Science

The Science of Ketamine-Assisted Therapy (KAT)

DISCLAIMER: Any mention of specific substances on this webpage and the research presented here, are intended solely for reference and educational purposes, and should not be considered as a promotion of a particular substance or as a replacement for seeking professional guidance from a qualified healthcare practitioner. Please be aware that our Center adheres to the legal regulations of South Africa and promotes a comprehensive, evidence-based approach to mental health. While we acknowledge the effectiveness of different medicines, medications and treatment modalities, we recognise that Ketamine-assisted therapy may not be suitable to every individual. 
Overview & Mechanism of Action

The psychedelic used by Equanimity Wellness works primarily by blocking the NMDA receptors in the brain. This allows for the balancing of two key brain chemicals or ‘neurotransmitters’ called Glutamate and GABA. Glutamate is our main excitatory neurotransmitter –  the ‘gas pedal’ of the brain. It plays a key role in motivation, learning and memory. GABA is the main inhibitory neurotransmitter – the ‘brake pedal’ of the brain. It reduces excitability and activity in the nervous system, allowing us to feel calm.

When optimal balance or ‘homeostasis’ is achieved between these two key neurotransmitters, the brain releases an important protein called Brain Derived Neurotrophic Factor (BDNF). BDNF has been likened to ‘fertilizer in the soil of the brain.’ It promotes the growth of new neural pathways (known as ‘neurogenesis’) and increased connectivity between existing pathways (known as ‘synaptogenesis’).

Neuroscience suggests a relationship between conditions like depression, anxiety, addiction, PTSD and OCD and reduced density, connectivity and communication between key neural pathways, resulting in low mood, excessive and repetitive worry, rumination and unhealthy habits.

However, through this process of neurogenesis and synaptogenesis, new and different brain regions are allowed to activate, connect and communicate. In this state of heightened connectivity, we experience fundamental shifts in our perceptions of ourselves and reality. These deep perceptual shifts allow us to process trauma and loss, resolve inner conflict, release suppressed emotion, gain self-insight and transform core beliefs and behaviors that may no longer serve us. Combining psychedelic medicine with therapy – hence the discipline of Ketamine-Assisted Therapy – allows us to deepen and sustain the profound benefits of psychedelic medicine.

A welcome analogy is to imagine the brain as a block of clay. Traditional therapies attempt to ‘chip away’ at this clay over time, shaping the mind into a more adaptive form. Ketamine-assisted therapy ‘heats up the clay,’ making the brain malleable and remoldable in a remarkably short space of time. Hence, under the right conditions, psychedelic-assisted therapy has been likened to ‘undergoing years of therapy in the space of a few hours.’

Ketamine-Assisted Therapy

2022 on combining ACT therapy with Ketamine

Mathai, D. S., Mora, V., & Garcia-Romeu, A. (2022). Toward Synergies of Ketamine and Psychotherapy. Frontiers in Psychology, 1203.

 

2022 systematic narrative review of Ketamine-assisted psychotherapy.

Drozdz, S. J., Goel, A., McGarr, M. W., Katz, J., Ritvo, P., Mattina, G. F., … & Ladha, K. S. (2022). Ketamine Assisted Psychotherapy: A Systematic Narrative Review of the Literature. Journal of Pain Research, 15, 1691.

 

2022 therapy augments effects of Ketamine for alcohol use disorder.

Grabski, M., McAndrew, A., Lawn, W., Marsh, B., Raymen, L., Stevens, T., … & Morgan, C. J. A. (2022). Adjunctive Ketamine With Relapse Prevention-Based Psychological Therapy in the Treatment of Alcohol Use Disorder. The American Journal of Psychiatry, appiajp202121030277-appiajp202121030277.

 

2022 optimizing Ketamine treatment with trauma-informed psychotherapy.

