Why Is Ketamine Recommended?

Ketamine is approved by the FDA for use in children and adults for anesthesia and as a pain reliever during medical procedures. Numerous studies show that subanesthetic Ketamine may be helpful in the treatment of depression, anxiety, PTSD, acute and chronic pain. Off-label use of medications is legal and common. In fact, about one in five prescriptions written in the US today are off label.   However, it can only be administered by a licensed professional. All ketamine practitioners at the clinic are licensed and trained in administering or monitoring. Ketamine can be given as an intravenous (IV) drip, intramuscular (IM) injection or as an oral lozenge when in an active psychotherapy session with your therapist who is certified in Ketamine assisted psychotherapy.  

In this practice we are specifically aligned with the Integrative Psychiatric Institute (IPI), and as a facilitator I have completed a nearly year-long fellowship in the Psychedelic-Assisted Therapy Program (PATP) in order to be considered certified.  Our practice will administer Ketamine and can also provide or refer for all other coaching components of  Ketamine assisted therapy.

Ketamine Preparation & Integration

Benefits

Everyone’s experience of ketamine therapy and the results that they see by the end of the treatment protocol will be different. They are not guaranteed and the compounds themselves are not magic pills. The therapeutic container that is established, the level of trust, safety, and readiness the person feels when going into the experience, and the level of preparation, intention-setting, and integration afterwards all play a significant role in driving enduring results to the program.

When administered by I/V (Intravenous) infusion, I/M (Intramuscular), or orally by Lozenges it can be over a period of 40 minutes to up to 4 hours, depending on the type of Ketamine administered. Additional very low dose maintenance treatments may be suggested, occurring about once a week in an oral dosing when used in therapy, with booster treatments by I/V or I/M once a month or less frequently as recommended.  Improvements may last several days up to a few months when a series of treatments are completed which are likely to be recommended so that symptom relief has a longer duration of action. While the goal is improvement of symptoms, individual results cannot be guaranteed. Please know that this is NOT a replacement for standard medications and psychotherapy, and treatment with other medications and ongoing psychotherapy as part of Ketamine therapy works best when part of an integrated treatment program.  

Procedure – Subanesthetic Ketamine therapy

You may ask your clinician any questions you may have concerning the procedure or effects of Ketamine at any time.

  • For Oral Ketamine Troches (Lozenges):  These can be self-administered just prior to your psychotherapy session with your own KAP certified therapist.  This is where you can go deeper than ever before while processing your emotions and the active work can be explored using the benefits of ketamine. This therapy session can last anywhere from 45 min -60 min, followed by a quiet relaxation of 30 min post session.

  • For intravenous (IV): An intravenous catheter is inserted into a vein in your hand or arm and a Ketamine infusion will be dripped into the vein over 40 minutes for effect, followed by a quiet relaxation of 30 min post session. This is typically done about 3 times a week over 2 weeks, followed by Maintenance treatments either weekly or monthly.

  • For Intramuscular (IM) treatment: An intramuscular injection of Ketamine is given into the deltoid muscle, and it will slowly diffuse into your body over the course of an hour for effect followed by a quiet relaxation of 30 min post session. This is also typically done about 3 times a week over 2 weeks, followed by Maintenance treatments either weekly or monthly.

Your level of sedation, blood pressure, heart rate, oxygen concentration, heart rhythm and respiration will be monitored. The procedure will last for about an hour, but you may need to be monitored for a little longer if you need more time to metabolize. If this occurs, we may move you to a different room to relax until you are ready to leave (during regular office hours).

Protocol

The course involves intake, preparation, the experiential session, and integration. Integration can be done individually or with a peer support group

  • Any Ketamine therapy experience will begin with an intake and eligibility process.  There are a number of contraindications for each compound, as well as eligibility criteria on top of this. This is to ensure the safety of the person and that they are seeking the right treatment for their specific area of focus.

    These initial meetings and conversations will be done with a licensed practitioner who will review medical history, discuss intentions and aims, and help provide an overview of the experience and the specific program that the client would be embarking on. If a fit is determined by the clinician, the individual can begin moving through the program experience.

    Each individual’s experience will vary. Some, all, or none of these experiences may happen in an individual ketamine therapy session. These are generally accepted as notable characteristics of the ketamine experience and the compounds that reliably induce some or all of these states.

  • A core component of a safe and beneficial ketamine therapy session and program is the preparation. Ketamine therapy requires a level of energetic investment and self awareness from the client as well as the practitioner to ensure safety, comfort, and positive short and long-term outcomes as part of these powerful experiences. Preparation can include learning and understanding about:

    • The richness of phenomenological/mystical experience

    • Sensations in the body

    • An altered experience of Self (non-ordinary state)

    • Timelessness, or altered sense of linear time

    • New or novel ways of thinking/feeling

  • Depending on the scope of the ketamine therapy protocol the client is embarking on, several repeat sessions spaced out over a number of months are optimal. Each session can last up to 45-60 minutes in length.

    Oral ketamine occurs anywhere from once weekly to twice in a week with a KAP therapist. It is usually done during an active therapy session to do deeper processing. These are followed by non-medication integration therapy sessions.

    I/M and I/V Ketamine is administered in a quietly relaxed and safe setting without psychotherapy.

    There can be 30 min of post treatment time needed before being released to go home.

    This quality of the experience is dependent on:

    • The individual (mindset)

    • The medicine being used

    • The environment (setting, including music)

    • Aims and goals of the client

    • Specifics of the protocol/program you may be interested in

    In addition, it is strongly discouraged to engage in any social engagements on that same day, including writing/posting the experience on social media, watching or listening to news, or engaging in social events. Each person experiences it differently, but most will agree that the emotions immediately after a ketamine experience are relaxed. Maintaining a calm nurturing environment is important for the next 24 hours.

  • Integration is the process of beginning to explore the insights, experiences, or feelings that arose during the experiential session, and determining how to bring those lessons back into day-to-day life. This is done in the service of personal healing, transformation, and growth and are often done in sessions subsequent to the experiential sessions.

    It is key to note that integration therapy sessions are more key to growth than the ketamine experience itself as these sessions allow you to encode the learning with a clear mind and shape how it can be implemented in real life.  Without it, much of the wisdom that can be gained from an experience can be lost.

  • Once the client has arrived at the end of the final session of their integration phase, it is highly contextual to the individual as to what happens next. Working with the clinician, the client can determine the next appropriate course of action, which is often one of the following:

    • Continuing on with a new program/treatment

    • Embarking on a different healing modality such as talk therapy to assist with the integration process

    • If the ketamine therapy protocol feels complete, and they return to life potentially healed or renewed

     As this is highly dependent on the individual, their results during the course of treatment, their intentions for the program, and the discretion of the clinician, this step will look different for each individual.

This is a high-level overview of a classic ketamine therapy program. As new science is introduced, new best practices with harm reduction are established, this experiential arc continues to evolve and adapt. It also leaves room for personalization, as some individuals may require or want additional therapy integration in-between ketamine sessions. Much like traditional therapeutic contexts, the exact shape and scope of the program will depend on what the practitioner and the client agree upon together, but this provides a generalized insight into an experience with psychedelic therapy in safe and legal contexts.

Fees

  • Psychiatric Diagnostic Evaluation (60 min): $500

  • Preparation session (45 min): $350

  • Administration of ketamine :

    • Oral ketamine $400 for each 60 min session (Psychotherapy included)

    • I/V or I/M $495 for each 60 min session *Total 6 sessions: $2790 (medication only)

  • Integration therapy sessions post treatment (45 min): $350

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