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, depression, 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, successfully alleviating symptoms in approximately 30 - 60% of individuals with treatment-resistant depression.
Ketamine-assisted therapy (KAT) is a unique therapeutic method used to address a variety of mental health conditions, including depression, post-traumatic stress, chronic pain, addiction, and some forms of anxiety. It involves the use of the psychoactive substance ketamine to enhance and deepen the therapeutic process, and the use of psychotherapy and other integrative forms of treatment to amplify and prolong the curative effects of ketamine.*
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.
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.
At Sage, we offer ketamine-assisted therapy as part of our comprehensive and holistic approach to wellness. We have found that this unique type of treatment is most effective when paired with other forms of therapy that complement and deepen the work. In addition to integration counseling, we offer acupuncture and bodywork to support the system in opening to the experience, moving blocked energy, and integrating the physiological and energetic effects.
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 two preparatory sessions before your first KAT session. In some cases, more than two session may be essential to your treatment. Note that we are offering virtual sessions as appropriate to accommodate for COVID-19 safety.
The ketamine 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, we primarily work with sublingual lozenges. 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 of ketamine. In this instance the ketamine is given as a shot into the deltoid or gluteal muscle. Onset of ketamine is 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. 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 of ketamine is needed. Please contact us directly for more detailed information and to answer any questions you might have.
Ketamine is used off-label for a variety of mental health disorders, 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 ketamine. These conditions include hallucinations, untreated mania, cardiovascular disease, uncontrolled hyperthyroidism, increased intracranial pressure, cystitis, or evidence of liver disease.
You will participate in a psychiatric intake if you are an appropriate candidate for this work, either virtually or in person.