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Ketamine Therapy FAQs

 

Your Ketamine Treatment Questions, Answered  
 

1. What is Ketamine Therapy and How Does it Work?

For decades, scientists believed that depression was due to an imbalance of neurotransmitters (chemical signals) in the brain. We now know that this is not the whole story. People with depression have fewer connections between neurons, and their brains show abnormal patterns of activity in specific neural networks.
 

Ketamine causes the growth of new connections between neurons and can help restore normal patterns of brain activity. Unlike most psychiatric medications, which attempt to balance levels of neurotransmitters, ketamine sets off changes in the brain that can lead to continued benefits even after the medication leaves your body.

 

People with trauma, anxiety, and depression have often built narratives about themselves and the world around them that were helpful at one point, but have become entrenched, have outlived their usefulness, and are now the source of much suffering.  Think of these narratives like walls that were once built to protect you, but now actually imprison you. Given the chance to break free, where would you go? What would you see? What would you learn along the way?

 

Ketamine reduces the activity of the brain network that generates thoughts about ourselves (the "default mode network). Because of this, ketamine offers a temporary escape from these narratives. This "departure" from the ordinary state of consciousness can be the start of a healing journey.  Ketamine alone however cannot do all the heavy lifting to help you get better. This is why the best and long-lasting effects of ketamine therapy are achieved with concurrent and specifically integrated therapy sessions.

2. Is Ketamine Therapy Safe and Effective?


Ketamine therapy, when provided with the correct components, can be both safe and effective. When we think of ketamine therapy we should really think of a 3 pronged approach which includes the ketamine administered in a way that provides high bioavailability, appropriate ketamine-assisted psychotherapy to help integrate and guide the patient, and for the treatment to be administered in the right set and setting. Set refers to the mind set before the treatment and setting refers to the location and space where the treatment is administered. The best location would be a calm relaxing place that the person can relax and let go so the treatment can have maximum effect.

 

As far as safety, ketamine has one of the best safety profiles of any anesthetic drug on the market. It has been FDA approved for over 50 years and has a great track record. Ketamine is so safe that currently in the hospital it is used mainly for children. Ketamine is also not known to suppress breathing and is very hemodynamically stable especially in the low doses used to treat mental health and chronic pain.

3. How long does Ketamine Therapy take to work?

Ketamine Therapy is a process and it takes several sessions before long lasting changes in behaviors can occur. Part of the reason why is because with ketamine therapy we are forming new neuronal connections via a process called neuroplasticity. This process takes time not just to form the new connections but also to re-enforce them and make them more robust. Current studies with ketamine therapy are showing that on average most patients will start to notice significant behavior changes between session 4 and session 8. Patients that see the best results are those that are dedicated to continue to practice and reinforce the new behaviors outside of the clinic.

 

 

4. How is Ketamine Therapy Administered?

There are several ways to administer ketamine and they all have their own pros and cons. Currently the gold standard of ketamine therapy involves getting an intravenous infusion of ketamine. This type of administration is ideal because it is 100% bioavailable, meaning that 100% of the medicine given will reach the target receptors and act on them. The infusion is also very titratable which means that if the patient is not in the therapeutics zone, the infusion can be increased or decreased accordingly to achieve the therapeutic zone where the patient can maximize their time doing the important subconscious work needed for long lasting results. The infusion unlike any other way of ketamine administration will allow the maximum time in the therapeutics zone to allow the patient to work through trauma subconsciously.

5. What are the Side Effects of Ketamine Therapy?


Ketamine therapy is extremely safe. The main side effect from ketamine therapy is nausea and vomiting. This tends to happen during the actual ketamine infusion and for a short period afterwards. Nausea usually occurs in 10-20% of patient and can be treated with oral, intramuscular or IV anti-nausea medicine. Some patients prefer a more natural drug free nausea prevention with essential oil or ginger chews.

6. How Frequently Do I Come in for Treatment?


During the initial induction phase, most patients come in once a week for the six-week induction course.  If someone shows a positive response to the induction course, we then work with patients on creating an individualized maintenance treatment course with less frequent treatments.


7. Is Ketamine Therapy FDA-approved for Depression Treatment?

Ketamine was FDA approved in 1970 for human use. Currently, the only ketamine therapy that is approved by the FDA for the indication of depression only is esketamine which is an intranasal ketamine. The bioavailability of intranasal ketamine is low (25%-50%) and the variable absorption make it non-ideal if you are looking to maximize results.

8. How Does Ketamine Therapy Compare to Other Depression Treatments?


Compared to oral medications, ketamine has almost double the effectiveness. Oral medications are effective in 50% of patients. If a patient fails the first trial than they have a 10-20% chance of being successful with subsequent oral medications. In comparison, 85% of patients will experience symptom relief after 4-8 ketamine sessions and nearly 50% of them will achieve complete remission. One of the reasons that ketamine is such an effective treatments is because ketamine therapy taps into the subconscious reasons of why someone is experiencing the symptoms of depression, PTSD and anxiety. Once an individual works through the core problems, their symptoms tend to resolve themselves. In contrast, standard oral medications only treat the symptoms.

9. Who Can Benefit from Ketamine Therapy?


Ketamine therapy has been very successful with treatment resistant depression, anxiety, PTSD, OCD, Bipolar disorder and chronic pain.

 

10. What is the Cost of Ketamine Therapy and Is It Covered by Insurance?


The cost of ketamine therapy can have wide ranges depending on what level of care you want to receive.  In general, infusions tend to be the more expensive, particularly if they are paired with ketamine - assisted psychotherapy provided by a trained physician. Research does show that the best outcomes are achieved when ketamine is administered as an infusion and it is paired with ketamine - assisted psychotherapy.

 

Ketamine therapy for mental health is currently not fully covered by insurance. Ketamine therapy can be covered with Health Savings Account (HSA) of FSA. In addition if you have a PPO insurance or other insurance that allows for out of network providers then we can generate superbills for your visits and help you submit them to your insurance for reimbursement. Our platform makes the process easy and streamlined. Ask us about our interest free financing!

11. Is Ketamine and Ketamine Therapy Legal?

Ketamine is 100% legal in all 50 states to be used under the care of a trained physician. Ketamine is considered one of the safest medications that we have and as such it has a prominent role in pediatric anesthesia and sedation. Ketamine was first approved by the FDA for human use in 1970 and has been used in hospitals and clinic ever since.

12. What will my experience be like with Ketamine Therapy?

After your virtual intake with our board-certified psychiatrist, you will come into our unique immersive environment clinic where you will have your first ketamine journey. The journey lasts 2- 2.5 hours and has 2 components. First is the ketamine experience and after that you will have a private ketamine assisted psychotherapy session with one of our experienced psychiatrists. The ketamine journey is described as a non-linear and non-verbal experience, but many patients describe sensations of floating, dissociation, visual and other sensory experiences. Sometimes the visuals are scenes but other times they can be colors or geometric patterns. The best part is that not every journey is the same so your experience will be different every time.

Whether you're curious about the treatment process, potential side effects, or the success rates of ketamine therapy, we've compiled a list of frequently asked questions to guide you through the process. Our goal is to provide you with the information you need to make an informed decision about your mental health treatment options

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