Ketamine is a medication developed in the 1960s, widely used in medical practice as an FDA-approved anesthetic for surgical procedures. It is classified as a dissociative, meaning it can induce a sense of detachment from one's environment, an "out of body" experience, and decreased sensitivity to pain. About 20 years ago, researchers discovered that ketamine has a remarkable ability to induce rapid neuroplasticity in the brain. This means it can quickly help form new connections that previously did not exist before. Since then, ketamine has been increasingly recognized in the psychiatric field as an innovative alternative to more traditional medications and treatments.

Ketamine is highly effective for treating symptoms of depression, anxiety, PTSD, and suicidal thoughts. Preliminary evidence also supports its use in bipolar depression, OCD, and substance use disorders.

The success rate of ketamine treatment varies due to factors such as the specific condition being treated, frequency of treatments, dosage, and whether it's combined with therapy. About 75%-80% of patients undergoing ketamine treatment for depression experience significant improvement in their symptoms. Ketamine shows particular promise for individuals with "treatment-resistant depression" — those who haven't found success with other medications or therapies.

Innovative: Traditional psychiatric medications, like SSRIs, often fall short in effectively treating mental health conditions such as depression, anxiety, and PTSD. Ketamine treatments fill the void left by these conventional options, offering a newer, more effective alternative. Expert: Your care will be provided by a board-certified psychiatrist with extensive training and experience in treating mental health conditions. This is unlike many Ketamine clinics, which are often run by by non-psychiatrists or mid-level practitioners such as nurse practitioners and physician assistants. Holistic: Unlike larger mental healthcare systems, which tend to value efficiency over comprehensive care, we take time to get to know you as a whole person. We view each patient as a unique individual in the context of their broader life circumstances, not just as a diagnosis Personalized: Your doctor will be with you to guide and support you through the entire process, from the initial consultation to preparation therapy sessions, to ketamine sessions, to post-treatment integration therapy sessions. This is in contrast to most other Ketamine clinics, which offer only medication administration without counseling or therapy. Seamless: We understand that dealing with the medical and mental health care systems can be complicated and frustrating. We are dedicated to providing a simple, patient-friendly experience within a welcoming and friendly environment.

Since ketamine has not yet been approved by the FDA specifically for depression or other mental health conditions, it is currently administered as an "off-label" treatment. Consequently, ketamine treatments are generally not covered by insurance, requiring patients to pay out-of-pocket. Sometimes, certain insurance plans will reimburse for out-of-network expenses for portions of care with us, including initial psychiatric assessments and therapy sessions. We can provide a “superbill” for you to submit to your insurance company in an attempt to get reimbursed; however, we do not work directly with insurance companies.

We accept credit cards, debit cards, HSA/FSA cards, checks, and cash. We aim to make the payment process as convenient as possible for all of our patients.

Yes, we offer financing through CareCredit, which allows you to spread the cost of your treatment over time with flexible payment options. CareCredit provides a “No Interest if Paid in Full Within 6 or 12 Months” plan, as well as various Reduced APR and Fixed Monthly Payment plans. Learn more and apply here.

Each ketamine session is tailored to the individual patient, with safety and support as the cornerstones of our therapeutic approach. Here’s a step-by-step guide to what you can expect during a typical session: A. Preparation: When you arrive, we'll conduct a brief check-in to assess your mental and physical well-being. This includes checking your vital signs and discussing your current emotional and mental state. You'll be settled into our space, designed to be soothing and welcoming, and we'll ensure you're comfortable, providing blankets, eye masks, and other items to enhance your relaxation. B. Ketamine Administration: Ketamine is administered via an intramuscular injection, typically in the shoulder. We'll prepare the injection site, calculate the precise dose of ketamine, and administer it in two separate doses about 10-15 minutes apart. This method allows us to closely monitor your reaction and ensure safety without adverse reactions. C. Onset of Effects: The onset and duration of ketamine's effects can vary. Most patients begin to feel the effects within 5 minutes of the injection, which can include relaxation, a sense of disconnection from your surroundings, and altered sensory perceptions. The peak effects usually occur within 15 to 30 minutes, with the entire experience typically lasting between 45 to 90 minutes. D. Experience during the session: During the session, you will enter a dissociative state, which varies from person to person but generally involves a detachment from your usual thoughts, feelings, and perceptions. You may experience sensations such as feeling outside your body, floating, or being in a dream-like state. You might also notice altered perceptions, such as seeing colors more vividly, hearing sounds differently, or experiencing changes in touch or temperature. Additionally, you may find yourself able to observe your usual thoughts from a more outside, objective perspective, or access emotions that are typically not available in normal states. These experiences, while they may feel intense at first, are completely normal and are an integral part of the therapeutic process. It is through these altered states that ketamine therapy can lead to new perspectives and insights, as well as powerful emotional release, helping you process and heal in ways that are difficult in ordinary consciousness. Throughout the session, our doctor will remain with you, providing support and monitoring your vital signs. Depending on how you’re feeling, the doctor might engage in light conversation to help guide your experience, though many patients prefer silence. We also offer music with pre-selected playlists to facilitate a more immersive journey. E. Discharge: As the effects of ketamine wear off, you will gradually return to your normal state of consciousness. The doctor will discuss your experience with you, helping you to process any new insights or emotions. We will monitor you until you are fully alert and ready to leave with your designated driver.

