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Ketamine For Anxiety

Anxiety disorders rank high among the most frequent mental health conditions worldwide. The World Health Organization (WHO) reports that more than 275 million individuals are affected by anxiety across the globe. Despite the availability of a variety of treatments, traditional medications or psychotherapies may not always prove to be effective.  Some classes of anxiety medications, such as benzodiazepines and SSRIs (selective serotonin reuptake inhibitors), carry serious potential side effects.  

Ketamine is an alternative or adjunctive treatment for poor responders or non-responders to standard treatments such as SSRIs, benzodiazepines, or cognitive-behavioral therapy (CBT).  In other words, patients may use ketamine on its own to treat their anxiety, or integrate it with their existing mental health regime.  AVYIA will work with you in which ever treatment regime you elect.    

Ketamine For Anxiety
Ketamine For Anxiety

Evidence Supports Ketamine As An Effective Treatment For Individuals With Anxiety

The body of scientific evidence supports Ketamine therapy is an safe and effective treatment tool to treat anxiety. Ketamine offers a fundamental different mechanism of regulating mood and emotions and it has a rapid onset of action to provide relief within minutes to hours, instead of weeks or months compared to the current standard first line therapy, the SSRIs.  Regain control over your life from challenging symptoms of anxiety through AVYIA’s safe and individualized ketamine therapy. Our individually tailored treatment programs offer an effective solution, empowering those who suffer from anxiety, the potential to safely and quickly overcome their awful symptoms.  Individual results may vary, and ketamine may not be for everyone.  However, many have already achieved remission of their diseases, and so can you.  Talk to one AVYIA’s clinicians today to see if ketamine is a right fit for you.

What Are Some Key Statistics of Anxiety Disorder?

Prevalence

Anxiety disorders are the most common mental health condition in the United States, affecting an estimated 31.1% of adults or 103 million at some point in their lives.

Age of onset

Age of onset

The age of onset for anxiety disorders varies, with some types of anxiety disorders more likely to begin in childhood or adolescence, while others may develop later in life.

Gender differences

Women are more likely than men to experience anxiety disorders, with a lifetime prevalence of 33.7% in women compared to 19.1% in men.

Comorbidity

Anxiety disorders often co-occur with other mental health conditions, such as depression, PTSD, bipolar, and eating disorders.

Disability

Anxiety disorders can cause significant disability, impacting an individual's ability to work, attend school, and maintain relationships. In fact, anxiety disorders are the second leading cause of disability worldwide.

Access to treatment

Effective treatments for anxiety disorders exist, including therapy and medication. However, many individuals with anxiety disorders do not receive proper care. Access to care can be limited by factors such as stigma, cost, and a shortage of mental health providers.

Types Of Anxiety Disorders

Ketamine therapy is an effective and fast-acting treatment option for managing a variety of anxiety disorders and symptoms. This therapy targets synaptic receptors in the brain almost instantly to regulate the brain’s response to stress and minimize the formation of traumatic memories.  Ketamine therapy has broad applications in mental health and can be used to treat a range of anxiety disorders, including:

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD)

This form of anxiety is known as an excessive concern over multiple factors at once. People with GAD often find it difficult to control worries about family, relationships, health, money and other everyday things.

Social anxiety

Social Anxiety Disorder (Social Phobia)

Social anxiety disorder involves an intense fear of social situations and a fear of being negatively judged or humiliated by others. People with social anxiety may avoid social interactions or endure them with significant distress.

Panic Disorder

Panic Disorder

It is best described as recurrent and unexpected panic attacks, which are sudden episodes of intense fear and discomfort. Attacks come with physiological changes such as increased heath rate, shortness of breath, and sweating

Phobia Related Disorders

Phobia-Related Disorders

Specific phobias are characterized by an intense and irrational fear of a particular object, situation, or activity. Common phobias include fear of heights, spiders, flying, needles, germs/dirt, thunder/lightening, or certain animals (i.e. snakes, dogs).

Seperation Anxiety Disorder

Separation Anxiety Disorder (SAD)

This is most commonly diagnosed in children, but can also occur in adults. The excessive fear or anxiety about being separated from attachment figures or significant individuals.

Agoraphobia

Separation Anxiety Disorder (SAD)Agoraphobia

When someone suffers from agoraphobia, they feel excessive fear or worry about leaving home or going to a crowded place. They may try to avoid these places or experience a panic attack if they are forced to be around other people.

How Does Ketamine Therapy Work in Treating Anxiety?

