Ketamine works on your neurotransmitters in your brain to help you make adjustments in how you currently experience the world. It can help you begin to explore new thoughts, behaviors, patterns, and habits.
Ketamine was approved by the FDA for use as an anesthetic and analgesic in 1970. The administration of ketamine in lower, sub-anesthetic doses to treat pain, depression, or other psychiatric diagnoses is a newer, off-label use. Psychiatric use of ketamine has become relatively widespread in recent years, has been studied and promoted by researchers at the National Institute of Mental Health, and has had front-page publicity as the newest antidepressant. Ketamine has been administered by intravenous (IV), intramuscular (IM), sublingual, oral, and intranasal routes. It is often used after other treatment approaches have been unsuccessful.
Ketamine is a new psychiatric treatment, the primary studies have been with depression, bipolar disorders, post traumatic stress disorder, and alcoholism. It is not yet a mainstream treatment, though there are now many studies that demonstrate it may be an effective treatment. Greater efficacy generally occurs with more than one treatment and is most robust when part of an overall treatment program including therapy. It may not permanently relieve depression.
When administered in the office an intramuscular (IM) injection is used, often in two divided doses. The medicine frequently elicits a Non-ordinary ‘altered’, ‘transcendental’, ‘mystical’, ‘spiritual’, or ‘religious’ experience. Commonly referred to as non ordinary states of consciousness (NOSC). Research suggests it is this psycho- active state that contributes to improving depression, helping addiction and suicidality, and supporting these changes moving forward in time.
*Ketamine for the treatment of mental health and substance use disorders: Comprehensive systematic review. (n.d.). PubMed Central (PMC).
You may experience important changes in personality, mood and cognition during treatment, or in the hours, days and weeks that follow. Some experiences may be temporarily disturbing to you. The ketamine experience itself is designed to enable your own healing wisdom to be accessed and beneficial to you. The psychotherapy and integration support provided will aid you in making your experience(s) valuable and understandable to you. We will endeavor to assist you in changing patterns of mind and behavior that are of concern and cause you difficulty.
Together, we are creating a state of mind (set) in a safe and conducive setting. After your experiential session, you will have a follow-up session focusing on integration of your experience which may lead to further sessions if you wish.
The length of ketamine sessions is 2 hours. This will include preparation; vital signs, discussing your intentions, guidance and expectations for the session, and dose determination. Your dose will be decided on collaboratively. The range will be approximately 0.25mg to 1.25 mg per kg body weight, using a well-researched weight-based protocol. The dose will depend on body weight, prior exposure to ketamine and other psychedelics, and sensitivity.
Once the medication has been administered, you will be mostly internally focused for the first 30 minutes to one hour, possibly longer. As the intense effects begin to wane you may feel like sharing your experience with your facilitator. All will be recorded by your provider or a recording device if you wish.
You will continue to remain under ketamine’s influence at a lesser extent for at least one hour, up to four following your treatment.
A driver is required on the day of your session.
Whether you do a series or a single session, an hour appointment for current or new patients will start the process. This is an opportunity to ensure ketamine is an appropriate intervention for you, discuss your goals of treatment, the risks and benefits of the medicine, what to expect on your day of treatment, and make sure all of your questions are answered.
The day of your medicine session you will be in the office for about two hours. We take the first half hour to talk about your intention, check your blood pressure, and prepare for the medicine. The next hour will be for the medicine experience, then the last 30 minutes is used to settle back into your body, discuss your experience and begin the idea of integration.
If a one time experience or after a series, a follow-up hour long integration session will be done the following week. Integration is an important element of the ketamine experience. It is an opportunity to practice and hold your new thoughts, ideas, and patterns that support your intention.