Muscat, S. A., Hartelius, G., Crouch, C. R., & Morin, K. W. (2022). Optimized Clinical Strategies for Treatment-Resistant Depression: Integrating Ketamine Protocols with Trauma-and Attachment-Informed Psychotherapy. Psych, 4(1), 119-141.

 

2021 therapy enhances durability of treatment effect.

Wilkinson, Samuel T., et al. “Cognitive behavioral therapy to sustain the antidepressant effects of Ketamine in treatment-resistant depression: a randomized clinical trial.” Psychotherapy and psychosomatics 90.5 (2021): 318-327.

 

2019 mindfulness-based therapy enhances positive effects with cocaine dependence.

Dakwar, Elias, et al. “A single Ketamine infusion combined with mindfulness-based behavioral modification to treat cocaine dependence: a randomized clinical trial.” American Journal of Psychiatry.xKetamine

Ketamine and Depression

2021 narrative review of Ketamine for depression.

Jelen, Luke A., and James M. Stone. “Ketamine for depression.” International Review of Psychiatry 33.3 (2021): 207-228.

 

2021 international expert opinion.

McIntyre, Roger S., et al. “Synthesizing the evidence for Ketamine in treatment-resistant depression: an international expert opinion on the available evidence and implementation.” American Journal of Psychiatry 178.5 (2021): 383-399.

 

2021 systematic review of 83 trials.

Walsh, Zach, et al. “Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review.” BJPsych Open 8.1 (2022).

 

2021 systematic review and meta-analysis.

Bahji, Anees, Gustavo H. Vazquez, and Carlos A. Zarate Jr. “Comparative efficacy of racemic Ketamine for depression: a systematic review and meta-analysis.” Journal of affective disorders 278 (2021): 542-555.

 

2019 review.

Krystal, John H., et al. “Ketamine: a paradigm shift for depression research and treatment.” Neuron 101.5 (2019): 774-778.

 

2017 consensus from the American Psychiatric Association.

Sanacora, Gerard, et al. “A consensus statement on the use of Ketamine in the treatment of mood disorders.” JAMA psychiatry 74.4 (2017): 399-405.

Ketamine and Addiction

2022 systematic review of 83 trials.

Walsh, Zach, et al. “Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review.” BJPsych Open 8.1 (2022).

 

2021 review for alcohol use disorder.

Worrell, Stephen D., and Thomas J. Gould. “Therapeutic Potential of Ketamine for Alcohol Use Disorder.” Neuroscience & Biobehavioral Reviews (2021).

 

2021 review for addiction, OCD and eating disorders.

Martinotti, Giovanni, et al. “Therapeutic Potentials of Ketamine in Obsessive–Compulsive Disorder (OCD), Substance Use Disorders (SUD) and Eating Disorders (ED): A Review of the Current Literature.” Brain Sciences 11.7 (2021): 856.

 

2021 Ketamine for cannabis use disorder.

Azhari, Nour, et al. “Ketamine-facilitated behavioral treatment for cannabis use disorder: a proof of concept study.” The American journal of drug and alcohol abuse 47.1 (2021): 92-97.

 

2019 RCT for cocaine dependence.

Dakwar, Elias, et al. “A single Ketamine infusion combined with mindfulness-based behavioral modification to treat cocaine dependence: a randomized clinical trial.” American Journal of Psychiatry 176.11 (2019): 923-930.

 

2019 RCT for cocaine use disorder.

Dakwar, E., et al. “Cocaine self-administration disrupted by the N-methyl-D-aspartate receptor antagonist Ketamine: a randomized, crossover trial.” Molecular psychiatry 22.1 (2017): 76-81.

 

2018 systematic review of Ketamine for substance use disorders.

Jones, Jennifer L., et al. “Efficacy of Ketamine in the treatment of substance use disorders: a systematic review.” Frontiers in psychiatry 9 (2018): 277.

Clinical Trials

2022 systematic review of 83 trials.

Walsh, Zach, et al. “Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review.” BJPsych Open 8.1 (2022).

 

2021 review of neurobiological mechanisms.

Kohtala, Samuel. “Ketamine—50 years in use: from anesthesia to rapid antidepressant effects and neurobiological mechanisms.” Pharmacological Reports (2021): 1-23.

 

2020 safety review of 6630 patients.

Feifel, David, David Dadiomov, and Kelly C Lee. “Safety of repeated administration of parenteral Ketamine for depression.” Pharmaceuticals 13.7 (2020): 151.

 

2018 blood pressure safety review.

Riva-Posse, Patricio, et al. “Blood pressure safety of subanesthetic Ketamine for depression: a report on 684 infusions.” Journal of affective disorders 236 (2018): 291-297.

 

2017 review on ethics and safety.

Singh, I., Morgan, C., Curran, V., Nutt, D., Schlag, A., & McShane, R. (2017). Ketamine treatment for depression: opportunities for clinical innovation and ethical foresight. The Lancet Psychiatry, 4(5), 419-426.

“Sitting, staring at the sun on top of the world on my last day after Yoga and meditation, crying tears of joy is one of the best feelings I've ever experienced in my life! Knowing that I was in a safe environment with incredible people that deeply care for my wellbeing allowed me the freedom to let go of my fears, my anxiety and perceived limitations. I was given a second chance at life and this is truly the greatest feeling in the world! I am extremely grateful to be part of this process.” | W.R.* *As a healthcare facility, we abide by patient confidentiality. All patient reviews are provided anonymously, unless express permission has been obtained to include their names.
“My journey brought me to a place of pure consciousness. I felt the moment of my conception and emerged from there freed of all my life’s pain, guilt, traumas and resentments. I felt an unbelievable power of self and I totally trust that I can achieve anything I set my mind to. I fell in love with Me, accompanied by overwhelming happiness that I had long forgotten. I had clarity and direction after years of being lost. The fact that I was not alone and was sharing this experience with five other, like-minded, people allowed me to fully immerse myself with no threat of judgement. Each person’s journey’s different but we were all in need of something and with careful preparation and guidance were able to achieve what we were seeking.” | B.S.* *As a healthcare facility, we abide by patient confidentiality. All patient reviews are provided anonymously, unless express permission has been obtained to include their names.
“The facilitators make you feel like you’re the only person there with the way they pay attention to your needs, see you and hold space for you. My life has been forever changed for the better. Any chance you can get to go, please do yourself the favor and go! Your future self thanks you in advance. What an experience! Eternally grateful to the wholesome humans behind this experience.” | S.N.* *As a healthcare facility, we abide by patient confidentiality. All patient reviews are provided anonymously, unless express permission has been obtained to include their names.
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Welcome to the Equanimity Wellness Centre

Equanimity is a next generation, evidence-based wellness centre – located in Sandton, South Africa – that offers a scientific approach to psychedelic assisted therapy.

Our holistic psychedelic-assisted therapy program is underpinned by international best-practice and safely administered and monitored by suitably qualified medical professionals.

The benefit of the psychedelic experience lies in the therapeutic system within which it is grounded. Only with thorough preparation, careful attention to set and setting, a trusting therapeutic relationship and ongoing integration can we begin to tap the truly wondrous potential of these compounds.

We’ve drawn on decades of clinical experience to craft the journey of a lifetime, tailor-made to your personal biography, intentions and long-term vision.

Monday to Friday 08:30 – 17:30
Saturday 09:00 – 13:00
Sunday Closed
DISCLAIMER & DECLARATION
 

This section of our digital platform is dedicated to professionals in the medical and psychiatric fields. It offers access to carefully curated, peer-reviewed articles from reputable journals, freely accessible online, which provide objective insights into the efficacy and application of the infusion agent used at our facility. However, we do not intend for this information to serve as a promotional tool for the wider audience.

By navigating further within this segment of our platform, you confirm your status as a registered expert within the medical or psychiatric health sector.