Ketamine therapy works by modulating the action of neurotransmitters that are responsible for anxiety.  Ketamine regulates the neurotransmitter glutamate at the NMDA receptor in the nervous system.  Simply put, this means ketamine re-balances your brain’s neurological chemistry back to its normal state.  Ketamine promotes neuroplasticity, or the ability to “re-wire” and restructure the brain.  This is achieved by acting on the mTOR pathway and inhibiting eEF2 kinase.  Ketamine also stimulates AMPA receptors, another type of glutamate receptor.  Activation of AMPA receptors is associated with an increase in brain-derived neurotrophic factor (BDNF), a protein that supports the growth and maintenance of nerve cells.  

While a single treatment session of ketamine therapy may provide effective relief from anxiety symptoms for days, AVYIA’s ketamine therapy program may achieve complete  disease remission for some individuals.  For others, periodic maintenance doses of ketamine may be needed for patients to stay in remission. For those who have not responded positively to traditional anxiety medications or therapies, ketamine therapy has been shown to be fast-acting, long-lasting, effective, and safe.

Ketamine acts on the NMDA receptor, mTOR pathway, and eEF2 kinase.  As a result, glutamate neurotransmitters are increased, and BDNF increases to promote neuroplasticity.  

Glue, P., Neehoff, S. M., Medlicott, N. J., Gray, A., Kibby, G., & McNaughton, N. (2018). Safety and efficacy of maintenance ketamine treatment in patients with treatment-refractory generalized anxiety and social anxiety disorders. Journal of Psychopharmacology, 32(6), 663–667. https://doi.org/10.1177/0269881118762073

Why Choose Ketamine?

Scienced-Backed – Ketamine therapy has been gaining increasing attention and popularity in the medical community as a safe and effective treatment option for anxiety. This type of therapy involves administering small and safe doses of ketamine to treat anxiety disorders. In recent years, peer-reviewed medical studies have demonstrated that ketamine can be used as a viable alternative to traditional medications, counseling, or psychotherapy.  It can also be used in conjunction to those standard therapies. 

Speed of Onset – Ketamine starts works on day one and typically within minutes upon starting an intravenous dose.  Traditional medications such as benzodiazepines, SSRIs, and SNRIs, require slow adjustments to the drug’s dosages, thus relief from symptoms can sometimes take days to weeks to months. Oftentimes, these medications carry many unwanted side effects. Finding the right medication or regimen of medications can be a long and frustrating journey.

Different Mechanisms – Ketamine acts on the glutamate system in the brain, specifically targeting NMDA receptors, which are involved in the regulation of mood and emotions. It is thought to modulate the release of glutamate and enhance synaptic plasticity. In contrast, SSRIs work by selectively blocking the reuptake of serotonin, a neurotransmitter involved in regulating mood. 

Long Lasting – With ketamine therapy, results are not only felt immediately, but symptom relief typically is long-lasting after completing a full treatment program. Many patients will enjoy remission of their anxiety after completion of a treatment program.  Others may have symptom relapses after a period of time.  Additional dosing sessions or a micro-dosing regimen may be needed to sustain anxiolytic (anxiety-reducing) benefits.   

3 Routes of Administration – Patients can choose from three of AVYIA’s treatment programs:  IV, intranasal, or microdosing oral tablets.  Our clinicians are happy to help if you’re unsure which route of administration is the best fit.  IV and intranasal routes provide rapid and profound therapeutic effects, while microdosing allows the patient to manage his or her regime on a daily basis over a longer period of time. 

Ketamine-for-Anxiety-Disorders

Mandal S, Sinha VK, Goyal N. Efficacy of ketamine therapy in the treatment of depression. Indian J Psychiatry. 2019 Sep-Oct;61(5):480-485. doi: 10.4103/psychiatry.IndianJPsychiatry_484_18. PMID: 31579184; PMCID: PMC6767816

What Are My Treatment Options?

Intravenously (IV):  Is performed under the safety and supervision of a licensed health care provider, such as a physician or nurse practitioner.  Results are often rapid, profound, and long lasting.  Dissociative effects, or an out-of-body experience is common during each treatment session.  These effects are short-lived after completion of the treatment and are monitored by medical staff. 

Intranasal:  Ketamine is inhaled into the nostrils under medical supervision from a health care provider.  Results are similar to that of IV.  This is an alternative to those whom aren’t fond of needles.  Dissociative effects, or an out-of-body experience may also occur in patients undergoing the intranasal route.

Oral Microdosing:  Daily, sublingual solutions and tablets that dissolve under the tongue, provide a more subtle approach to treatment.  For those whom aren’t fond of the potential dissociative effects seen in the IV or intranasal route.

Ketamine Assisted Psychotherapy:  With a success rate of 60 to 80%, many patients have found that working with a therapist during their ketamine therapy to be satisfying and effective.  Studies support that when ketamine treatments are combined with KAP, patient outcomes and engagement in the therapeutic process is better than ketamine alone. This synergistic approach helps individuals to explore and understand the root causes of their anxiety. Furthermore, psychotherapy offers a range of techniques, tools and coping strategies so patients can build the skills to better manage stress and navigate anxiety-inducing situations in their daily lives. 

