What is Ketamine?
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.
What is Ketamine Assisted Therapy?
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 compliment 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.
What to expect
We will start with a phone screening in which we will discuss your symptoms and determine whether ketamine-assisted therapy might be of benefit to you. If so, you will meet with our psychiatric nurse practitioner for an initial consultation and psychiatric assessment.** If you qualify for our program after the clinical intake, you will be scheduled for preparatory sessions in which you will get to know the therapist who will be supporting your treatment, and prepare for the ketamine-assisted therapy session. There will be a minimum of two preparatory sessions before the first ketamine-assisted therapy session. In some cases, more than two session may be essential to your treatment.
The ketamine session itself typically lasts 3 hours. While there are many possible routes of administration, we primarily work with sublingual lozenges. These are allowed to dissolve and held in the mouth for approximately 10 minutes. The effects begin to appear after about 15- 20 minutes, peak for about 40 minutes, and dissipate over the following 1-2 hours. Positive impacts on mood have been shown to last over the following days and sometimes weeks.
After your first KAT session, you will have at least 1-2 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. Please contact us directly for more detailed information and to answer any questions you might have.
Ketamine is used off-label for individuals with chronic and treatment resistant mental health disorders. Its benefits are seen in persistent conditions such as depression, chronic pain, anxiety disorders, post traumatic stress disorder, and addiction.
In order to qualify for our ketamine-assisted therapy program, you must have tried a minimum of two prior forms of treatment with little to no success. Examples of prior forms of treatment include psychiatric medications, psychotherapy, intensive outpatient programs, and holistic therapies.
Requirement for the program
Ongoing participation in concurrent weekly therapeutic treatment is required for the duration of your participation in our ketamine program. The therapy requirement is not limited to traditional psychotherapy, and can be provided by a Sage Integrative Health provider or an external therapist with whom you have an established relationship.
*Our therapeutic model has been developed with the support of the Kriya Institute,the Healing Realms Center, and Polaris Insight Center.
**Psychiatrist, Dr. Gary Bravo provides clinical supervision for ketamine sessions.
Photograph by Eric Hunt, 2005.