Ketamine Vs. Psilocybin Therapy

As interest in psychedelics for personal growth and healing increases, I’m often asked about the difference between the many psychedelics. Two medicines often compared in the therapeutic space are ketamine and psilocybin (“magic mushrooms” or “shrooms”). 

So when should you choose one over the other? How do they impact the brain? What are the long-term effects of each? What’s the trip like? 

The Difference Between Ketamine and Psilocybin

1. Drug Types

   Ketamine and psilocybin belong to different drug categories. Ketamine is primarily a dissociative anesthetic that also exhibits psychedelic characteristics (especially at high doses), whereas psilocybin is a tryptamine psychedelic. Both substances can evoke feelings of connectedness, insights, and mystical experiences but achieve these effects through different mechanisms.

2. Legal Status

   The legal status of ketamine and psilocybin differs significantly. Ketamine has been legally used as an anesthetic in medical settings like operating rooms and emergency departments for several decades. Since the 2010s, it has also been utilized off-label as a legal psychedelic for treating mental health issues. Psilocybin was banned for general use in the United States under the Controlled Substances Act in 1970. In 2022, Proposition 122 decriminalized the use of psilocybin for personal and therapeutic use in Colorado and it has started to make its way back into public awareness. 

3. Historical Background

   Ketamine was synthesized in 1962 as a safer anesthetic alternative. Over time, its applications have broadened, including its use in therapeutic settings. Psilocin, the precursor to psilocybin, is found naturally in certain fungi. Once ingested, it converts to the psychoactive compound psilocybin. Since it has been found growing naturally on every continent, we know that civilizations worldwide have used psilocybin in ceremonies throughout history.

4. Methods of Administration

   There are several routes of administration for ketamine, including intramuscular injection, intravenous infusion, intranasal spray, and oral lozenges. Psilocybin is typically ingested orally.

5. Duration of Effects

   The duration of effects varies between ketamine and psilocybin. A ketamine session generally lasts from 30 minutes up to two hours (depending on the route of administration), whereas a psilocybin trip can last between three to five hours. Clients usually feel ketamine within 10 minutes of administration, while psilocybin can take up to an hour to take effect.

6. Effects on the Body and Mind

   Research on the effects of psychedelics on the human body and mind is ongoing, but some differences are known. Ketamine primarily affects GABA and glutamate levels, which can rapidly reduce suicidality. In contrast, psilocybin mimics serotonin, a neurotransmitter commonly targeted by antidepressant medications.

Similarities Between Ketamine and Psilocybin

1. Both Induce Psychedelic Experiences

   A study by Vollenweider and Kometer (2010) compared the effects of ketamine and psilocybin, noting that psilocybin trips tend to produce more pronounced visual changes and imagery, whereas ketamine experiences often evoke a stronger sense of unity. Despite these differences, both substances can lead to mystical, insightful, and transcendental experiences characterized by visual phenomena, physical sensations, messages, and other perceptual changes at the peak of the trip.

2. Both Offer Mental Health Benefits

   Research on ketamine has primarily focused on its efficacy in treating depression and suicidal ideation, while studies on psilocybin have examined its effects on depression and end-of-life anxiety. However, both substances have shown antidepressant and anti-anxiety properties. Additionally, they are used to address trauma-related disorders, chronic pain, and substance use disorders, highlighting their broad therapeutic potential.

3. Both Have Potential Side Effects

   Ketamine and psilocybin-assisted therapy share similar risks and side effects, such as changes in blood pressure and heart rate. Some individuals with hypertension and unmanaged blood pressure conditions may not be eligible for these treatments. 

Learn More

In our practice, we offer ketamine therapy using oral lozenges along with somatic and trauma therapy methods for maximum efficacy. We find that a ketamine session is most effective when combined with certain therapeutic modalities, including EMDR, somatic therapy, and IFS/parts work. If you are interested in learning more about ketamine therapy and if it’s a good fit for you, feel free to reach out to schedule a complimentary consultation. You can also learn more about ketamine therapy by checking out our blog.