As you may know, I just finished an intense course of study to become certified as a Psychedelic Assisted Therapist.  Since completing that work, I’ve connected with quite a few other therapists and guides engaging in this kind of work, and I have integrated these ideas into my clinical practice.  I believe in the healing potential of these medicines, and their positive impact on brain neuroplasticity.

 

But what are the differences?

 

Psilocybin therapy and ketamine therapy are both forms of psychedelic-assisted treatment used primarily for mental health conditions like depression, PTSD, and anxiety. However, they differ significantly in terms of their mechanisms of action, experience, legal/regulatory status, and clinical use.

Here’s a breakdown of the key differences:

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1. Substance and Mechanism of Action

• Psilocybin:

  • Derived from: Psilocybin mushrooms (“magic mushrooms”).

  • Mechanism: Serotonergic psychedelic – primarily activates 5-HT2A serotonin receptors.

  • Effect: Profound alterations in perception, sense of self, and cognition, often leading to mystical or spiritual experiences.

• Ketamine:

  • Originally used as: An anesthetic.

  • Mechanism: NMDA receptor antagonist; also affects glutamate and opioid systems.

  • Effect: Dissociative experiences, often described as feeling “detached” from body or surroundings, but usually less “visionary” than psilocybin.

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2. Therapeutic Use and Frequency

• Psilocybin Therapy:

  • Usually involves 1–3 guided sessions, with preparation and integration therapy.

  • Long-lasting benefits after just one or two doses have been reported in clinical trials.

  • Therapy sessions last 6–8 hours, often with eyeshades and music, under supervision.

• Ketamine Therapy:

  • Typically involves a series of infusions or doses (e.g., 6–12 over several weeks), with booster sessions as needed.

  • Effects last a few days to a few weeks, so ongoing treatment is often necessary.

  • Sessions last about 1–2 hours, sometimes combined with psychotherapy.

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3. Subjective Experience

• Psilocybin:

  • Deeply introspective, often involves strong emotions, visual and auditory hallucinations.

  • Frequently described as mystical, spiritual, or life-changing.

• Ketamine:

  • More of a dissociative state, sometimes dreamlike or abstract.

  • Less emotional depth or personal insight for some patients (but varies).

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4. Legal and Regulatory Status

• Psilocybin:

  • Still classified as a Schedule I drug in the U.S. (illegal federally).

  • Legal for therapy in Oregon and Colorado under state programs; in clinical trials elsewhere.

  • Gaining traction for FDA approval as a treatment for major depression.

• Ketamine:

  • FDA-approved (as a general anesthetic and for depression in the form of Spravato [esketamine]).

  • Legally prescribed “off-label” for depression, PTSD, anxiety, etc.

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5. Clinical Evidence

• Psilocybin:

  • Strong evidence for treatment-resistant depression, end-of-life anxiety, and addiction.

  • Long-lasting improvements in mood and well-being after few doses.

• Ketamine:

  • Rapid reduction in suicidal ideation and depressive symptoms.

  • Especially effective for acute intervention, but may require ongoing use.

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If you think you are interested in either, let’s chat.  We are conducting a 1-day Ketamine retreat later this year – this a great way to learn about Ketamine, use it in a safe and therapeutic environment, and reap the benefits of it’s healing power.

 

Fall Retreat – clink link