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Ketamine is a dissociative drug commonly used as a rapid antidepressant for patients with persistent mental health symptoms of depression, anxiety, and PTSD. Although the benefits of ketamine are fast-acting they may not last long without other lifestyle changes. With the possible limited duration of its benefits, some ketamine patients may experience symptoms of depression within two weeks of their final infusion¹.


Avesta Ketamine and Wellness Protocols

Thus at Avesta Ketamine and Wellness, our protocols are designed to taper patients off slowly to mitigate this decline and we recommend patients start to exercise and maintain a healthy nutritional diet. The positive aspect of this plan is that optimizing your ketamine infusions is easy and completely doable with a few changes in your lifestyle practices. A recommended change in lifestyle for ketamine can include optimizing your sleep and diet, as well as leading an active lifestyle.


One of the important ways we recommend prolonging the mental health benefits of your ketamine treatments is by improving your physical wellness. Our mental and physical health often impact one another, therefore it makes sense improving one may improve the other.


How Exercise Affects Your Brain

Living an active lifestyle has been recommended for decades, as exercise is connected to the release of endorphins known to make individuals feel happy or content. Even just 20 minutes of exercise can improve your self-esteem and ability to concentrate.


In the long term, people who make exercise a part of their daily or weekly routine experience additional mental health benefits such as improving their brain’s ability to regulate stress hormones and your brain’s capacity to experience feelings of joy. These benefits can be felt days after a workout session, as your brain releases “anti-depressive acids” into the bloodstream².


When you feel joy or motivation, you are experiencing small doses of dopamine being released by dopamine receptors, which activates your brain’s reward system. Sometimes issues with mental health may be due to lower-than-optimal levels of dopamine. One study found that the brain increases dopamine circulation when we exercise, and can even be increased in the brain up to 24 hours after exercising for less than an hour³.


A fitness routine occurring an hour each for a minimum of three times a week lasting eight or more weeks may even permanently increase our brain’s dopamine receptors. Our reward systems become less responsive as we age when were less active, but with frequent workouts, your brain’s reward system will also remain active; keeping you happier, healthier, and feeling young for longer⁴.


Another way the brain combats symptoms of depression with an increase in activity is through lactate. Lactate is a metabolic acid that can cause sore muscles in the body, especially after a workout session. In the following days post-workout, “lactate has been found to reduce feelings of depression⁵.”


Once released through exercise, lactate travels from the muscles, through the bloodstream, and to its destination in the brain where it will work to block symptoms of depression. Researchers have found that “lactic acid causes cells in the brain to release more noradrenaline, a hormone, and neurotransmitter which is fundamental for brain function. Without it, people can hardly wake up or focus on anything⁵.” This indicates that lactate can continue fighting symptoms of depression days after being released during an exercise session.


Ketamine and Physical Wellness

Researchers at Yale also created a study to discover whether there is any correlation between ketamine and prolonging its mental health benefits with aerobic exercise. For the study, subjects attended supervised workout sessions where they rode “stationary bicycles at a moderate intensity, for 45-minute sessions, three times per week, for a total duration of three months¹.”


In one group, the subjects received a single ketamine infusion before beginning the exercise regimen. In the second group, subjects were given a series of ketamine infusions over two weeks while they began their workouts. The study concluded with mixed results due to the various uncontrolled factors, but they also found that “preliminary evidence suggests that ketamine’s antidepressant effects may be amenable to augmentation strategies¹.”


The research conducted by Yale indicates that an aerobic exercise regimen of moderate to vigorous intensity for a minimum of 30 minutes, occurring 3-4 times a week with a fitness professional’s supervision for three months may be effective for lessening symptoms of depression when paired with ketamine treatments¹.


Beginner Exercises for Wellness

If you experience symptoms of depression or other mental illness symptoms and don’t already participate in an active lifestyle, it can be easier said than done to accomplish a single exercise session, let alone set a routine.


Avesta Ketamine and Wellness Recommendations

Start Small

Starting your exercise journey can feel daunting, but starting slow will be key to setting and maintaining a workout routine. Start with something light and gradually increase your fitness levels over time, and participate daily. It matters more your activity levels are regularly increased, rather than what activity you engage in.


In the beginning, low-impact exercises for ketamine patients or anyone just starting their fitness journey will be best for maintaining a routine in the long run. Some light exercises could include stretching, walking, or at-home workouts. For increased accountability, joining an exercise challenge, paying for a gym or class membership, or having a friend you can work out with can all help with keeping your momentum going.


Start with what feels comfortable; if 5 minutes or 10 minutes is where you’re at, start there. Once this time frame becomes easy, you can increase the duration of your activity or add on a new activity. This will help you build strength and stamina over time, even if you only increase your levels slightly⁶.


Join a Group for Motivation

If group activities are more up your alley, there are many exercise classes designed for people at every level, including beginners. Exercises like yoga or swimming are great for slow and low-impact exercises. Other upbeat activities also offer beginner classes, so you can choose anything that’s more up to your speed, such as cardio and other aerobic exercises, Pilates, swimming, boxing, dance, and more.


Different fitness activities can be good for targeting different mental health areas as well. Yoga can be great for flexibility as well as slowing down and engaging in mindfulness practices. This can help halt negative thoughts and patterns before they spiral further into symptoms of depression. Cardio or aerobic exercise will get your heartbeat up more which will release more endorphins that may help you feel better; whereas strength and weight training can help you feel stronger physically and mentally.


Be Gentle with Yourself

Your exercise regimen is entirely customizable to what works for you and what you enjoy doing. The more you enjoy your workouts, the more likely you are to maintain them. Remember, if in the beginning, or months into your journey a day is skipped, you always have tomorrow. Some days will be harder than others, and that’s okay. As long as you get back up the next day or next week, that’s all that matters.


Avesta Ketamine and Wellness

At Avesta Ketamine and Wellness, we value your mental health and are committed to improving your well-being. If you are interested in learning more about ketamine infusions paired with a regular exercise routine, please schedule a consultation.


Read our article Best Lifestyle Practices for Ketamine Patients to learn more about different lifestyle practices for wellness with your ketamine treatments.


¹ McCarthy, Sean J. (2019). Ketamine Plus Exercise for Major Depressive Disorder: A Randomized Controlled Trial. Yale School of Medicine Physician Associate Program Theses. 65. Retrieved January 24, 2023, from


² Affordable Ketamine. (2020, November 14). How exercise can change the brain. Affordable Ketamine. Retrieved January 24, 2023, from


³ Basso, J. & Suzuki, W. (2017, March 28th). The Effects of Acute Exercise on Mood, Cognition, Neurophysiology, and Neurochemical Pathways: A Review. Retrieved January 26, 2023, from,


⁴ McGonical, K. (2020, January 6th). Five Surprising ways exercise changes your brain. Retrieved January 26, 2023, from, _exercise_changes_your_brain


⁵ University of Bristol. (2014, February 11). Lactate and brain function: How the body regulates fundamental neuro-hormone. ScienceDaily. Retrieved January 26, 2023, from,

⁶ Bubnis, D., & Yetman, D. (2020, June 12). Endurance Vs. Stamina: Differences and Tips to Improve Both. Healthline. Retrieved May 22, 2023, from

⁷ Types of Low Impact Workouts. (2022, November 26). Health. Retrieved May 22, 2023, from

Photo by Andrea Piacquadio:

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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