Ketamine Assisted Psychotherapy
/The following is from Dr. George Anderson’s website Holo Integrative Psychiatry. Here at Red River Counseling, we’re excited to have Dr. Anderson as an in-house referral source for our clients.
We are excited to offer Ketamine therapy for clients in the Jackson Mississippi metro area. This is a very different treatment option than has ever been available in the past. You may have already heard about and researched Ketamine and are looking for a local provider. For others, you may just be exploring this treatment. We have answered some common questions below. After reading the information presented here, feel free to setup a phone consult to take the next step. Unlike at many infusion clinics, you will be supported before, during, and after each ketamine treatment.
What is Ketamine?
Ketamine is an “off-label” medication treatment option for depression, anxiety, PTSD, and other psychiatric conditions. Initially gaining approval for anesthesia, Ketamine has been used since 1970 with an excellent safety record. For psychiatric conditions, studies have now shown that the medicine can be effective at treating psychiatric conditions at much lower doses than are used for anesthesia. The medication may result in rapid improvement in symptoms for many patients. Ketamine can be considered a non-classical psychedelic. You may have heard recently about the exciting news of psychedelics being used for treatment. Unlike LSD or psilocybin, however, Ketamine is legal in the US and is able to be prescribed for psychiatric conditions.
How does it work?
To get scientific, Ketamine works as an antagonist at the NMDA receptor in the brain, which is part of the brain’s Glutamate system. While it is not yet fully understood, one of the ways it is thought this may help in depression and other psychiatric conditions is by increasing activity of a substance called Brain Derived Neurotrophic Factor (BDNF). It is believed that psychedelic treatments, including Ketamine, cause an increase in neuroplasticity via increased activity of BDNF. This increase in neuroplasticity might improve one’s ability to form new ways of thinking and coping, allowing someone to get “unstuck” from the depressive or anxious thought patterns that have been entrenched. It’s important to remember that it’s the process, not just the medicine.
How is it given or taken?
Ketamine is different from traditional psychiatric medications in that it isn’t taken every day. Ketamine can be administered as an intravenous infusion (IV), an intramuscular shot (IM), an oral lozenge/troche, or a nasal spray (esketamine). In our clinic, we utilize intramuscular (a shot) or oral Ketamine lozenges, in tandem with psychotherapy. For those afraid of shots or who prefer a milder introduction to the Ketamine experience, the lozenge may be used. The Ketamine experience often brings up psychological content that, when processed or integrated, may help a patient heal emotionally. Usually, we recommend a patient receive two Ketamine treatments per week for about 3 weeks, or 6 total sessions, with a therapy session once a week to help integrate the thoughts and emotions that come up during the session. Some patients find that they benefit from ongoing maintenance treatments periodically after the initial treatment series.
What does a Ketamine session “feel like?”
Every experience is different depending on the person and no two people will likely experience the medicine the exact same way. Ketamine is considered a non-classical psychedelic. People undergoing Ketamine treatment may experience dissociative effects and/or psychedelic or mystical experiences. They sometimes describe part of the experience as feeling “out of body” or traveling in space. Some may remember past experiences that they haven’t yet processed, but which may be contributing to their psychiatric symptoms or behaviors without even realizing it. They may be able to form a different perspective on problems or past experiences in their life or develop a different relationship to their problems. Some report experiencing a “dissolution of self or ego,” where they are able to escape their own negative views of themselves, their situation, and the world around them. The medicine experience usually lasts about 40 minutes to an hour, though some effects may last longer. The increased neuroplasticity may last longer, providing continued healing past the time that the medication wears off.
Is it scary?
For most patients, Ketamine is not a scary experience. The most important thing to help ensure a beneficial experience is focusing on the best “set and setting.” Set has to do with your mindset and intention going into the experience. Setting has to do with feeling you are in a safe and supportive environment and being taken care of. We spend time ensuring these two factors are attended to and that you feel safe and supported going into the experience. Even with safe set and setting, some patients can have challenging experiences in which they may confront something traumatic from the past or a fear they have. We believe each person has an innate inner healing intelligence. Your mind knows where it needs to go to heal and the items that need to come up will come up. The material that does surface can be addressed in our integration therapy sessions.
How long does it take to work?
Some people report improvement in symptoms as soon as a few hours after their first treatment. Some may need several sessions to begin feeling better. In a study by Shiroma et al, 25% of patients responded after first dose, 58.3% responded after 3rd dose, and 91.6% responded after 6th dose.
Who may benefit?
We utilize Ketamine Assisted Therapy for patients with depression, suicidal thoughts, anxiety, OCD, chronic PTSD, and some substance and behavioral addictions. Patients who haven’t achieved adequate relief with medications or who could not tolerate the side effects of traditional medications may be candidates for this treatment option.
Are there any risks?
Yes. As with any treatment or medication, there are potential risks and side effects. Prior to deciding to move forward with treatment with Ketamine, your provider will perform a psychiatric exam to determine if you are a candidate and will go over the most common and severe potential risks and side effects with you.
Are there any conditions that would prevent treatment with Ketamine?
The following are considered contraindications and individuals with these conditions are advised not to use Ketamine.
A history of psychosis, such as hallucinations or delusions.
Untreated hyperthyroidism
Uncontrolled hypertension
Severe sleep apnea
Active mania or hypomania
Can I drive myself to the treatment session?
No. After Ketamine treatment, you should not drive until the next morning after a full night of rest. You should avoid operating heavy equipment or making important decisions. We require you to have a driver for treatment sessions. Do not show up without a driver as your session will have to be canceled and subject to a late cancellation fee.
Will insurance cover this treatment?
No. At this time, commercial insurance does not generally cover Ketamine treatment.
How much does it cost?
Each treatment session is $500. You’ll also need to meet with a psychiatrist for evaluation and at least one therapy session prior to your first Ketamine treatment. This session is important to build trust with your provider prior to the first Ketamine experience. We recommend a therapy session for integration each week during your Ketamine series. Typically, patients will have 6 treatments for a full course, with three integration sessions. Some patients may experience transformation or improvement with fewer sessions. We will discuss the treatment course that best fits your needs and take into consideration your preference for number of sessions and spacing of the sessions. See full price list on our pricing page.
What if I already have a psychiatrist?
If you already have a psychiatrist, we are happy to provide Ketamine Assisted Psychotherapy for you and you can continue seeing your psychiatrist during and after the treatment. We take referrals from psychiatrists, other physicians, and therapists. We are able to collaborate with your provider as needed.