Psychedelic-assisted therapy is gaining recognition as an innovative and effective approach to treating depression. However, legal access to most psychedelic substances remains limited.
In this article, we’ll discuss ketamine and Spravato as legal, FDA-approved medicines with psychedelic-like properties and similar benefits in treating depression.
What Is Psychedelic-Assisted Therapy (PAT)?
Psychedelic-assisted therapy (PAT) combines the use of psychedelic substances with professional therapeutic support. These may be classical psychedelics, such as LSD and psilocybin (the active ingredient in magic mushrooms), or non-classical psychedelics, such as ketamine and MDMA.
During a psychedelic experience, people enter an altered state of consciousness. In this non-ordinary brain state, they may have emotional insights and realizations that are hard to reach through traditional talk therapy alone.
Psychedelic-assisted therapy has shown promising results in treating several mental health disorders, including depression. It can provide relief to those with a severe condition who haven’t benefited from conventional psychiatric treatment.
Is Psychedelic Therapy Legal?
In the United States and many other countries, classical psychedelics are mainly classified as Schedule 1 (or the international equivalent). This means it’s illegal to possess or distribute them, and therapeutic use is generally restricted to tightly regulated clinical trials. In recent years, however, a few U.S. states—such as Oregon, Colorado, and New Mexico—have begun to make limited exceptions.
Ketamine is Legal and FDA-Approved
Ketamine was approved by the FDA in 1970 as a general anesthetic. It has a long-standing safety profile in both emergency and surgical medicine.
More recently, ketamine has become sought after for its antidepressant effects, especially in patients who hadn’t responded to other treatments. While ketamine isn’t a classical psychedelic, it can induce psychoactive effects that facilitate similar benefits for therapy.
Ketamine is not a Schedule I drug, unlike LSD and psilocybin, and can be legally prescribed for off-label use. This includes mental health purposes, making ketamine one of the only legal “psychedelic” therapies in the U.S. today.
How Ketamine Produces Psychedelic Effects That Aid Depression Treatment
Ketamine produces dissociative and psychoactive effects that can be therapeutic.
During a ketamine session, patients often describe sensations like:
- A feeling of detachment from the body, otherwise known as dissociation.
- A sense of peace or clarity
- Vivid imagery or introspective insights
- Emotional release or catharsis
These experiences may open the door to cognitive shifts that are often hard to access through talk therapy alone.
Ketamine and the Brain
Ketamine works differently from traditional antidepressants. SSRIs target the chemical messenger serotonin, and make changes over several weeks. Ketamine, on the other hand, targets the chemical messenger glutamate, which affects signaling in the brain. This action increases activity in brain regions associated with emotional regulation and mood, providing instant benefits.
In addition, ketamine stimulates neuroplasticity, which is the brain’s ability to form new connections. This is a mechanism shared with classical psychedelics. By making the brain more flexible, ketamine can potentially help “reset” neural pathways associated with negative habits and thinking.
Is Ketamine FDA-Approved for Depression?
Ketamine is available in two forms:
- Racemic ketamine: This is the standard form. It’s a 50/50 mix of two mirror-image molecules (called enantiomers): R-ketamine and S-ketamine. In clinical settings, it’s primarily administered as an injection.
- Esketamine: This is just the S-ketamine half of that mix that has been isolated. In clinical settings, it’s administered as a nasal spray with the brand name Spravato.
While racemic ketamine is FDA-approved as an anesthetic, its use in mental health is considered “off-label.” This means it isn’t FDA-approved as a mental health treatment, but doctors can prescribe it if they think it’s medically appropriate.
Spravato, on the other hand, is FDA-approved. The medication was approved for treatment-resistant depression (TRD) in 2019, and major depressive disorder with suicidal ideation (MDSI) one year later.
This approval means the FDA has officially determined that the drug is safe and effective for depression, based on rigorous clinical data. It also means the majority of insurance providers can cover the costs, making it a financially accessible treatment option. However, it’s only available to those with a clinical diagnosis of TRD and MDSI.
Ketamine Therapy at Emerge Ketamine in Boston
At Emerge Ketamine, we offer both FDA-approved Spravato treatment and intravenous (IV) ketamine infusions for patients seeking relief from depression and related mood disorders.
Our approach combines ketamine treatments with medical supervision and compassionate support. While we don’t offer direct ketamine-assisted psychotherapy, our staff will be here to offer reassurance and provide verbal support during sessions. We will also provide tailored aftercare to help you integrate and make the most of these experiences.
If you want to know more about our services, be sure to get in touch.
Key Takeaways
- Psychedelic-assisted therapy combines psychedelic substances with therapeutic support.
- Most classical psychedelics remain illegal in the U.S., though some states have begun to allow limited therapeutic use.
- Ketamine is legal, FDA-approved as an anesthetic, and widely used off-label for depression; Spravato (esketamine) is its FDA-approved form for mental health treatment.
- Spravato’s FDA approval ensures proven safety, regulated administration, and potential insurance coverage for eligible patients.
- Emerge Ketamine offers both IV ketamine and Spravato to patients struggling with depression and other mental health disorders.