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Spotlight: Ketamine Harm Reduction

Prevention & Treatment in Ketamine Use Disorder - When a medicine becomes a poison
Michael DeMarco, PhD

by Michael DeMarco, PhD

Ketamine is a well-studied medicine compound in various species, including humans, at a wide range of doses and routes of administration. When ketamine is misused, as with any medicine, it can be detrimental effects on the body, mind, heart and spirit.

From the psychedelic harm reduction approach, the use of this medicine is lacking integration. When we are out of balance with the medicine, making sense of the experiences and applying this knowledge as future wisdom in a healthy, happy, self-actualized life going forward.

Practitioners in a healthier balance with psychedelic medicine work with the minimal amount of medicine journeys, for the most amount of long-term improvement in mind, body, heart and spirit, it - the human experience.

Psychotherapists are practitioners of the conscious human experience.

Let's address how you can work with a medicine that improves your human experience, and how to prevent or treat misusing a drug that is doing you harm.

Naltrexone in the Treatment of Ketamine Use Disorders: A Case Report and Literature Review (Verma, et al, 2025)
“findings consistent w/ 2 prior reports - use of naltrexone in KUDs at the dosage of 50 mg/day successfully helped patients achieve abstinence... naltrexone reduces antidepressant effects of ketamine, indicating overlap between opioid system & ketamine’s NMDA receptor activity. ”
Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

(2025) Naltrexone study suggests positive results in the treatment of ketamine use disorder

Ketamine Harm Reduction
Ketamine prescribed off label is a legal possibility for some use cases. Your medical provider and pharmacist will discuss the various indications and risks involved. Talk to your independent medical provider to see if you might be a candidate for medicine in conjunction with psychotherapy.
Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

Ketamine harm reduction resources | Psychedelic Institute of Mental Health & Family Therapy

Spotlight: On “Rare but relevant: Ketamine-induced cystitis - an in-depth review for addiction medicine” (Abdelrhamen, et Belal 2025) and psychedelic harm reduction, psychotherapy, support
Rare in ketamine use disorder. Rarer still in ketamine psychedelic assisted psychotherapy as prescribed by your medical provider with support from a mental health specialist, supportive cognitive behavioral therapy approaches to mental health, recovery and harm reduction.
Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

2025 research on what has been called "ketamine bladder", a condition not usually seen in structured ketamine-assisted psychotherapy treatment.

Spotlight: Smart Recovery & Psychedelic-Assisted Psychotherapy
On Psychedelics in Recovery
Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

More like this

Spotlight: A long, strange trip: Ketamine treatment in psychiatry (Nutt, et al, 2025)

"...mystical experiences were strongly related to immediate and sustained psychiatric benefits at the group level and on an individual, session-by-session basis across the six doses, providing mechanistic support for ketamine-psychotherapy pairings."

Spotlight: Rapid-acting NMDA and GABAergic Modulators in Mood Disorders: From Synaptic Mechanisms to Clinical Practice (Serretti, 2025)

"Depression is increasingly conceptualized as a disorder of impaired synaptic plasticity and excitation-inhibition imbalance within corticolimbic circuits. Ketamine, brexanolone, zuranolone, offer complementary approaches to restore circuit function."

Spotlight: Personality profiles and trauma history in ketamine therapy for mood and anxiety disorders: A latent profile analysis of short-term outcomes (Gregoire, et al, 2025)

"Personality traits relate to baseline mental health severity but not short-term response to ketamine. Trauma history may predict greater benefit from treatment."

Spotlight: Changing your mind: neuroplastic mechanisms underlying the therapeutic effect of psychedelics in depression, PTSD, and addiction (Palhas, et al, 2025)

"Serotonergic psychedelics & ketamine appear to share common cellular mechanisms. They both recruit glutamatergic neurons to stimulate BDNF-trKB signaling, promoting synaptogenesis via the mTOR pathway. These changes may explain their efficacy in depression, anxiety, PTSD, & addiction."

How does ketamine affect psychotherapy?

Studies suggest that human support is a factor in ketamine psychedelic therapy

Spotlight: Modulation of functional network co-activation pattern dynamics following ketamine treatment in major depression (Taraku, et al, 2025)

"findings suggest ketamine modulates brain network dynamics which may normalize dynamic patterns seen in TRD at baseline toward patterns seen in controls. Changes in Salience Network state dynamics may correspond to improvements in ruminative symptoms following ketamine therapy."
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