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Maximize Ketamine’s Benefits with Physical Wellness

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Ketamine is a dissociative drug commonly used as a fast-acting treatment for persistent depression, anxiety, and PTSD. The compound works incredibly well to resolve mental health symptoms and bring people into remission. However, ketamine therapy benefits may not endure without lifestyle changes, and patients may relapse within two weeks. Fortunately, ketamine and exercise is an incredible combination to help patients stay well in the months and years following infusions.

This article explores the connection between ketamine and working out for long-lasting depression relief. 

Ketamine and Working Out: A Complimentary Protocol

Exercising may be critical in lengthening ketamine therapy benefits because physical activity improves brain and immune function. It also releases endorphins, neurotransmitters, and growth factors that support mood regulation. Working out also enhances the brain’s ability to regulate stress hormones. Even 20 minutes can improve self-esteem and concentration levels.

In the long term, ketamine and exercise can encourage significant mental health benefits for patients who make it part of their daily or weekly routine. 

infographic about ketamine and exercise

Dopamine Boost

One study found that the brain actually increases dopamine circulation during exercise. 

Dopamine is a neurotransmitter that is crucial in various brain functions. It works by transmitting signals between nerve cells in areas associated with motivation and reward. When released, dopamine reinforces behaviors that lead to pleasure and improve mood, motivation, focus, and cognitive function. Dopamine is also implicated in regulating movement and emotional responses.

  • Even workouts that last less than an hour can boost dopamine levels for a full 24 hours.
  • However, a fitness routine lasting eight or more weeks and occurring an hour each time for a minimum of three times can permanently increase the brain’s dopamine receptors. 
  • Frequent workouts can keep the brain’s reward system active longer, preventing the usual age-related decline.  
IV Ketamine infusions for depression anxiety ptsd chronic pain fibromyalgia CRPS Bethesda MD McLean VA Washington DC

Lactate Release

Ketamine and exercise are also beneficial because of the brain’s ability to increase lactate levels during physical activity. 

Lactate is a metabolic acid that can cause sore muscles after a workout. But in the days following exercise, lactate can also reduce feelings of depression.

Once released, lactate travels from the muscles through the bloodstream to its destination in the brain. In the brain, lactate acts as a metabolic acid that stimulates the release of noradrenaline, a hormone and neurotransmitter essential for neural function. Increased noradrenaline levels also promote wakefulness, attention, and focus, counteracting the lethargy and lack of concentration often associated with depression. 


Exercise can also help alleviate depression by affecting the body’s immune and inflammatory response. When people are stressed or feeling down, the body’s immune system gets activated, producing various inflammatory markers like cytokines. However, physical activity can mitigate this immune response, providing a natural means to combat adverse feelings.

During exercise, muscles release myokines, which are bioactive molecules with anti-inflammatory properties. These molecules act as mediators, dampening inflammatory processes and potentially contributing to improved mood regulation.

Brain-derived Neurotrophic Factor 

Another mechanism for exercise’s antidepressant action is its ability to promote brain-derived neurotrophic factor (BDNF). BDNF is a crucial protein involved in neurons’ growth and survival, transmitting signals between cells and creating new neurons in a process called neurogenesis. 

Studies have found that people with depression have lower levels of BDNF and lower BDNF levels are associated with an increased frequency of symptoms, reduced hippocampal volume, and impaired neuroplasticity. 

Fortunately, ketamine and aerobic exercises can enhance BDNF levels and neuroplasticity in people with depression, with higher-intensity workouts generally yielding a more significant increase–at least in the short term. The long-term effects of exercise on BDNF in depressed people are less understood.

Studies Showing the Connection Between Ketamine and Exercise

Understanding the power of exercise on mental health, Yale researchers created a study to determine whether working out can truly prolong the benefits of ketamine therapy. For the study, subjects rode stationary bicycles at a moderate intensity for 45 minutes thrice per week for three months.

  • In one group, the subjects received a single ketamine infusion before starting the exercise regimen. 
  • In the second group, subjects received a series of infusions over two weeks while they began their workouts. 

The study concluded with mixed results. However, the research indicated that an aerobic exercise regimen of moderate to vigorous intensity for a minimum of 30 minutes, occurring three to four times a week, may be effective for easing symptoms of depression when paired with ketamine.

IV Ketamine infusions for depression anxiety ptsd chronic pain fibromyalgia CRPS Bethesda MD McLean VA Washington DC

Which Exercises Work Best To Prolong Ketamine Benefits

Combining aerobic workouts with resistance training has the added benefit of improving cardiovascular and muscular fitness.

All forms of exercise can improve depression symptoms and thus support prolonged ketamine therapy benefits. However, research shows that aerobic exercise may be superior. In fact, aerobic exercise is as effective as pharmacotherapy in reducing depressive symptoms. 

