Ketamine treatment approved in Norway as first country in the world

On Monday, August 25, a decision was made that marks a historic breakthrough in Norwegian mental health care. The Decision Forum for New Methods has agreed to introduce ketamine treatment in Norwegian hospitals for patients with treatment-resistant depression.

This gives hope to those who are not helped by established treatment options – and puts Norway on the map as the first country in the world to introduce ketamine treatment nationally in the public health system. There are many reasons why this is important.

Psikologvirke first to offer ketamine treatment among psychology clinics in Norway

We can thank Lowan Stewart, the founder of this development, for the first time. Axon Clinic for. He has worked tirelessly for the past 10 years towards this goal, which was achieved in close collaboration with Ingmar Clausen, head of Psykforsk – Innovative treatment research at Østfold Hospital, where Psykologvirke's co-founder Ivar W. Goksøyr has also been associated for the last 8 years.

At Psykologvirke, we are proud to be the first established psychology clinic in Norway to offer ketamine-assisted therapy, in close collaboration with our long-standing colleagues at Axonklinikken. Psykologvirke now has 11 therapists certified in the method, and more are in the process of being certified – also at our specialist trauma department – The trauma center.

As with most other treatment options, ketamine treatment is absolutely essential for some, useful for others, while for others it has no effect. For some, the benefit is only short-lived. Psykologvirke will help to further develop and strengthen this treatment option so that more people benefit more.

Read more in the medical journal aboutImplementation of ketamine treatment at the Hospital in Østfold

Ketamine and the importance of psychological expertise

Research in this field has been ongoing for many years, but has also been limited by a lack of financial incentives, as ketamine is not patentable. Most studies to date use ketamine as a purely pharmacological treatment.

However, recent research suggests that ketamine-assisted psychotherapy provides longer-lasting effectsIt is therefore crucial that the psychology profession takes ownership of this development.

Through our expert psychotherapeutic professional community, we want to contribute to developing even more robust and long-lasting synergies between the medical and psychotherapeutic treatment components that ketamine-assisted therapy consists of.

To date, research on ketamine-assisted therapy has focused on third-wave therapies. We believe there may be significant potential in combining ketamine with the psychodynamic and emotion-focused therapies in which we have expertise, such as this article exemplifies.

This way, we can hopefully reach even more of those who have suboptimal benefits from both ketamine treatment and/or psychotherapy alone. Ultimately, it's about using the tools we have to create lasting change in people's habitual patterns.

Psikologvirke has already contributed to the development of psychedelic therapy in Norway for many years, and has recently contributed to a publication in a peer-reviewed journal, an international, consensus-based framework for educational requirements: A model training curriculum for psychedelic, psycholytic, and entactogen-assisted psychotherapy.

We also contribute to developing the educational offerings that are now also on the way here in Norway, including at further education in psychedelic therapy at the University of Innlandet.

More indications than treatment-resistant depression

The decision-making forum has initially approved ketamine for treatment-resistant depression. At the same time, there is research and clinical experience that points to efficacy in other conditions as well. In collaboration with Axonklinikken, we can in some cases, after individual assessment, also offer treatment for other indications, assuming treatment resistance (link to meta-analyses behind each indication).

All patients undergo a thorough examination to clarify the indication, and the treatment takes place within safe medical conditions.

How does ketamine treatment take place?

A typical treatment process consists of:

  1. Investigation and preparation – medical and psychological assessment, as well as planning of treatment courses.
  2. Implementation – Ketamine is given under close medical supervision, with one of our psychologists in the room.
  3. Integration and follow-up – after each treatment, we work with the patient to process and integrate the experiences therapeutically, to increase the chance of lasting change.

Research and experience show that the framework surrounding the treatment can be of great importance: safe surroundings, competent staff and thorough follow-up seem to some to be the difference between no or short-term effect, and more long-lasting changes.

Hear Ivar Goksøyr talk about, among other things, the importance of approve ketamine treatment in Drivkraft on P2

How does ketamine-assisted therapy work?

The effect of ketamine-assisted therapy is therefore about more than the medication itself. Research suggests that several mechanisms work together:

  • Biological: Ketamine has acute antidepressant properties and promotes neuroplasticity in the brain, which can provide increased flexibility and susceptibility to change.
  • Psychological: During treatment, the patient can gain insight into their own unconscious patterns, gain better access to trauma memories and experience an overview effect with new perspectives on themselves, others and the world.
  • Existential/emotional: Many report deep experiences of meaning, self-acceptance, or connection, which can contribute to lasting change.

Ketamine can thus open a window for change, but it is in combination with therapeutic support and integration that its potential is truly exploited.

A new offer in mental health care

For patients with severe depression and other disorders that do not respond to established services, ketamine treatment represents a new option. We are very pleased that this treatment is now available at Norwegian hospitals. Not least since treatment at private clinics is still relatively expensive.

Psikologvirke is working, among other things, to develop group-based interventions to reduce costs, including in collaboration with colleagues in Switzerland, where psychedelic therapy with MDMA, psilocybin, LSD and ketamine has been available for a number of years.

We ourselves already have experience in implementing psychotherapy with labored breathing which can produce an altered state of consciousness. Furthermore, a combination of conscious connected breathing and group therapy is under development.

We look forward to contributing our psychotherapeutic expertise to the further development of the field, in close collaboration with Axonklinikken's medical and psychological expertise. In this way, we hope to be able to reach more of those stuck in suffering.

Media coverage of Norway's approval of Ketamine

Read more about the case in national and international media here: