Understanding the Medicine
Integrative Ketamine Therapy
Ketamine is an FDA-approved anesthetic that has been used safely in medical settings for over 50 years. It is a World Health Organization essential medicine used daily in emergency rooms and surgical suites worldwide. In sub-anesthetic doses administered within a clinical setting, ketamine has shown significant promise for treatment-resistant depression, PTSD, anxiety, OCD, and existential distress.
It is not a daily pill, nor is it a "one-and-done" magic cure. It is a powerful catalyst for your ongoing healing journey.
Traditional psychiatric medications (like SSRIs) often require daily use to manage symptoms. Ketamine is fundamentally different. Biologically, it promotes rapid neuroplasticity — literally helping the brain form new synaptic connections. It can create the conditions for deeper therapeutic engagement — not by numbing the pain, but by temporarily shifting your relationship to it. This is what makes the preparation and integration around it so important.
Ketamine Therapy (KT)
Clinically supervised IV or IM ketamine sessions with our physician and nurse practitioner. The base offering for every patient.
Ketamine-Assisted Psychotherapy (KAP)
A therapist is present during the ketamine session itself, providing real-time clinical support. Recommended for complex presentations or available as an enhancement.
The Science
How Ketamine Works
Ketamine opens a temporary window of neuroplasticity, making your brain highly adaptable. It promotes rapid formation of new synaptic connections, allowing entrenched patterns of thinking and feeling to shift. This is the biological foundation for the potential for new patterns to form — not just symptom suppression, but the conditions for lasting change.
Clinical research highlights ketamine's rapid action on glutamate receptors, often providing meaningful relief from heavy depressive symptoms within hours — a mechanism fundamentally different from traditional antidepressants that target serotonin. This is why ketamine can help people who haven't responded to SSRIs or SNRIs.
Ketamine temporarily disrupts the Default Mode Network — the brain's "autopilot" responsible for rigid, repetitive thought patterns. This creates space for new perspectives and deeper therapeutic engagement. It's not that the medicine solves your problems; it creates a window where you can see them differently.
Ketamine is FDA-approved as an anesthetic. Its use for psychiatric conditions is considered "off-label" — a common and well-established practice in medicine (similar to how beta-blockers are prescribed for performance anxiety or stage fright).
At Althea NOLA, we primarily use intravenous (IV) and intramuscular (IM) administration. IV provides the most precise dose control and consistent absorption — the infusion runs approximately 45 minutes at a carefully controlled rate. IM offers a similar clinical experience with a slightly different onset profile. The route is determined collaboratively with your clinical team based on your needs and comfort.
The Science Behind the Shift
Understanding the biology helps demystify the medicine — and clarifies why the relationship around it matters just as much.
Restoring the Foundation
BDNF (Brain-Derived Neurotrophic Factor) is a key protein involved in the growth and maintenance of neurons. Research indicates that in treatment-resistant depression, BDNF levels are often significantly depleted. Ketamine appears to restore them rapidly — within hours, not weeks.
This is why preparation and integration matter. The biology creates the opening. The therapeutic relationship helps you build something lasting in that space.
Lullau et al., Frontiers in Neuroscience, 2023 · Int J Mol Sci, 2024 · Krystal et al., Neuropsychopharmacology, 2024
Restoring the Riverbed
Traditional antidepressants modulate serotonin and typically require 4–6 weeks to take effect. Research indicates that ketamine's action on glutamate receptors can produce meaningful symptom relief in hours — a fundamentally different mechanism of action.
This rapid shift is not the destination. It is the opening that makes deeper therapeutic work possible when you would otherwise be too depleted to engage.
Krystal et al., Neuropsychopharmacology, 2024 · Anand et al., NEJM, 2023 · Zolghadriha et al., BMC Psychiatry, 2024
A Season of Flexibility
Neuroplasticity is the brain's ability to reorganize itself by forming new neural connections. Research indicates that ketamine temporarily enhances this capacity, allowing new behaviors, thought patterns, and habits to be learned during this window.
This is why we schedule integration sessions within this window. The medicine opens the door — but you still have to walk through it, and we walk alongside you.
Wu et al., Biological Psychiatry, 2021 · Vasavada et al., Translational Psychiatry, 2023 · Kim et al., Frontiers in Psychiatry, 2022
Gentle Precision, Not Sedation
At sub-anesthetic doses, ketamine produces a dreamlike, spacious state rather than unconsciousness. This allows the therapeutic experience — reflection, emotional processing, somatic awareness — to happen during the session itself.
The experience is often described as spacious, reflective, or quietly expansive. No two sessions are the same, and a trained clinician is with you throughout.
Fava et al., Molecular Psychiatry, 2020 · Singh et al., J Clin Psychiatry, 2023 · Frontiers in Psychiatry, 2023
Quieting the Inner Narrator
When the Default Mode Network is overactive — as it often is in depression, anxiety, and PTSD — it can keep you locked in rigid, self-critical thought loops. Ketamine appears to temporarily quiet this network, creating space for new perspectives to emerge.
This is not about erasing who you are. It is about loosening the grip of patterns that no longer serve you, so that preparation and integration can help you build something different.
Nugent et al., Biological Psychiatry, 2019 · Li et al., Eur Arch Psychiatry Clin Neurosci, 2020 · Evans et al., Psychological Medicine, 2022
Why 6–8 Sessions, Not One
While a single session can produce rapid symptom relief, research indicates that the neuroplastic benefits of ketamine build cumulatively. Each session deepens the biological opening; each integration session helps you consolidate what surfaces.
A powerful catalyst used once is still just a moment. A catalyst used with intention, over time, within a clinical relationship — that is where sustained change lives.
aan het Rot et al., Biological Psychiatry, 2010 · Murrough et al., Biological Psychiatry, 2013 · Phillips et al., Am J Psychiatry, 2019
Preparation as Foundation
Research consistently indicates that therapeutic alliance — the quality of the relationship between patient and clinician — is one of the strongest predictors of treatment outcomes, regardless of modality. This holds true for ketamine-assisted psychotherapy as well.
We do not hand you medicine and leave the room. This is a concierge practice built around presence, not protocol.
Flückiger et al., Psychotherapy, 2018 · Dore et al., J Affective Disorders, 2019 · Greenway et al., Psychedelic Medicine, 2023
Integration as Architecture
The neuroplastic window ketamine creates is temporary. Without active integration — therapy, reflection, behavioral practice — the brain's default patterns reassert themselves. Relief without integration is temporary.
Integration is where the actual healing happens. The medicine opens a window. Integration is what you build while that window is open.
Wu et al., Biological Psychiatry, 2021 · Dore et al., J Affective Disorders, 2019 · Wilkinson et al., Psychotherapy and Psychosomatics, 2021
Conditions & Safety
Conditions that may benefit
Outcomes depend on far more than diagnosis alone — your readiness, your support system, your history, and your relationship with the clinical team all matter.
Safety & risks
Physically, the most common risks during a session include a temporary increase in blood pressure, mild nausea, and dizziness — all of which we monitor and can address in real time.
Psychologically, ketamine produces an expanded state that can surface difficult emotions, memories, and sensations.
Risk assessment is a continuous process that all of our staff engage in at every encounter.
Contraindications
Because safety is our primary directive, certain conditions are absolute contraindications, such as pregnancy and breastfeeding. All other medical conditions are assessed carefully and compassionately during your medical screening.