A breakthrough treatment for depression, anxiety, trauma, and chronic pain
by Dr. Dustin Sulak, July 2021
Over the past 3 years, my colleagues and I have treated nearly 200 patients with ketamine, and have been sincerely impressed by the safety, versatility, and effectiveness of this intervention. Considering my long interest in natural medicines and emphasis in helping patients replace pharmaceutical drugs with natural treatments, it’s been a bit of a surprise to recently discover the holistic physical, mental, and spiritual healing potential unlocked by this pharmaceutical agent originally discovered in 1963 and approved by the FDA in 1970.
Classified as a dissociative anesthetic, ketamine is on the World Health Organization’s List of Essential Medicines due to its well-established safety profile. It is most commonly used in surgical settings for anesthesia, especially in pediatrics and veterinary medicine, because unlike most other anesthetics, ketamine does not suppress breathing and cardiac function.
In the last two decades, ketamine has been increasingly researched and clinically applied at sub-anesthetic doses as an off-label treatment for various chronic treatment-resistant mental health conditions, such as depression, alcoholism, substance dependencies, post-traumatic stress disorder, obsessive compulsive disorder, other psychiatric diagnoses, and for chronic pain. In 2019, the FDA approved a specific version of ketamine (esketamine nasal spray) for treatment-resistant depression, but this treatment is expensive and limited in availability.
Like cannabis, ketamine can be effective at mildly psychoactive doses, though some patients experience more profound and long-lasting results with stronger doses given under supervision in our clinic. These psychedelic doses can be transformational at a core level. Conversely, topical ketamine can provide excellent relief of localized pain without any psychoactive effects.
At Integr8 Health, we work with compounding pharmacists to formulate ketamine into a variety of delivery methods to best suit the goals of treatment. Troches, oral dissolving tablets, nasal sprays, and topical creams can all be used in the outpatient setting, and are surprisingly inexpensive. We also offer intramuscular injections of ketamine in the clinic as an adjunct to osteopathic treatment and therapy.
Interestingly, a single dose of ketamine that only lasts an hour or so can produce days, weeks, or even months of sustained improvement in symptoms. How is this possible? The primary mechanism of ketamine in chronic conditions is related to its capacity to help people disengage from limiting patterns of thought, behavior, and physiology. After this disengagement, patients are able to re-integrate with new, more functional patterns in their place.
Like any treatment, ketamine is not effective for everyone. Most of the clinical studies evaluating low-dose oral ketamine have found ~70% response rate. Potential side effects are usually mild and transient, and can include a short-term elevation in blood pressure and/or heart rate, dizziness, sedation, impaired balance and coordination, nausea, blurred vision, vivid dreams, perceptual disturbances, confusion, euphoria, and fatigue. These side effects usually begin after oral administration and last 30 minutes to 2 hours.
Examples of clinical studies:
“I started the oral ketamine over a year ago after losing my pain doctor suddenly, as well as all of my opiate pain medication. My new GP also insisted I stop an antidepressant I had been taking for years too. I was a hot mess! Dr. Sulak suggested the ketamine and it worked very well to ease all of my symptoms of withdrawal, pain, and depression/anxiety. It was not a cure all of course, but it sure helped me immensely, and I would recommend the use of this drug to anyone who needs it! I also highly recommend Dr. Sulak as a care provider for this and medical cannabis. The whole experience has been life saving.”
“Ketamine helps keep me grounded! It helps me channel my negative thoughts during the dose, and my following days are positive and calm.” – Female, age 55
“Ketamine has been a critical tool for me to help reduce symptoms of many conditions; sleeplessness, muscle spasms, nerve pain, energy level, and support for emotional wellness have all improved as a result of continued therapeutic use. I also feel thoroughly supported in a safe, clinical setting where the use and experience was fully communicated and monitored. I had no fear or concerns adding this as a very effective tool in my therapy, and hope to continue to explore the benefits in a more significant way. There are no long-term negative effects that I’ve encountered so far.”