Q: What is Ketamine?

Pharmaceutically, ketamine is a dissociative anesthetic– a medication that produces a temporary sense of disconnection between mind and body, and from one’s normal reality, memory, and sense of identity. Ketamine is one of the most widely used drugs in modern medicine, and listed on the World Health Organization’s Model List of Essential Medicines – medications considered to be most effective and safe to meet the most important needs in a health system. It was developed in 1963, FDA approved in 1970. Many hospitals, surgical centers and medical offices use it because its effects are fast, safe, short-lasting, analgesic in nature, and is even safe for pediatric patients. Ketamine has been shown to be particularly effective with chronic mood disorders, pain, and other mental health conditions which can be severe, recurring, disabling, and even life-threatening. In the last twenty years, ketamine has been used as an accessory in some severe and “treatment-resistant” conditions (not successfully treated by other modalities or drugs), including depression, severe anxiety disorders, PTSD, OCD, suicidal ideation, and other psychiatric diagnoses (Rodrigues et al., 2013). Ketamine is currently being studied with those who have substance use disorders. Many current medical treatments for these conditions simply don’t work, or they take weeks to “kick in”. In addition, medications can create side effects that are sometimes worse than the initial disorder. Although ketamine has been used as an anesthetic agent for many years, its application as an adjunct to psychotherapy and other medications is relatively new and “off label.” Based on our review of available research coupled with our own clinical experience, we have found that when used appropriately, Ketamine paired with psychotherapy, KAP, is effective, and decreases negative mental states wherein individuals have found themselves stuck, or found their conditions to be treatment-resistant.

Question 1

Is therapy right for me?

Accepted Answer

Everyone has a need for improvement. We all have habits to be changed, relationships that could be stronger, and insight and self awareness to be gained. Although psychotherapy can benefit all people, there are some times in life where it may be especially helpful. People often consider some form of psychotherapy after a major traumatic life event, when they feel their life is “stuck” or “out of control”, or when another perspective is needed.

Question 2

How does therapy help?

Accepted Answer

When you have experienced a traumatic life event, are working through a transition period, or you are feeling anxiety or depression, you may feel stress and negative emotions. Psychotherapy can help you to process and explore what you are feeling, assess your goals, and move forward. When you have lost self confidence/esteem or feel that your life has lost its meaning and excitement, these losses have a significant impact on your overall happiness and contentment with life. Psychotherapy can help you regain confidence in yourself and others, gain control again of you, assess what is important to you, and reignite your passion for life.

Question 3

Can therapy help my relationship?

Accepted Answer

There are times in life when important relationships become strained, unsatisfying or cause distress. Therapy can help you evaluate all aspects of the relationship from a nonjudgmental and unbiased perspective, improve communication skills, encourage honesty and openness, and promote a healthy reconnection with those you care about. If a relationship ends, therapy will help you understand your role in that “ending" and work to restore your trust in yourself and others. If you are trying to rebuild a relationship, couple’s therapy can help improve communication skills, see your partner from a different perspective, and learn to love each other again.

Question 4

Can therapy help change my bad habits?

Accepted Answer

We often get stuck in just thinking about change or not knowing how to change. Another perspective can help you see how to change and that change is possible. When you become aware of bad habits or patterns of behavior that produce unwanted results, psychotherapy can help you explore the origin of these as well as your motivations for continuing these behaviors and your reasons for seeking to change them. When we feel we are acting productively, caring for ourselves and others, and working toward positive changes, we experience increased happiness and life satisfaction.

Question 5

What is Ketamine?

Accepted Answer

Pharmaceutically, ketamine is a ​dissociative anesthetic– a medication that produces a temporary sense of disconnection between mind and body, and from one’s normal reality, memory, and sense of identity. Ketamine is one of the most widely used drugs in modern medicine, and listed on the World Health Organization’s Model List of Essential Medicines – medications considered to be most effective and safe to meet the most important needs in a health system. It was developed in 1963, FDA approved in 1970. Many hospitals, surgical centers and medical offices use it because its effects are fast, safe, short-lasting, analgesic in nature, and is even safe for pediatric patients. 
 