Aerobic exercises include:

  • Jogging or running
  • Cycling
  • Swimming
  • Jumping rope
  • Rowing
  • Dancing
  • Elliptical training
  • Kickboxing
  • Hiking

Resistance training exercises include:

  • Squats
  • Bench presses
  • Deadlifts
  • Pull-ups
  • Lunges
  • Push-ups
  • Bicep curls
  • Tricep dips
  • Shoulder presses
  • Leg presses

Avesta Ketamine and Wellness Recommendations

Despite the benefits, exercising consistently can feel challenging and time-consuming, especially for people who have not previously worked out. 

Starting Small

Exercise newbies may want to start slow before establishing a daily workout regimen. They might begin with light activities and gradually increase their fitness levels. Consistently moving while incrementally raising the intensity level is more important than the specific activity.

Low-impact exercises may be optimal for ketamine patients who just completed a protocol because they are gentle and provide benefits without overwhelming the body as it adjusts to the treatment’s effects. Light exercises include stretching, walking, yin yoga, and gardening. 

Another key to maintaining an exercise habit is choosing a comfortable duration; if five or ten minutes feels manageable, start there. As that span becomes easier, extend the workout time and introduce new activities. 

Exercise regimens are entirely customizable, and skipping days at the beginning is OK. The most crucial aspect is enjoyment. The more people enjoy working out, the more likely they will maintain and slowly amplify the effort. 

This gradual increase will help build strength, stamina, focus, joy, and balanced mental health. 

Considering Workouts that Incorporate Mindfulness

Ketamine and exercise of any form is beneficial for improving mood and cognition. However, people with depression may want to consider workouts that incorporate mindfulness for several reasons. 

First, mindfulness exercises help decrease stress by focusing the person’s attention on the present moment. This focus can interrupt habitual negative thought patterns that contribute to depression. Additionally, these exercises enhance body awareness, leading to better recognition and management of physical tension and emotional stress. Additionally, mindfulness exercises can amplify improvements in concentration and mental focus.

A few mindfulness-based exercises include:

  • Yoga: This ancient practice involves various postures and controlled breathing exercises. It promotes physical flexibility, strength, and mind-body awareness, which can alleviate depression symptoms by fostering a greater sense of peace and stability.
  • Tai Chi: Often described as meditation in motion, Tai Chi is a gentle form of martial art focusing on slow, graceful movements and deep breathing. It is particularly effective in reducing stress and anxiety, which are common in individuals with depression.
  • Pilates: This method focuses on core strength, posture, and alignment through controlled movements. It also requires participants to maintain a focused, mindful practice, which can help divert attention away from depressive thoughts.
  • Mindful Walking: Mindful walking involves intensely focusing on the physical experience, noting the sensation of each step and the rhythm of the breath. This form of walking can turn a simple activity into a meditative practice.
  • Qigong: This traditional Chinese exercise technique integrates physical postures, breathing techniques, and focused intention. Qigong is perfect for managing energy levels and reducing mental stress.

Other Lifestyle Changes that Align with Ketamine Therapy

Ketamine and exercise are critical combinations. However, synergistic lifestyle practices like adequate sleep, optimized nutrition, and social engagement also play a key role in extending the benefits of ketamine therapy. 


  • A diet rich in omega-3 fatty acids, vitamins, and minerals supports the production and function of neurotransmitters related to mood regulation.
  • Anti-inflammatory foods can decrease systemic damage, which is often linked to depression.


  • Adequate sleep enhances neuroplasticity, which is crucial for the brain’s ability to adapt to new learning and emotional resilience.
  • Sleep helps to balance neurotransmitters that affect mood, including serotonin and dopamine, which are critical for maintaining the antidepressant effects of ketamine.

Social Engagement:

  • Regular interaction with friends and family can provide emotional support and buffer against stress.
  • Participating in group activities and community events can help reduce feelings of isolation and boost overall mood.

Ketamine Therapy at Avesta

Avesta’s ketamine clinics in Washington, D.C., Bethesda, MD, and McLean, Virginia, have been serving patients in their pursuit of enduring mental health for eight years. Their care team ensures every patient receives effective treatment and support both in and outside of the clinic. 

If you are interested in learning more about ketamine infusions paired with a regular exercise routine, please schedule a free consultation.

IV Ketamine infusions for depression anxiety ptsd chronic pain fibromyalgia CRPS Bethesda MD McLean VA Washington DC

Author Dr. Ladan Eshkevari, PhD, CRNA, FAAN Dr. Eshkevari is the lead clinician at Avesta, and is a long time researcher and educator in physiology, biophysics, and anesthesiology. She is passionate about assisting patients with retractable, difficult to treat mood disorders, and relies on the latest research to bring evidence to Avesta’s practice to better understand and serve patients.

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