What is the difference between ketamine and psilocybin for therapeutic use?

Ketamine has been FDA approved in the United States since the 70s. It is currently used in the medical field as an anesthetic, and has been for decades. Psilocybin was outlawed in 1970 with the Controlled Substances Act. It is, however, being studied in clinical trials now. Ketamine was developed in 1962. Psilocybin occurs naturally in different fungi around the world, and have had ceremonial uses for many years. Ketamine can be administered through many different routes, intravenous (IV), intramuscular (IM), intranasal, oral. Psilocybin is consumed orally. 

 

The ketamine journey is much shorter than a psilocybin experience. Here at Reset Restore MD, we administer a weight-based dose of ketamine through an IV infusion that runs over 40 minutes. Psilocybin journeys last anywhere from 3-8 hours depending on the dosage. Research is continuing on both ketamine and psilocybin. Neither substance should be taken recreationally and should be under the direction of a medical provider.

 

Psilocybin is a tryptamine alkaloid found in several species of psilocybe mushrooms. Its potential antidepressant efficacy was suggested by preliminary studies involving patients with life-threatening cancer. Psilocybin works by activating serotonin receptors, most often in the prefrontal cortex. This part of the brain affects mood, cognition, and perception.

 

In a phase 2 trial published in 2022, psilocybin was administered in a single session with psychological support, a 25-mg dose but not a 10-mg dose resulted in a significantly greater reduction in treatment resistant depression at 3 weeks but was associated with adverse events. In a systematic review and meta-analysis published in 2023, the antidepressant effects of psilocybin assisted psychotherapy in patients with moderate depressive disorder, psilocybin was found to have a significantly greater antidepressant effect compared to the comparator arms. Response and remission rates also favored participants who received psilocybin. Psilocybin was well tolerated across studies, with the only serious adverse events occurring rarely in participants.

 

Side effects of psilocybin may include visual or auditory hallucinations, distorted perception, headache, nausea, dizziness, fatigue, euphoria, depersonalization, dilated pupils, impaired concentration, lack of coordination, paranoia, and in some clinical trial participants suicidal ideation or self-harm. Research is evolving on psilocybin and its use in treatment resistant depression.  Psilocybin remains outlawed in the United States.