Ketamine has been shown to be particularly effective with chronic mood disorders, pain, and other mental health conditions which can be severe, recurring, disabling, and even life-threatening. In the last twenty years, ketamine has been used as an accessory in some severe and “treatment-resistant” conditions (not successfully treated by other modalities or drugs), including depression, severe anxiety disorders, PTSD, OCD, suicidal ideation, and other psychiatric diagnoses (Rodrigues et al., 2013). Ketamine is currently being studied with those who have substance use disorders. Many current medical treatments for these conditions simply don’t work, or they take weeks to “kick in”. In addition, medications can create side effects that are sometimes worse than the initial disorder. Although ketamine has been used as an anesthetic agent for many years, its application as an adjunct to psychotherapy and other medications is relatively new and “off label.” Based on our review of available research coupled with our own clinical experience, we have found that when used appropriately, Ketamine paired with psychotherapy, KAP, is effective, and decreases negative mental states wherein individuals have found themselves stuck, or found their conditions to be treatment-resistant.

Question 6

How does Ketamine work?

Accepted Answer

Ketamine works through the glutamates – powerful chemicals in the nervous system that are responsible for sending signals between nerve cells, and that play an important role in learning and memory. We know that in cases of depression, regions of the brain which help govern mood may shrink. Animal research, however, has shown that ketamine can stimulate neural growth in these regions within days (and sometimes hours), and researchers hypothesize there is similar action in humans. 
 
Researchers also hypothesize that ketamine enables a reprieve from habitual patterns of thought that underlie mood and behavior, thereby creating an opportunity for learning new and healthier patterns of thought. In our experience, KAP not only affords a reprieve from detrimental thought patterns; the intervention can actually lead to a reprocessing of negative perceptions and thoughts that are causing or perpetuating unhealthy mental, emotional, and even physical states. Many times these thought patterns have entrenched themselves in the subconscious of the person having been learned early in life. Ketamine provides a way for these unconscious thought patterns, even painful ones, to come to the surface and be dealt with in an appropriate way.

Question 7

How is Ketamine administered?

Accepted Answer

Ketamine can be administered in a variety of ways. In our practice, ketamine is administered by intravenous infusion (IV). Dosage is determined by various physical factors including weight, sensitivity to medication, and history of drug use. The ketamine process is unique depending on the dosage and receptiveness of the individual. Our medical team will check your vital signs before and after the administration, and be on hand throughout the session to monitor physiological responses to the treatment.

Question 8

What is Integrated Ketamine Assisted Psychotherapy (IKAP)

Accepted Answer

Both psychotherapy and ketamine are effective in helping with mood disorders and pain, but the combination of the two has been shown to be much more effective than either on its own. Our program emphasizes the potential for change and the creation of new neuropathways which can facilitate change quickly. Our experience suggests that the administration of ketamine is most effective when paired with psychotherapy. We offer a psychotherapy program which will 1) explore limiting thought patterns and conditions which may be keeping you “stuck”, 2) prepare you for your ketamine sessions including answering any questions or concerns you may have, 3) guide you through your ketamine session, and 4) assist you in exploring and integrating your experiences afterwards.

Question 9

What can I expect from a Ketamine treatment?

Accepted Answer

The ketamine experience is marked by an easing of the patient’s typical concerns and preoccupations, all while maintaining conscious awareness. This psychological relaxation allows an alleviation of negative feelings and preoccupations. You will most likely experience a feeling of peace, devoid of stress, tension, or depression. However, psychedelic effects may also be experienced. These effects may include distorted visualization of colors, a feeling of floating, out-of-body sensations, vivid dreaming, and changes in the processing of sight, touch, and sound. These effects typically start within 5 minutes of ketamine dosing. The dissociative effect predominates for a time, usually 20 -30 minutes although this period of time seems timeless. Re-administration of ketamine midway through the session is sometimes given to maintain the effects of the medication until the end of the session.
 
We believe that these ‘dissociative’ experiences are instrumental in providing relief from psychological pain and tend to generate a more positive way of looking at life. We also believe that this altered state of mind and the exploration and experience of other possible states of consciousness create new neuropathways and therefore, different ways of thinking and being. Each of your ketamine sessions will be attended by a therapist who will spend time initially getting to know your concerns and mental health issues. The therapist will then act as a guide to help facilitate a growth-promoting, even life-changing experience. Each session lasts between 60 and 90 minutes depending on the individual. Even though the benefits of ketamine may be felt quickly, repeated sessions of 2-3 per week are recommended for the first few weeks for enduring benefit. Ketamine usually works to some degree immediately and can continue working days and weeks after.

Question 10

What conditions can Ketamine help?

Accepted Answer

• Depression
 • Obsessive-Compulsive Disorder (OCD)
 • Anxiety Disorders
 • Post-Traumatic Stress Disorder (PTSD)
 • Suicide Ideation
 • Addictions 
 • Pain

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