In our practice, we use IM (intramuscular) ketamine for its balance of efficacy, safety, and patient comfort.

A full treatment course consists of 6 ketamine treatments over the course of 3-4 weeks. In addition to these ketamine treatment sessions, our protocol includes "preparation" and "processing" therapy sessions. These sessions aim to enhance the therapeutic effects of ketamine by preparing patients mentally and emotionally before treatments and helping them integrate their experiences afterward. Many people start to feel better after the first ketamine session, but for others, it may take a few sessions before they notice improvements in their symptoms. It is crucial to complete the entire course of treatment because research has shown that it improves the chances for success and prolongs the benefits.

After the initial 6 treatments, many patients move to maintenance sessions at a reduced frequency. The frequency of maintenance visits varies from person to person. Some patients might come once a week for one month after their initial course, then switch to every other week for the next month, and so on. Others may only return for sessions as needed if they notice their symptoms reappearing. We will check in with you periodically after the initial course to assess your need for maintenance doses or additional support services, tailoring ongoing care to your evolving needs.

Before Treatments: • Do not eat for at least 3 hours before treatment to minimize the risk of nausea and vomiting. • You can drink clear liquids (like water, apple juice, or black coffee) until 2 hours before your appointment. After that, no drinking until after the infusion. After Treatments: • Arrange transportation home from the clinic on ketamine treatment days. • Rest and relax for the remainder of the day after treatment to ensure optimal recovery. • Do not engage in potentially hazardous activities, such as driving or operating machinery, until you've slept well and feel fully awake the next day. • Abstain from consuming alcohol or marijuana for a minimum of 24 hours post-treatment to avoid adverse effects.

The starting dose is 0.5 mg per kilogram of body weight. This is lower than the doses used for anesthesia or recreational purposes. The exact dose may need adjustments based on the individual's response to treatment. The goal is to find the right balance, minimizing side effects while maximizing benefits, because everyone's body reacts differently to medication.

Ketamine is very effective at quickly "jump-starting" an improvement in mental health symptoms. However, it's crucial to have a plan to maintain those benefits. To enhance and prolong the improvements from ketamine, we recommend: • Adopting behavioral and lifestyle changes, including regular exercise, a healthy diet, and developing healthy coping mechanisms for stress. • Engaging in outside therapy and coaching before, during, and after ketamine treatment. Cognitive-behavioral therapy (CBT) can be particularly beneficial. • Exploring new or revisiting psychiatric medications that have been effective in the past.

Ketamine is very safe when administered under medical supervision. It is crucial for ketamine to be prescribed and overseen by a medical professional with the necessary knowledge and expertise. Without the proper supervision and monitoring, ketamine can be extremely dangerous and even lethal. Its misuse has been linked to adverse events, including the deaths of well-known individuals, highlighting the risks of unsupervised use. At our clinic, ketamine is administered in controlled doses with monitoring to ensure the well-being of our patients.

In addition to ketamine's legitimate medical uses, it is also misused as a recreational drug, often called "Special K." The doses used recreationally are usually much higher than those we use in a clinical setting to treat mental health conditions. Using ketamine recreationally, especially at high doses, offers a very different experience compared to its use for therapeutic purposes. Outside a clinical setting, recreational use can lead to a distressing state known as a "K-hole," characterized by profound dissociation, reduced awareness, and a lack of responsiveness to external stimuli. Chronic misuse and abuse of ketamine can lead to other significant health issues, including bladder problems, liver damage, and brain toxicity.

