Ketamine Therapy Glossary

Patient-friendly definitions for 31 medical and clinical terms commonly used in ketamine therapy.

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Bioavailability: The percentage of a drug that reaches the bloodstream after administration. IV ketamine has near 100% bioavailability, while sublingual forms typically achieve 25-35%.Learn more
Booster session: An additional ketamine treatment session given after the initial series when symptoms begin to return. Booster frequency varies by individual, typically every 3-8 weeks.Learn more

Comorbidity: The presence of two or more medical conditions occurring simultaneously. Many ketamine therapy patients have comorbid conditions like depression with anxiety or chronic pain.Learn more
Contraindication: A condition or factor that makes a particular treatment inadvisable. Common ketamine contraindications include uncontrolled hypertension, active psychosis, and certain heart conditions.Learn more

Dissociation: A temporary feeling of disconnection from one’s body, thoughts, or surroundings. During ketamine therapy, mild-to-moderate dissociation is common and typically resolves within 1-2 hours.Learn more
Dissociative: A class of drugs that produce feelings of detachment from the body or surroundings. Ketamine is a dissociative anesthetic, and mild dissociation during treatment is normal and temporary.Learn more
Double-blind: A clinical trial design where neither the participants nor the researchers know who is receiving the treatment vs. placebo. This reduces bias in measuring outcomes.Learn more

Esketamine: The S-enantiomer (mirror-image form) of the ketamine molecule. Marketed as Spravato, it is the only FDA-approved form of ketamine for treatment-resistant depression.Learn more

FDA-approved: A designation meaning the U.S. Food and Drug Administration has reviewed evidence and determined a drug is safe and effective for a specific use. Spravato (esketamine) is FDA-approved for treatment-resistant depression.Learn more

Glutamate: The most abundant excitatory neurotransmitter in the brain. Ketamine’s interaction with the glutamate system is thought to be a key mechanism behind its therapeutic effects.Learn more

Half-life: The time it takes for half of a drug to be eliminated from the body. Ketamine’s half-life is approximately 2-3 hours, meaning its acute effects wear off relatively quickly.Learn more

Infusion protocol: The standardized plan for administering IV ketamine, including dose, infusion rate, duration, and number of sessions. Most protocols involve 6 sessions over 2-3 weeks.Learn more
Integration: The process of making sense of and incorporating insights from a ketamine therapy session into daily life. Integration therapy with a counselor can enhance long-term treatment benefits.Learn more
Intramuscular (IM): A method of drug delivery via injection into muscle tissue. IM ketamine injections offer rapid absorption and are an alternative to IV infusions.Learn more
Intravenous (IV): A method of drug delivery directly into a vein through a needle or catheter. IV ketamine infusions provide the most precise dosing and highest bioavailability.Learn more

K-hole: A colloquial term for a state of deep dissociation at high ketamine doses. In clinical settings, doses are carefully controlled to avoid this state while still achieving therapeutic benefit.Learn more

Maintenance therapy: Ongoing treatment sessions scheduled after an initial series to sustain therapeutic benefits. Ketamine maintenance sessions are typically spaced weeks or months apart.Learn more

Neuroplasticity: The brain’s ability to form new neural connections and reorganize itself. Ketamine is believed to enhance neuroplasticity, which may explain its rapid antidepressant effects.Learn more
NMDA receptor: A protein on brain cells that responds to the neurotransmitter glutamate. Ketamine works primarily by blocking these receptors, which triggers a cascade of changes that can rapidly relieve depression and pain.Learn more

Off-label: The use of a medication for a purpose not specifically approved by the FDA. Most ketamine therapy (except Spravato) is considered off-label, though it is legal and commonly prescribed.Learn more

Placebo-controlled: A type of clinical trial where some participants receive an inactive substance (placebo) instead of the actual treatment. This design helps determine if a drug’s effects are genuine.Learn more
Psychedelic-assisted therapy: A treatment approach combining a psychoactive substance with psychotherapy. Ketamine-assisted psychotherapy (KAP) pairs ketamine sessions with talk therapy for enhanced outcomes.Learn more

Racemic ketamine: Ketamine containing equal parts of its two mirror-image forms (R-ketamine and S-ketamine). This is the standard formulation used in most IV infusion clinics.Learn more
Remission: A significant reduction in symptoms to the point where they no longer meet diagnostic criteria. Studies show ketamine can produce remission in 30-40% of treatment-resistant depression patients.Learn more
REMS program: Risk Evaluation and Mitigation Strategy, an FDA safety program. Spravato must be administered under a certified REMS program where patients are monitored for at least 2 hours after dosing.Learn more
Response rate: The percentage of patients who experience a meaningful improvement (typically 50% or greater reduction in symptom scores). Ketamine response rates for depression range from 50-70% in clinical trials.Learn more

Screening: The medical evaluation performed before ketamine therapy to determine if a patient is a suitable candidate. Screening typically includes medical history, current medications, and psychiatric assessment.Learn more
Set and setting: The mental state (“set”) and physical environment (“setting”) in which a psychoactive experience takes place. Both significantly influence the quality of a ketamine therapy session.Learn more
Sublingual: A method of drug administration where medication is placed under the tongue and absorbed through the mucous membranes into the bloodstream.Learn more

Titration: The gradual adjustment of medication dosage to find the optimal therapeutic level. Ketamine dosing is often titrated across sessions based on patient response and tolerance.Learn more
Treatment-resistant depression: Depression that has not responded adequately to at least two different antidepressant medications taken at adequate doses for sufficient duration. Ketamine shows particular promise for TRD.Learn more

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