Ketamine for Severe Depression

What is the sound of one hand clapping?

In the Zen Buddhist tradition, a master may ask a student “what’s the sound of one hand clapping?” the answer may come in the form of a slap of a stick across the student’s hand. The lesson being taught is that there are some questions for which no answer can be articulated in words. The answer is an experience. An experience which dissolves the ego and dismantles one’s false autobiographical narratives. Patients with severe depression need just such an answer because, for many of them, traditional psychotherapy and antidepressants just haven’t worked. While there are certainly some important biochemical and pharmacologic effects that ketamine provides, what really sets it apart is its potential to create a transpersonal experience that can completely remodel a patient’s psychological paradigm. Since we opened in 2015, Klarisana has stood apart from many other centers because this is the foundation of our treatment model. Other centers view ketamine therapy like an “oil change shop”…we view it as an individualized journey that optimizes the mystical and transformative aspect of the experience.

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The Biochemical

There is clearly a biochemical component to how ketamine treats depression. The exact mechanism (as with many treatments for mental health) is not totally understood. One of the leading theories is that ketamine blocks the NMDA receptor which causes an increase in a chemical called BDNF (brain derived neurotrophic factor). This increase in BDNF causes new synapses (connections) to be created in the brain which in turn improves one’s mood. While this is certainly important, we believe that this is only one part of how ketamine treats depression…

The Transformational Experience

The central theme of Klarisana’s treatment strategy is that the experiential (or psychedelic) effect of ketamine is not a side effect to be eliminated, but rather a foundational component of how it treats depression. Our doses are much higher than the traditional “NIH protocol” and we seek to create an intense transpersonal and transformational experience. This cannot be achieved with low dose nasal spray like Spravata (esketamine) and it cannot be achieved when clinicians administer concurrent doses of benzodiazepines such as Valium.

The Psychotropic Therapeutic Response

At Klarisana, we believe that ketamine can take the mind to a place where the lies of the ego are destroyed, where the echoes of one’s past are silenced, and where the paradigm of how a person views themself is fundamentally deconstructed. The point where a person crosses into this space is what we call the Psychotropic Therapeutic Response. To guide patients into this space, we progressively increase the dose of ketamine throughout the six infusion Induction Series to the point where the ego gets fully dissolved and one’s true self gets uncovered. Questions? contact us here. learn more about Ketamine for Severe Depression today.

Why Don’t I just Use Esketamine (Spravata)?

There are some very important differences…and similarities…between the ketamine we use at Klarisana and that which Janssen put in the new nasal spray which they are marketing as Spravata.

  • Ketamine exists as a mix of molecules that are mirror images of one another. This is like looking at left and right gloves. They look similar but they are not superimposable. All that Janssen Pharmaceuticals did was filter out the right ”right hand” version and are just selling the left hand version; S-ketamine
  • Each dose will have two sprayers with a total dose of 54 mg of ketamine. By comparison, most of our patients are receiving 100-200 mg of intravenous Ketamine over an hour.
  • Janssen feels that the experiential effects of ketamine are NOT an important part of the therapy, so they have sought to decrease the dose as much as possible to eliminate any of the transpersonal or psychedelic effects of ketamine. We, on the other hand, believe this is a critical part of the therapy.
  • The FDA requires that Spravata be administered in a physician’s office and the patient must be monitored for two hours. Make sure to bring a book to read because with such a low dose, you will just be sitting around for two hours and will likely be bored.
  • One dose of Spravata will cost much more than one hour of ketamine infusion therapy. For some, it may be covered by insurance but ultimately it is much more expensive than generic ketamine and the cost is ultimately a waste of money for the American healthcare system. One way or another we all pay for it. There is no free lunch. Learn more about Ketamine for Severe Depression.

It's difficult to describe depression to someone who's never been there, because it's not sadness. I know sadness. Sadness is to cry and to feel. But it's that cold absence of feeling – that really hollowed out feeling.

JK Rowling

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