How do I know if Ketamine is right for me VERSUS Magic Mushrooms?
I love answering this question because either way you slice it, these two psychedelic medicines are mostly likely going to help! There’s so much overlap in terms of the psychedelic experience itself, but there are a few key factors that help patients determine which might be the best option for them to start with.
Also, before we get too deep into this conversation, I want to be very clear that in Oregon, as of the time this blog post is published, psilocybin is still illegal to use. However, in January 2023, there will be many healthcare centers and providers engaging in specific training to be able to help people with certain mental health conditions by treating them with psilocybin.
So, this is one of the main reasons that I often help patients learn more about ketamine assisted therapy. Ketamine is a controlled substance, but it is legal and there are many amazing training programs for providers to learn how to use this safely in office with patients right now. Psilocybin might be slightly more well-known with the general public (thank you Michael Pollan), but the research on ketamine is expanding rapidly and the results are very promising.
So, without further ado, here are some of the most helpful differences between ketamine and psilocybin that patients are weighing when considering journey work.
Mechanism of Action:
Most people who are seeking healing with psychedelic medicines may not be as interested in the specific scientific details on the mechanism of action for these medicines. I however, feel that this is super important as this is one of the best ways to differentiate ketamine from psilocybin. Ketamine works on multiple brain pathways, and ultimately supports improved synaptic connections between neurons via Glutamate (a very important excitatory neurotransmitter in the brain) and NMDA receptor antagonism, which has been shown to help with acute depression and suicidal ideation. We also know that ketamine can improve chronic pain, partly due to improved synaptic connectivity and partly due to minor stimulation of sigmoid opiate receptors in the brain. Many of the physical benefits of ketamine last so much longer than the journey itself because of the changes that happen over time with improved synaptic connections in the brain…amazing!
Psilocybin works more directly with serotonin receptors in the brain, specifically the 5HT2A receptors which are different from the mechanism of most antidepressants (which work on 5HT1A receptors). The stimulation of the 2A receptors improve creative thinking around stressors/obstacles which is very helpful for people who feel depressed and stuck. These 2A receptors also allow for increased neuronal “cross talk” which is another way of saying that they open the lines of communication between neurons so that new pathways of thinking and perceiving the world can be experienced.
Ketamine:
NMDA receptor antagonist (helps with acute depression and suicidal ideation)
Glutamate receptor antagonist (increases the excitatory neurotransmitter glutamate which has been shown to be significantly reduced in depression)
Increases brain levels of BDNF
Sigmoid receptors (positive effect on chronic pain)
Psilocybin:
Agonist of 5HT2A receptors (binds to specific serotonin receptors in the brain…not the same ones as antidepressant medications).
Very little dopamine agonism (compared to LSD)
Duration of effect:
I think this is one of the stand out ways to differentiate ketamine journeys with psilocybin journeys. I also have seen these medicines used back to back within the same time frame and they often work synergistically.
I love ketamine because this is a much shorter journey. It feels “bite sized” although the insights and epiphanies that come from this space are just as intense, valid, and life-changing as they are with any other medicine. What I love about ketamine is that you can set a clear intention and come back with lots of material for processing, but not an overwhelming amount.
On the other hand, with psilocybin or longer journeys, the opportunity to dive into the deepest, sometimes darkest places in our psyche happens over this longer period of time. I think psilocybin can be extraordinary in a retreat setting or when someone really takes a few days to be with the medicine.
Some people choose to do several short ketamine sessions and then a larger/longer psilocybin journey, and this is a really nice approach for novice psychonauts as the ketamine experiences help provide shorter, often less anxiety-provoking experiences and set a good foundation for longer, larger session with other medicines. I have many other opinions and strategies to share on this particular concept but I’ll put that in another blog for future reading.
Ketamine: approximately 75-minute journey time, session total: 3 hours
Psilocybin: approximately 6- hour journey time, session total: 8-10 hours
Safety profile:
Ketamine: caution in some mental health disorders, high blood pressure, some cardiovascular conditions and some bladder conditions, some medications
Psilocybin: caution in some mental health disorders, some cardiovascular conditions, some liver conditions, some medications
Quality of the Experience:
Just to be clear, with all psychedelics, there is some overlap in terms of what kinds of experiences people can have. Overarching themes of connectedness, love, new perspective about life and healing, are shared among many medicines. This comparison is truly artificial, and the range of experience with psilocybin versus ketamine versus any other substance is individual at its core. However, I do think it’s helpful for patients/participants to have a general sense or understanding of what differences they might experience with different medicines. I have spoken to friends, patients and colleagues who are very experienced psychonauts and many will agree that some medicines just speak to some people more than others and it’s all okay. If we come to these experiences with a sense of curiosity, openness and intention for healing, each medicine will show itself to you in a deeply loving and personal way.
Ketamine:
- Rolling landscapes
- Connection, heart-opening
- Muted visuals
- Tends to be inwards (eyeshades, headphones), introspective until the journey is done
- Feeling of spaciousness, molecules, expansion and upward movement
- Disconnection or being completely out of the body and then coming back into the body
- Altered body perception, present moment awareness
- Altered perception of time and space
- Insights, messages, epiphanies
Psilocybin:
- Vivid visuals
- Increased/heightened senses (smell, taste)
- Some people are very introspective, some are more social/communicative
- Present moment awareness, body awareness
- An altered sense of time and space
- Insights, messages, epiphanies
- Sense of beings, entities, helpers, guides
Where it comes from:
Ketamine: Lab
This is lab created, combination of a ketone with an amine (organic compounds). This was originally discovered when scientists were searching for the “perfect anesthetic” for surgery in the 1960’s. What’s amazing about this molecule is it’s incredible variety of uses. Ketamine can be micro dosed, moderate doses are psychedelic in nature, and at high doses it’s a very effective and safe short term anesthetic. Ketamine is also versatile in it’s administration. I can be ingested orally or intranasally, and can be injected just under the skin (subcutaneous), to the muscle (intramuscular injection), or administered intravenously (IV). Although not directly from the Earth, I truly believe that our creation of this amazing medicine was divinely inspired.
Psilocybin: Nature
This is the more scientific name for magic mushrooms! And magic they are! They grow on almost every continent on Earth (but prefer the subtropics for sure) and there are over 200 species known to contain the “active” ingredient known as psilocin. The most common is psilocybe cubensis, but many other species are employed for powerful healing journeys. This medicine is ingested orally, either by eating the dried whole mushroom bodies and caps or dried and powdered and placed into capsules for ingestion. Some people even make magic mushroom tea! What I love about this is that these mushrooms come directly from nature, and if organically grown, they are free from chemicals and can be taken in their most holistic form. The only “downside” of ingesting magic mushrooms themselves instead of a psilosin standardized extract is that you don’t know exactly how much of the “active ingredient” or potency there is until you try it. For many, this is not a problem and feels like part of the adventure. For some, this can make them feel more anxious or stressed because they don’t know their “true dose”.