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Be Very Cautious of At-Home Ketamine “Therapy”

On March 4th, 2019, the U.S. Food and Drug Administration (FDA) approved the use of ketamine for the treatment of treatment-resistant depression (TRD), marking a pivotal moment in the recognition of ketamine as a potent therapeutic agent for mental health conditions. Unlike traditional antidepressants, ketamine and similar psychedelics operate through distinct mechanisms, offering a high effectiveness rate and a favorable safety profile. This development is particularly significant as a growing number of patients find conventional treatments ineffective. Given the increasing prevalence of mental health issues across all age groups, but notably among adolescents and the elderly, the introduction of ketamine and other psychedelics into the treatment spectrum is timely and critical.

The concept of at-home ketamine therapy, which allows patients to order ketamine online for doorstep delivery, presents a novel approach to treatment. Today we will delve into this further, urging a cautious perspective towards what might initially seem an overly convenient solution. While increased access to various medicines, including ketamine, is a positive advancement, it's crucial to critically examine the potential downsides of at-home ketamine use. These concerns necessitate a broader discussion to ensure the public fully understands the implications of relying on such a potent treatment option outside a controlled medical environment.

How does at-home ketamine “therapy” work?

The journey to at-home ketamine therapy often starts with an online search, leading to a selection from an increasing number of ketamine providers. This process may include a consultation with a healthcare professional, though it's not always a requirement. Most of these companies prescribe an oral form of ketamine, The guidance provided, however, seems to be less formal, sometimes including automated apps that check in on you. Some of these apps require patients to choose between a smiley or frowny face button on their phone, hoping to receive feedback on what to do next. While some providers demonstrate a commitment to quality care, there's a growing concern that the industry, on the whole, might prioritize profit over patient safety and efficacy of treatment.

IV and oral at-home ketamine “therapy” are not the same

At Innerbloom ketamine therapy we offer intravenous ketamine for two reasons: safety and efficacy. As previously mentioned, there are various forms of ketamine, however, IV ketamine is the superior route of administration for various reasons. Let’s do a side-by-side comparison between IV ketamine and at-home oral ketamine.

IV ketamine

  • Most studied and supported form of ketamine in the scientific community
  • 100% bioavailable
  • Predictable dose and experience
  • Ability to stop an infusion
  • Precision: ability to titrate and find exact “goldilocks” dose with the most therapeutic potential
  • Ability to treat potential side effects (i.e., nausea) with ease given established IV access
  • Treatment in a monitored setting by physician or qualified healthcare provider

Oral at-home ketamine

  • Oral ketamine had been found to be a potentially less effective form of ketamine with a delayed onset of anti-depressant effects
  • 20-25% bioavailable (meaning most of the ketamine does not reach the bloodstream and has no effect)
  • Less predictable experience (i.e., dose is depended on rate of absorption and other patient specific factors)
  • No ability to stop or take back dose, rather patient must wait for effects to “run its course” and wear off
  • Less guidance on proper use and dose that is specific to each patient
  • Potential for abuse with often marginal oversight on when and how to properly use
  • Potential harm to self and others – patients may have an adverse reaction and may put them and others at risk if for example they choose to drive to hospital or seek help when they are unsupervised, unmonitored, and often simply alone

Potential benefits of oral ketamine

Oral ketamine on initial appearance seems like an attractive option and could make ketamine an accessible, affordable, and helpful option in certain context – for example, when a patient needs an immediate response to an acute issue such as suicidal ideation. However, it is important to recognize its limitations as noted in this 2019 research, “Literature on oral ketamine is thin and that there are many areas that need more investigation, especially matters related to pharmacokinetics, physiologic effects, abuse potential and strategies to mitigate illicit use, and adverse effects and efficacy relative to other routes of administration. Until studies of a sufficiently high quality become available, the use of oral ketamine to treat depression must be considered experimental.”

Final thoughts

The literature supports that ketamine is a safe, rapid, and effective treatment option for a range of mental health disorders, including depression, anxiety, and pain. Its use, along with other potent psychedelics, is becoming increasingly common and appears to be here to stay. We are enthusiastic about the public gaining access to this transformative therapy for mental health.

The business of at-home ketamine delivery is undeniably lucrative, raising significant concerns for us. We urge you to exercise caution with offerings that may seem too good to be true. While the idea of using ketamine in the comfort of your own home might sound appealing, questions arise about its effectiveness and safety in such a setting. What recourse is available if something goes awry? Who supports you when the experience becomes difficult? Where is the guidance from a properly trained professional to maximize the therapeutic potential of ketamine?

These are crucial questions we encourage you to consider if you're thinking about using ketamine at home. At Innerbloom Ketamine Therapy, we understand the significance of the entire therapy experience. We are dedicated to creating an environment that maximizes comfort, safety, and efficacy for our clients.

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