The most common side effects during a ketamine treatment session include sleepiness, dizziness, vertigo, nausea, and headache. Ketamine can also raise your blood pressure and heart rate and slow down your breathing. These changes typically occur only during the treatment and return to normal a few hours after it ends. While allergies to ketamine are rare, they can occur. We monitor you closely throughout the session to ensure your safety, and we have medications available to manage any side effects if needed. In the event of an unforeseen emergency, our clinic is equipped to provide immediate monitoring and assistance, and we will call 911 for additional support if necessary. So far, low doses of ketamine used under medical supervision for mental health conditions haven't been linked to serious long-term issues. However, as ketamine's use in psychiatry is relatively new, research on long-term effects spanning many years is limited.

While rare, some patients might experience a negative emotional and psychological reaction to the effects of ketamine. The feeling of dissociation, or feeling detached from your body and surroundings, is usually a relaxing and pleasant experience for most patients and is considered to be a key factor in ketamine's effectiveness. In fact, research indicates that the level of dissociation experienced may directly correlate with the treatment's effectiveness, highlighting its importance in the therapeutic process. However, this sensation can cause anxiety or discomfort for some individuals. In these instances, our team is well-trained and experienced in providing support, reassurance, and therapeutic techniques to help you navigate the experience calmly and safely. If absolutely necessary, we can administer medication for anxiety, though we do so sparingly. This is because such medications can diminish the overall effectiveness of the treatment.

Ketamine has the potential for addiction if used improperly. However, when administered under the supervision of a physician in a clinical setting, the risk of addiction is very low. This is partly because the medication is only given while in the clinic, with no take-home doses provided. Our clinic follows rigorous guidelines to ensure safe and effective treatment, minimizing any potential for misuse or dependency.

You cannot receive ketamine treatments if you have been diagnosed with any of these conditions: • Unstable heart disease (e.g., chest pain, arrhythmia). • High pressure inside the skull (aka elevated intracranial pressure). • Certain blood vessel disorders (e.g., aneurysms, arteriovenous malformation). • A history of bleeding within the brain (aka intracerebral hemorrhage). • Increased pressure in the eye (aka uncontrolled severe glaucoma). • Current manic episode (e.g., abnormally elevated mood that affects judgment and behavior). • A history of schizophrenia. • A previous allergy to ketamine or esketamine. If you have any of the following conditions, you could still be eligible for ketamine treatments, but we may require documentation and/or clearance from your primary treating physician: • High blood pressure (aka hypertension) • Stable heart disease (e.g., well-managed coronary artery disease or a history of heart attack with no current symptoms). • Kidney disease. • Active substance abuse.

Due to potential risks to the baby, ketamine treatments are not recommended for individuals who are pregnant or breastfeeding.

Most medications are safe to use with ketamine. However, some medications might decrease ketamine's effectiveness, including: • Lamotrigine • Benzodiazepines (such as Xanax, Valium, Ativan) • Antipsychotic medications (such as Abilify, Seroquel, Latuda, Risperdal, Zyprexa) • Diphenhydramine (found in some over-the-counter allergy medications) While stopping these medications during ketamine treatment isn't absolutely necessary, staying on them might necessitate a higher dose of ketamine, potentially increasing the risk of side effects. If you're considering tapering off these medications, please consult with your psychiatrist or prescribing provider for a safe tapering plan. Some of these medications require time to be reduced gradually. For those who continue these medications throughout ketamine treatments, we sometimes recommend skipping your morning dose or taking half your usual dose on the day of your ketamine session.

Ketamine can be risky for individuals with substance use disorders due to the potential to destabilize and trigger their substance use; however, it also offers potential benefits. In some cases, when added as part of a comprehensive treatment plan including therapy and support for addiction, ketamine has been shown to help reduce harmful substance use. Careful assessment by healthcare professionals is vital to weigh the risks and benefits and determine if ketamine treatment is appropriate. Additionally, certain substances can decrease ketamine's effectiveness, including: • Alcohol • Cannabis/Marijuana • Opioids • Kava We advise our patients to abstain from alcohol and drugs for at least 5 days before and 24 hours after treatment to ensure the best possible effect from ketamine.