Ketamine-Assisted Therapy

Ketamine is a psychoactive drug classified as a dissociative anesthetic. It was first synthesized in 1962 and has been used in the United States as an anesthetic in medical settings since 1970. It is on the World Health Organization's List of Essential Medicines Ketamine has been used off-label in sub-anesthetic doses for the past 20 years to treat chronic pain, symptoms of depression, anxiety disorders and a variety of other mental health concerns, thanks to its rapid onset antidepressant effects, sometimes providing nearly immediate relief from emotional and physical pain.

While the antidepressant effects tend to be temporary after a single ketamine treatment, multiple treatments have proven to have a cumulative effect, showing lasting positive shifts in mood and successfully alleviating symptoms in approximately 30 - 60% of individuals with treatment-resistant depression.

In low doses, ketamine can serve as a supportive adjunct to psychotherapy, as it provides an opportunity for the temporary softening of the psychological defenses, allowing for deeper self reflection and psychotherapeutic processing for a more effective treatment.

In moderate doses, ketamine has psychedelic effects, which have been shown to facilitate profound transpersonal experiences. These types of experiences can help people in a variety of ways, offering important clarity and insight into one's struggles, adding a spiritual dimension to ongoing therapeutic work, and facilitating a sense of meaning and interconnectedness.

We will start with a phone screening in which we will discuss your symptoms and determine whether ketamine-assisted therapy (KAT) might be of benefit to you. If so, you will meet with our prescribing physician for an initial consultation and psychiatric assessment. If you qualify for our program after the intake, you will be scheduled for preparatory sessions in which you will get to know the therapist who will be supporting you in your treatment, and prepare for your KAT session. There will be a minimum of three preparatory sessions before your first KAT session. In many cases, more than three preparatory sessions are indicated.

The ketamine therapy session itself typically lasts 3 hours if in person, and 2-3 hours if virtual. Your therapist will be with you throughout the ketamine session, either in person or over video/phone. While there are many possible routes of administration for your dose of ketamine, we primarily work with sublingual lozenges, rather than ketamine infusions. The effects begin to appear after about 15- 20 minutes, peak for about 40 minutes, and dissipate over the following 1-2 hours. On occasion we also offer intramuscular (IM) injections. In this instance the ketamine is given as a shot into the deltoid or gluteal muscle. Onset is typically within 5 minutes and lasts about 60 minutes. Positive impacts on mood have been shown to last over the following days and sometimes weeks in all modes of administration.

After your first KAT session, you will have at least 2 integration sessions in which we will help you integrate your experience during the ketamine session, discuss how you responded to the medicine, and determine an individualized course of treatment moving forward. Generally, multiple ketamine sessions are required in order to experience lasting effects. We recommend a commitment to at least 3 ketamine sessions, as this medicine tends to have a cumulative effect and is most beneficial after multiple treatments. We also offer closely-supervised at-home lozenge sessions, once you have become familiar with the medicine and its effects, to help make the treatment more affordable.

During the course of treatment, medication follow up appointments with the prescriber are required at minimum every three months, or at the time an additional refill is needed. Please contact us directly for more detailed information and to answer any questions you might have regarding KAT as a treatment for depression or any other mental health concern.

Ketamine is used off-label for a variety of mental health challenges, including depression, chronic pain, anxiety, post traumatic stress disorder, and addiction.

Some medical and psychiatric conditions need to be treated before you can safely work with KAT. These include hallucinations, untreated mania, cardiovascular disease, uncontrolled hyperthyroidism, increased intracranial pressure, cystitis, or evidence of liver disease.

A psychiatric intake process regarding your mental health history will help you determine if you are an appropriate candidate for this work.

We are currently in-network with Enthea. For all other insurance providers, we offer superbills for your appointments, which you can submit to your insurance for potential reimbursement.