Ketamine is a dissociative anesthetic. Developed out of the desire for an ideal anesthetic with analgesic (pain-relieving) properties, it was first synthesized in 1962, patented in 1966 and approved for human use by the FDA in 1970. It is widely used in operating rooms for general anesthesia and in emergency departments for procedural sedation.

Ongoing research is still figuring out the many ways in which Ketamine affects the brain, but scientists agree that by blocking the NMDA receptors, ketamine infusion treatments prompt the brain to increase the production of synaptic signaling proteins, Glutamate, in the prefrontal cortex. The prefrontal cortex is known to have a crucial role in a person’s ability to regulate their mood.

Brain imaging has shown Ketamine also promotes the growth of new synapses in the prefrontal cortex, resulting in greater connectivity in the brain, while also switching certain connections on and off. This combination of events is thought to be the main reason for the rapid anti-depressant effect.

The good news is that ketamine is a very safe drug, particularly when used at low doses. That does not mean that it is without risks. Before beginning your treatments, we will review your medical and psychiatric history, current medications, and allergies to ensure that there are no contraindications to pursuing ketamine therapy. If we have any concerns regarding safety, we will ask for input from your primary care physician or appropriate specialist. We will not proceed with any treatments if we feel it is dangerous for you in any way. Every patient is monitored closely throughout their treatment with a primary care physician in the room with you during the entire treatment, regardless of age or health conditions.

Ketamine is not chemically addictive like some other psychiatric medications are. There are reports of recreational users being psychologically addicted to Ketamine. However, given in a medical setting at infrequent intervals there is little risk of psychological addiction. In fact, Ketamine has been shown to help with cravings and withdrawal symptoms of other chemically addictive substances.

Ketamine can support the following:

Depression

Anxiety

PTSD (‘big’ and ‘small’ Traumas)

OCD

Postpartum mental health

Premenstrual dysphoric disorder (PMDD)

Personal/spiritual growth

Burnout

Chronic pain conditions

CRPS

Migraines

Fibromyalgia

Gender Affirmation Therapy

Not all potential clients need referrals, although most are referred by a psychiatrist, therapist, or primary care doctor. When we have a referral, we know that a trained professional has evaluated you and believes that ketamine may be of benefit to you. If you self-refer, there may be additional screening and sessions to determine whether ketamine therapy may be appropriate for you.

Ketamine can be administered in a variety of ways, including as an intravenous infusion (IV), intramuscular injection (IM), a subcutaneous injection (SC), intranasally, or sublingually/orally (SL) as a dissolving troche or tablet. Routes vary in the onset, bioavailability and duration of active effects for each person.

Though research has demonstrated an antidepressant response to low doses that are minimally psychoactive or sub-psychedelic, this effect tends to be cumulative, requiring repeated administrations over short periods of time. Some practitioners view the psychedelic and dissociative experiences that occur at higher doses to provide a more robust and longer-lasting outcome.

Though experiences vary greatly, it is generally thought that lower doses provide empathogen-like (heart-opening) responses, while higher doses create dissociative, psychedelic, out-of-body, ego-dissolving peak responses.

We use a range of dosing and route of administration (ROA) strategies to tailor a personalized approach for each client. In our practice, ketamine is administered by either:

Sublingual (oral) dissolving tablets, a lower-dose strategy which may allow for psychotherapy during the treatment, and an easier experience for those who are hesitant about injections

Intramuscular injection (IM), given in the shoulder, delivers a highly bioavailable amount of medicine and a rapid onset. IM can provide the same dose used in sublingual administration, or a higher dose that creates a more dissociative experience

The choice of dose and route of administration also depends on multiple factors, including client preference, therapeutic goals, prior exposure to ketamine and other psychedelics, body height and weight, and sensitivity. Those without prior experiences are advised to begin with lower doses to reduce anxiety and build familiarity with ketamine’s effects.

We don’t know if ketamine will work for any one person. Ketamine’s effectiveness is dependent on many variables such as individual biology, genetics, psychological makeup, and the nature of the condition ketamine is being used for. Our initial screening will help us begin to assess whether we believe ketamine is likely to be effective for you. If we think ketamine is not likely to be effective, we may refer you for other mental health services instead.

Ketamine has been shown to be effective for treatment resistant depression in about ⅔ to ¾ of clients. If you enter treatment with us, we will monitor your response using a series of self-reported symptom scores. Usually, it takes at least three or four treatments before we can begin to tell if ketamine is effective–although some people feel a positive effect almost immediately!

It is common to feel sleepy or “out of it”, dizzy or nauseous. If you suffer from anxiety, you may feel a little more anxious after the first couple of treatments. We will provide medications to combat nausea prior to the start of your session. Most side effects will resolve within minutes to a couple hours and should not persist beyond the day of treatment. Some people can experience mild headaches, more vivid dreams, and rarely nightmares, which we have seen persist for a few days following treatment.

Benzodiazepines (e.g. Xanax, Ativan, Klonopin) and possibly lamotrigine (A.K.A. Lamictal) can decrease the effectiveness of ketamine. This does not mean you should stop these medications! Doing so can have serious consequences. We will review your medications during the consultation and we may ask you to make some adjustments to your dosing schedule if you are taking any medications that could interfere with ketamineItem description

We do not. Most insurance companies do not cover ketamine administration for mood disorders or chronic pain. Many insurance companies will reimburse a percentage of the fees for the medical assessments and therapy sessions.