Technically, ketamine is not classified as a psychedelic medicine, but rather a dissociative anesthetic. However, ketamine does have psychedelic effects at higher doses. The classical psychedelics include psilocybin (magic mushrooms), LSD, DMT, and mescaline, which work on a specific serotonin receptor. Ketamine, on the other hand, is an NMDA receptor antagonist which modulates glutamate levels. Interestingly, both ketamine and the classical psychedelics result in similar changes in the brain that are correlated with antidepressant effects.
What do we even mean by “psychedelic”? The word psychedelic means mind manifesting, and many people experience a psychedelic journey as having aspects that reveal unconscious material, like memories, symbols, and fantasies. Often there may be heightened sensory input as well, such as interesting visualizations or music that has an amplified feeling component. Many people find the content of this psychedelic material to be rich with potential learning about themselves, others, and the world. At Voyage Healing, we are skilled at helping people understand this deeply personal experience, and giving them tools to apply this knowledge to their daily lives.
For many, ketamine does indeed have psychedelic qualities. In fact, I’ve heard some patients say that ketamine reminded them of LSD, or is the most psychedelic experience they’ve ever had. The ketamine experience seems to vary tremendously person to person. Some may see different colors and shapes or have a vivid waking dream like quality. For others there may be a pleasant feeling of floating. Still others feel a profound sense of healing, love, and empathy. Although most people feel relaxed with ketamine, occasionally one may find ketamine anxiety provoking, especially for those that try to hold onto control. At Voyage Healing, we are well prepared to give patients extra support and tools to move comfortably through their ketamine sessions.
Interestingly, both ketamine and the other psychedelic medicines create two similar changes in the brain that are correlated with antidepressant effects. Firstly, both ketamine and psychedelics result in a state of brain neuroplasticity. This means that nerve cells in the brain are growing and making new connections. It is thought that new learning can take place during this neuroplastic window, which lasts about 72 hours post ketamine infusion.
A second change which occurs with both ketamine and psychedelics, is a decrease in the default mode network. The default mode network is the circuitry in our brain which is involved in depressive thinking and rumination. When one worries about oneself in the past or the future, there is increased activity in the default mode network. Not surprisingly, turning down the default mode network is correlated with improved mood. The combination of having one’s usual negative thoughts decreased, plus having new nerve growth and connections likely plays a powerful role in changing negative habits and dysfunctional thought patterns.
In summary, although ketamine works through a different receptor than the classical psychedelics, ketamine and psychedelic medicine have much in common. Firstly, the experience itself, may be mind altering and psychedelic. Secondly, there is a definite overlap in terms creating a neuroplastic state and decreasing the default mode network. And perhaps most importantly, many patients are benefitting from the incredible healing potential of these medicines. Of course, it is important to remember that for most patients, psychedelics and ketamine are not magic bullets. But, they do offer healing potential for overcoming existential, personal, and interpersonal suffering.
