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 and Intranasal Spravato 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)

Depression
Suicidal ideation
Social anxiety disorder
Palliative care
Eating disorders
Substance use disorders
Generalized anxiety disorder
Obsessive-compulsive disorder (OCD)
Migraines
Neuropathic pain
Complex regional pain syndrome (CRPS)

We focus on ketamine therapy via the Intramuscular, Intranasal Spravato and IV 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 on the day they start, and that relief is sustained well after the medicine 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 very 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.

YES! Most ketamine therapy providers do not contract with insurance companies. Insurance companies generally do not view IV ketamine therapy as “medically necessary”, or they attribute the type of therapy as “experimental”. Lucid can provide its patients with a superbill for IV and IM treatments and we take insurance for Spravato treatments.

We typically recommend a series of 6 ketamine treatments, when IM or IV is used, with their paired integration sessions over the course of 10 weeks. Spravato treatments are once or twice a week. 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.

Spravato treatment are typically follow a much longer time course. In this program clients are under treatment for months until symptoms have clear improved.