Ketamine is a dissociative anesthetic that was discover in 1962. Recently, a growing body of research has shown positive benefits in using ketamine therapy as an intervention for mental health disorders, chronic pain, suicidal ideation, and psychological exploration. The FDA approved esketamine nasal spray (Spravato) as a method for combating treatment-resistant depression in March 2019, and further extended the approval for treatment in adults with Major Depressive Disorder and acute suicidal ideation/behavior. Ketamine is widely regarded as one of the most important mental health breakthroughs in recent years.
Ketamine interacts with the brain in a different way than other conventional antidepressants. It works with unique neural pathways affecting multiple neurotransmitters and can lead to neuroplasticity. Often, rapid positive changes in mood and pain symptoms are seen after treatment, but most patients need more than one medicated session in the first phase of treatment in order to sustain the benefits. When combined with other types of psychological support the effects of ketamine can be prolonged significantly. Across the board we have observed positive changes in the brain centers involved in executive functioning, learning, cognitive flexibility, attention, and memory.
Medical professionals are seeing ketamine’s wide variety of uses. Intravenous and Intramuscular ketamine therapy are the most commonly used method of delivery, and, additionally, have the most research supporting effects on treatment-resistant depression, as well as other long-term pain and mental health conditions.
Some of the other areas where ketamine has been shown to be effective include:
Post-traumatic stress disorder (PTSD)
Social anxiety disorder
Substance use disorders
Generalized anxiety disorder
Obsessive-compulsive disorder (OCD)
Complex regional pain syndrome (CRPS)
At SBKT we focus on ketamine therapy via the Intramuscular approach. For patients who cannot receive IM treatment we offer a number of other options (sublingual tablets, intravenous & intranasal). Frequency and method of treatment are topics that we discuss with our patients in their medical consultation at the beginning of the process, so that they can make the most informed decision about how to proceed with their care.
Patients who receive ketamine treatments often report that they feel positive effects during the session, and that relief is sustained well after the drug has been metabolized and eliminated by the body. Positive changes are incredibly subjective, and success looks different to each patient, but feeling better can take the form of subtle changes in your day-to-day function, that may lead to improvements to your mood or pain. These effects have been seen to last anywhere from a few hours to several weeks after treatment. It is important to note that ketamine is not a cure for these disorders/symptoms, but it can be used as a tool for long-term management, and to drive change and transformation. We use the medicine in conjunction with other types of psychological support before, during, and after the medicine session, and we have found that this greatly enhances the benefits of the medicine compared to using it on its own.
Ketamine is considered a safe medication across the board, but how it is used and who uses it determines how it safely it can be used in the outpatient environment.
Dr. Drozd is a board certified Emergency medicine physician with 15 years experience improving the wellbeing of his patients. He has observed the benefits of psychedelics their impact on improved wellbeing in the clinical setting and is also trained as a Ketamine practitioner. In his experience in a hospital setting, he wasn’t satisfied with they way western medicine approaches treating symptoms and sickness. He believes that understanding who the patient is, what they’re going through, and then treating them to improve health the best, most sustainable approach to improving your wellbeing. In his continued research, he believes that Ketamine treatments can provide that missing piece many people are looking for to feel well again.
Our process starts with a medical/psychosocial consultation to gain background information on our patients. In this consultation we discuss the treatment plan, dosage your intention and address any questions or concerns that might be present. Our intake process requires that patients share their medical history, as well as any prior treatments for psychological issues in a questionnaire. There are very few contraindications when using ketamine for therapy, but we are obligated to screen for issues that would make a potential candidate ineligible.
According to most recent studies, and testimonies from ketamine therapy practices, about 70% of patients respond positively and begin to “feel better” after their first ketamine treatment. Even more, 80-86% of patients who undergo this type of therapy report positive changes after they seek treatment in practices that prioritize set and setting, with other types of psychological support to supplement. We typically recommend a series of 6 treatments with 6 corresponding integration sessions with our team of coaches and therapists, to be administered over the course of 8 weeks.
Some conditions that can be treated with ketamine differ from others, and thus would require different cadences, dosages, delivery methods, and lengths of time for experiencing the medicine. We welcome open communication from the patient about their acute and overall experiences while they are going through the therapeutic program, so that adjustments can be made to support their success.
Physical side effects from ketamine therapy are mild, and do not occur in every patient. Nausea, vertigo and headaches are the most common, and can be treated in session.
Other side effects can include an increase in blood pressure and heart rate, some respiratory depression, or simply a larger degree of mental dissociation than the patient was expecting. We screen each patient for these risk factors, but in the event that they do occur, stopping the experience, and/or treating them with medications are always an option. These side effects generally do not persist, and usually last between 5 and 15 minutes. Most people report feeling lethargic as a side effect in the hours after their treatment, but the feeling dissipates as ketamine is metabolized and eliminated from the body. There have been virtually no long-term side effects reported by practitioners.