The Benefits of Ketamine Therapy for Anxiety

Ketamine’s advantage over standard mental health treatment options is its safety, rapid effects, and sustainment of symptom relief.  Patients have reported a remarkable decline in their anxiety symptoms in just a matter of minutes to hours following their inaugural treatment session.  Furthermore, remission is achieved for many patients, thanks to the drug’s ability to promote neuroplasticity in the brain.   Ketamine therapy has also shown to be effective for patients who have not responded well to typical antidepressant or anxiolytic drugs. 

The benefits of ketamine Therapy for Anxiety

FAQ

Ketamine is a dissociative anesthetic first synthesized in the 1960s and approved by the FDA in 1970. At first, it was used for the induction of anesthesia prior to operations. However, upon scientific discovery of its effectiveness to treat various mental health conditions such as anxiety and depression, the use of Ketamine has since been adopted to do just that.  

Combining ketamine and psychotherapy, commonly known as ketamine assisted psychotherapy, or KAP, is to help guide the patients in their ketamine treatments, enhance the treatment outcomes, and develop lifelong strategies to prevent relapse. Ketamine works by relieving emotional distress related to traumatic experiences, enabling patients to confront the root cause of their issues more comfortably. Ketamine assisted psychotherapy can further help to increase the effectiveness of ketamine by helping patients gain a deeper understanding of their emotions and experiences, leading to increased self-compassion and acceptance. This process of self-discovery and self-acceptance can be essential for healing and personal growth. Combining the two can make it easier for the individual to engage in a more holistic therapeutic process and make progress towards their treatment goals.  KAP has scientific backings, as KAP studies have shown to produce better outcomes compared to just using ketamine alone.  

We recommend completing 6 treatment sessions of intravenous ketamine infusions, delivered over 3 weeks.  Each treatment session is an approximately 2 hours.  Prior to starting the treatment program, you will have a telehealth appointment with one of our providers to discuss your medical history and treatment details.  

Should you elect the intranasal route, we recommend 8 treatment sessions over 4 weeks, each session lasting 2 hours approximately.  Similar to the IV route, we require a telehealth appointment prior to starting the treatment program.  

Alternatively, patients can choose to microdose on a daily basis. AVYIA offers oral rapid dissolving tablets for individuals who choose to treat anxiety using a more subtle, but longer term approach.

Side effects are generally mild and well tolerated.  Symptoms may vary from patient to patient, but common side effects are slight elevations in blood pressure and nausea. Nausea can be easily treated with antiemetics or anti-nausea medications on the spot. 

Psychedelic experiences and dissociative effects may occur in the doses we give for IV and intranasal treatments.  This is also known an out-of-body experience, or going on “a trip.” After completion of a treatment, some patients have reported false epiphanies, such as “knowing the meaning of life.” 

All these effects are typically short lasting once the treatment is over.  Patient’s are back to their baseline the next day typically, but we still recommend exercising caution.  Patients should not drive while under the influence of ketamine, nor should they make rash decisions on false epiphanies.  Finally, AVYIA requests patients have a responsible adult present to monitor patients after the healthcare providers finish their monitoring efforts.  

There are very few medications that shouldn’t be mixed with ketamine as they might impact the effectiveness of the medication. On the day of treatment, it’s best to avoid benzodiazepines like Xanax, Klonopin, or Valium and amphetamine-based stimulants such as Adderall or Ritalin.  Holding prescription narcotics or opioids the day of an IV or intranasal treatment can decrease potential drowsiness, and should be held prior to each treatment session.  

Anything can be misused.  However, in our experience, it’s rare to see a patient misuse ketamine.  Patients on ketamine for mental health reasons typically start and stop the drug responsibly.  AVYIA’s ketamine therapies always start with an in-person assessment and requires close supervisions by one of our medical providers. AVYIA constantly assesses patients throughout the treatment program to minimize any type of risk.  

Despite having a reputation of being used recreationally used to achieve “a trip,” ketamine is still very much consider low risk.  Ketamine is classified as a schedule III substance by the DEA, but many ketamine experts believe ketamine should be lower on the list of scheduled substances due to it relative safety.  

Results vary from patient to patient.  IV and intranasal infusions typically affords the most rapid results.  Some patients report significant improvements with the first treatment session, while others may require several sessions to notice the benefits.  

Microdosing typically takes a little longer to reach noticeable improvements in mood because the program starts patients off at a low dose and titrates up day by day.  However, many patients on daily microdosing have reported noticeable improvements within the first day or so as well.    

For more frequently asked questions, please visit our FAQ page.