Ketamine Assisted Therapy
Ketamine-assisted therapy (KAP) evolved out of research protocols developed for psilocybin and MDMA-assisted therapy used for PTSD, depression, addiction, and end of life issues. For now, Ketamine is the only legally available psychedelic medicine available for this approach outside of a research setting.
My approach is based on this research and additional trainings. I completed a year long psychedelic-assisted therapy training, and specific training in Ketamine-assisted psychotherapy at the Ketamine Training Center. This approach allows for faster and deeper healing when combined with effective integration therapy sessions.
History Of Ketamine
Ketamine is a schedule 3 medication that was first discovered as an anesthesia medication in the 1960’s. It has a long safety record as an anesthetic and analgesic agent at much higher doses that we use for KAP. Ketamine’s ability to treat psychological or psychiatric issues was first reported in the early 70’s when there was still a lot of research using psychedelics for psychiatric conditions.
In the mid 2000’s ketamine started being used for treatment resistant depression (TRD) using the IV infusion model minimizing psychedelic effects. It has also been used as a compounded nasal spray and more recently a new patented form of ketamine has come on the market (Spravato) also for TRD.
For over 5 years ketamine assisted therapy method has continued to evolve out of the research protocols I mentioned above. There have not been any cases of persistent negative psychiatric, medical or increased substance abuse when used in a clinical setting. Bladder dysfunction has been reported in recreational users of ketamine with high and frequent dosing. In clinical practice this has rarely occurred.
How Does It Work?
Ketamine’s activity stems from an antagonizing effect on NMDA receptors through the glutamate neurotransmitter matrix. This is a very different pathway than any other psychiatric medication on the market (SSRI’s, SNRI’s, mood stabilizers, antipsychotics, benzodiazepines etc.)
Ketamine is classified as a dissociative anesthetic. At the dosage range we use for KAP you will likely experience a trance like state in lower doses and a psychedelic experience at higher dosages. Anti-anxiety and anti-depressant effects are likely. The therapeutic effect generally occurs with multiple treatments and as part of an over-all treatment plan.
Eligibility for Ketamine Assisted Therapy
Before beginning ketamine treatment in any form, you will be screened to make sure it is safe and appropriate for your situation. Ketamine is compatible with most psychiatric medications. You are not eligible if:
- You are pregnant or breast feeding due to potential negative effects on the fetus or infant.
- You have untreated hypertension as ketamine increases blood pressure similar to exercise. Once your blood pressure is under control we can reevaluate.
- You have a history of heart disease may also be a contraindication depending on the severity.
- You have untreated hyperthyroidism.
Based on individual needs, I offer several methods of working with Ketamine
Low dose Sublingual Lozenge: Allows for a consciousness experience in an interactive psychotherapy framework. This provides a time-out from ordinary mind, relief from negativity, depression, and a reset for new consciousness. It is a gentle entrance to working with this medicine and can also be used as an ongoing tool in therapy sessions. The first ketamine session will be sublingual to assess sensitivity to and tolerability of the medicine. For some clients I will do the initial sublingual screening session and then they will continue sublingual therapy sessions with a trained trauma therapist at an outside location.
Higher Dose Intramuscular Injection: Engenders a transformative experience; a journey that is unique to the person and leads to a shift in the usual ways of being and viewing oneself and one’s world. At this dosage range ketamine creates a non-ordinary (“altered”) state of consciousness in order to facilitate profound transpersonal (“transcendental”, “mystical”, “spiritual”, “religious”) peak experiences. These may prove to be auspicious in resolving existential problems, accelerating psycho-spiritual growth, and supporting deep personal transformation. Generally, we ask new patients undergoing IM treatment to make a commitment for three IM sessions as a minimum exposure to this method of employing ketamine. This allows for familiarization with this potent experience and the amplification of its benefits.
Sublingual Ketamine for Home Sessions: For people who have previously had a positive experience working with Ketamine in sessions and suffer from treatment-resistant depression.
A Combination of Methods: May be used over time in support of relief from suffering, depression, PTSD, and obsessional mind.