Most ketamine therapy providers do not contract with insurance companies. Insurance companies generally do not view ketamine therapy as “medically necessary”, or they attribute the type of therapy as “experimental”. SBKT can provide its patients with a superbill to present to their insurance upon request.
Currently Dr. Drozd administers ketamine via intramuscular injection for the majority of patients in the program. Dosage and frequency of sessions are determined on an individual basis, which are discussed in the patient’s initial medical consultation. For most patients we
recommend a series of six ketamine sessions paired with their respective integration sessions, over the course of 8 weeks. Treatment schedules can vary depending on the patient and practitioner availability. Some patients will require more than the recommended amount of sessions, and others will require less.
Our initial medical consultation to determine eligibility and details of treatment costs $345 and is a one-time appointment. Each subsequent appointment is priced per visit. We typically recommend a 50 minute
preparatory session with the assigned therapist before the patient comes in for their first ketamine treatment. The cost of this preparatory session, and each subsequent 50 minute Integration session is $195. Ketamine treatment sessions are two hours long, with time dedicated for experiencing the medicine, as well as integration in the later half of the session. The cost of each individual ketamine session is $745. For special circumstances we do offer prescriptive services for at-home ketamine treatments when symptom management with more frequency is needed. Although it is possible for participants to receive ketamine treatments without the other aspects of psychological support, we have seen greater degrees of patient success when patients go through the entire course of treatment and utilize the treatment/integration model over the course of consecutive weeks. Above all else, our goal is to understand what you need and help with your healing.
It is, but the doses used in our therapeutic program are significantly less than what one would take recreationally. Developing an addiction is highly unlikely. The methods we use to cultivate a therapeutic mindset, and the tranquil setting in which we administer and support our patients are major contributors to the difference in experience between this type of work and recreational use of ketamine.
Ketamine is what is known as an NMDA receptor antagonist. It affects parts of your brain that are involved in pain perception, memory, and learning. While experiencing ketamine, and in the days after a treatment, there is an increase in neuroplasticity, or a re-wiring/reorganization of certain pathways in the brain. This allows space for new thoughts, new ways of processing, and new ways of thinking about and dealing with internal and external stressors in your life.
Ketamine is recommended for an assortment of persistent mood disorders and chronic pain syndromes. Treatment resistant depression (TRD) and general anxiety disorders (GAD) are some of the most common ailments for which ketamine can be used. Depressive states that are parts of larger disorders can also be improved by ketamine, ranging from lows experienced in bipolar disorder, postpartum depression, and PTSD (post-traumatic stress disorder). Chronic pain syndromes can include headaches, reflex sympathetic dystrophy (complex regional pain syndromes), fibromyalgia, among others.
Part of ketamine’s benefit is that it is, comparatively, very low risk. It does increase blood pressure and heart rate, so if there are any preexisting conditions that affect these two factors the candidate may not be eligible for treatment. Occasionally ketamine can upset the stomach, but this will usually subside in a matter of hours. Additionally, patients can sometimes experience emergence reactions as they come out of the sedated state and experience some anxiety or terrors as reality settles back in. Our team is trained in crisis management and are prepared to deal with any and all peripheral effects of ketamine treatment.
Chill. Bring an eye mask or music if you like. You really won’t be able to carry on a conversation. You’ll be in a comfortable recliner in a room by yourself during the infusion. A nurse or physician will be frequently checking in on you. During the medicine session we invite you to meditate on your goals, intentions and mantra while you get comfortable. We will supply you with noise canceling headphones, a soft couch to recline on, and blanket to feel held. There will always be someone in the room with you to hold space for you during the entire experience.
Success and improvement look different for every individual, but most people report “feeling better” after their first treatment. This can take the form of less feelings of negativity, increased mental clarity, a lifting of “fog”, lessening of pain in parts of the body, among other benefits. As treatments continue, more positive effects are usually seen over time, and compounding dosages in rapid succession (over the course of a few hours) has been shown to bolster pain reduction properties over a longer period of time.
Yes, you should discuss you treatment with all of your other providers and we will help support you during this focus healing process.
We typically recommend a series of 6 ketamine treatments with their paired integration sessions over the course of 8 weeks. Sometimes changes can be seen after the first ketamine session, and other times it takes 3-5 sessions before change starts to occur. Regular boosters have been shown to prolong the positive benefits and help with pain/symptom management. Patient and practitioner availability, and patient circumstances can affect the total duration of treatment.