Ketamine infusion plus psychotherapy: Berlin practice offers alternative treatment for depression

The method is called "Augmented Psychotherapy" and shows how depression can be treated when psychotherapy and psychopharmacology are combined.

Augmented Psychotherapy works with altered states of consciousness

The method is called "Augmented Psychotherapy" and shows how depression can be treated when psychotherapy and psychopharmacology are combined. This is exactly what Dr. med. Andrea Jungaberle and her colleagues do in their Friedrichshain group practice. We visited the interdisciplinary team and found out about the innovative procedure.

Pharmacologically based long-term therapies are often the treatment of choice for depression. A new approach to help depressed people is augmented psychotherapy, which uses, among other things, mind-expanding substances. The altered states of consciousness induced in this way are then therapeutically integrated. "Augmented psychotherapy ultimately means psychotherapy plus. That means we supplement psychotherapy with something that is added, in our case usually the administration of ketamine intravenously. Or also techniques that do not pharmacologically alter consciousness, such as the Lucía lamp," explains Andrea Jungaberle, MD, co-founder of the "Praxis für Psychiatrie & Psychotherapie - Augmented Psychotherapy" in Berlin's Friedrichshain district.

Whether ketamine-assisted therapy can take place is subject to strict testing

Studies from the USA and the evidence base indicate that ketamine-assisted psychotherapy could achieve therapeutic success in the treatment of severe depression, treatment-resistant depression, substance use or anxiety disorders or even burnout, for example, according to the physician. In her practice, however, it is mainly depression that is treated. The health condition of the patients is carefully checked beforehand, for example for previous illnesses. "We are very careful about that. In the case of patients who have recently suffered a stroke or heart attack, we would look very carefully to see if the patients are suitable." Sebastian Gaus, MD, a specialist in psychiatry and psychotherapy, adds: "Contraindications from a psychiatric point of view would be, for example, psychotic illnesses or also a bipolar illness with frequent manic phases or also an active substance use disorder."

Ketamine activates receptors in the brain

If contraindications can be ruled out, precise preparation takes place in therapeutic sessions. Already in the run-up to the ketamine doses, altered states of consciousness can be achieved with the help of light or breathing techniques. Finally, ketamine is administered in a controlled setting under psychological and anaesthesiological supervision. Patients experience intense changes in consciousness through the administration of ketamine. Neurophysiologically, receptors in the brain are activated that are normally very difficult to activate in depressed individuals. This enables a different experience and sensation. In subsequent psychotherapeutic sessions, the experiences made under ketamine are integrated.

The team expects success from the psychotherapeutically accompanied ketamine therapy, especially for those people for whom the classic long-term treatment with antidepressants does not bring about an improvement in their health situation. "We are increasingly seeing people who do not see any improvement in their depression symptoms under long-term psychopharmacotherapy, e.g. with antidepressants, or who also suffer from a high side effect burden. These patients make up about one third to 50% of patients taking antidepressants. And offering a new therapy alternative here is a mission for us," says Gaus.