights. This integration process can be critical for helping patients incorporate meaningful changes into their life. Research has shown that combining ketamine infusions with psychotherapy can lead to more sustained improvements in mood and reductions in symptoms of depression, anxiety, and PTSD.
A patient receives IV Ketamine
Ketamine Assisted Therapy is performed in a medical clinic under the supervision of medical staff. Users will remain in a chair for the duration of their experience
What is Psilocybin?
Psilocybin is the active compound found in certain species of mushrooms, commonly referred to as "magic mushrooms.” It belongs to a class of substances known as classic psychedelics, which also includes LSD, DMT, and mescaline, substances known for their profound effects on perception, mood, and cognition.
Psilocybin interacts primarily with serotonin receptors in the brain, particularly the 5-HT2A receptor. The resulting altered state is characterized by visual and auditory hallucinations, changes in thought patterns, and a sense of interconnectedness with the environment and others. It has an extremely low toxicity, and while negative psychological effects are a risk, there has never been a documented overdose death.
Psilocybin has thousands of years of history of use in various cultures, particularly among indigenous peoples in Mesoamerica, where it has been consumed in religious and spiritual ceremonies. Traditional uses often center on healing, divination, and connecting with the divine spirit. The historical cultural significance of psilocybin mushrooms is well-documented in archaeological records, including depictions in ancient art and in the oral histories of indigenous communities.
Recently, psilocybin has gained renewed attention for its potential therapeutic benefits and its use in treating a range of mental health disorders, including depression, anxiety, PTSD, and substance use disorders. Advanced stage clinical studies have shown promising results, with psilocybin therapy leading to significant reductions in symptoms, often after just one or two sessions. The therapeutic effects are thought to be mediated by psilocybin's ability to disrupt rigid patterns of thought and behavior, referred to as the Default Mode Network (DMN), allowing individuals to gain new perspectives on their lives and experiences.
In 2023, Oregon became the first state to legalize the regulated use of psilocybin for adults over the age of 21. This allows adults to access psilocybin at licensed Service Centers such as Lucid Cradle under the guidance of a trained facilitator and using state-certified, lab-grown mushrooms, without a prescription or medical referral.
The legalization of psilocybin in Oregon, Australia and soon, Colorado marks a significant shift in public policy and reflects growing recognition of the potential benefits and relatively low risk. This development is beginning to bridge ancient traditions with modern scientific research, offering new possibilities for mental health treatment.
Psilocybin is naturally occurring in some species of mushrooms.
Synthetic formulations, such as COMP360, are also possible.
How Psilocybin Assisted Therapy Works
In Psilocybin Assisted Therapy, psilocybin is administered orally under professional supervision. Sessions can last 8-10 hours and may involve lying stationary, blindfolded, and listening to music or offer you the ability to be expressive and move around, depending on the constraints of the Service Center. Providers should offer preparation and integration sessions help in processing experiences. Currently, psilocybin therapy is not covered by insurance.
Psilocybin Assisted Therapy (PAT) is a structured therapeutic approach that involves the administration of psilocybin in a controlled and supportive environment, under the supervision of trained professionals, designed to facilitate deep psychological exploration and healing.
In a typical PAT session, psilocybin is administered orally, usually simply by eating the fruit or consuming a ground up form in capsules. The effects of psilocybin generally begin to manifest within 30 to 60 minutes of ingestion and can last anywhere from 4 to 8 hours, depending on the dosage.
Some protocols under development, such as those from Johns Hopkins, require participants to lie down in a comfortable, stationary position, typically wearing a blindfold to minimize external visual distractions. Some believe this inward-focused approach helps the individual concentrate on their inner experiences, emotions, and thoughts. Prescribed music is often used, with playlists carefully selected to guide the participant through different phases of the experience.
However, the structure of a psilocybin session can vary depending on the Service Center's approach. Lucid Cradle offers a more flexible environment where individuals may select their own music and are encouraged to move around, engage in creative expression, or interact with their facilitator and surroundings as they wish. This self-directed approach can be particularly beneficial in maximizing comfort, especially for those that are uncomfortable with restrained conditions.
Preparation and Integration are critical components of Psilocybin Assisted Therapy. Before the psilocybin session, participants typically engage in one or more Preparation sessions with their therapist and/or facilitator. These sessions aim to set intentions, address fears or concerns, and establish a trusting relationship between the participant and the facilitator. Preparation creates psychological safety and supportive environment for the psilocybin experience on Administration day, essential for achieving therapeutic outcomes.
Following the psilocybin session, Integration sessions help participants process and make sense of the insights and experiences they encountered during the altered state. This involves discussing the experience, exploring its meaning, and finding ways to apply the lessons back into everyday life. This is crucial for translating the often profound and abstract experiences into practical changes and improvements.
Due to the legal status of Psilocybin as a Schedule I drug in the US, Psilocybin Assisted Therapy is not covered by insurance. Costs can be significant, especially when considering the comprehensive nature of the therapy, including preparation, the psilocybin session itself, and therapeutic integration sessions, however they are generally comparable to other forms of intensive, specialized therapy and wellness services.
A guided experience with psilocybin at Lucid Cradle
Lucid Cradle offers personalized guidance and features multiple rooms that clients are free to explore during their psilocybin journey.
Distinct Substances and Approaches
Both Psilocybin Assisted Therapy (PAT) and Ketamine Assisted Therapy (KAT) offer novel approaches to addressing mental health disorders that have proven resistant to conventional treatments. Psilocybin, with its deep roots in cultural and spiritual practices, offers profound psychological insights and opportunities for healing. Ketamine, repurposed from its origins as an anesthetic, can provide rapid relief from depressive symptoms through its unique mechanism of action on the brain’s glutamate system. Despite their differences in origin, pharmacology, method of action and patient experience, they both offer hope where traditional methods have fallen short.
In both cases, structured and supportive environments ensure that patients can safely explore and integrate their experiences. While these therapies are not yet widely covered by insurance, there is growing acceptance and an increasing body of research supporting their efficacy and promise.
For individuals struggling with mental health challenges, choosing the righ path is important.
Reach out to us with further questions and to schedule your consultation for legal Psilocybin Services in Bend, Oregon.
References
Dore, J., Turnipseed, B., Dwyer, S., Turnipseed, A., Andries, J., Ascani, G., ... & Wolfson, P. (2019). Ketamine Assisted Psychotherapy (KAP): Patient demographics, clinical data, and outcomes in three large practices administering ketamine with psychotherapy. Journal of Psychoactive Drugs, 51(2), 189-198.
Krystal, J. H., Abdallah, C. G., Sanacora, G., Charney, D. S., & Duman, R. S. (2019). Ketamine: A paradigm shift for depression research and treatment. Neuron, 101(5), 774-778.
Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., ... & Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of Psychopharmacology, 30(12), 1181-1197.
Nichols, D. E. (2016). Psychedelics. Pharmacological Reviews, 68(2), 264-355.
