Ketamine is a legal, safe and effective medicine used to treat a variety of mental health conditions, including depression, anxiety and PTSD.  Ketamine has rapidly-acting antidepressant and mood-enhancing effects, which can begin to take effect within 1-2 hours after treatment and last for up to 2 weeks.

It works by blocking the brain’s NMDA receptors as well as by stimulating AMPA receptors, which are thought to help form new synaptic connections and boost neural circuits that regulate stress and mood.  Ketamine has also been shown to enhance overall neuroplasticity, the brain’s ability to form and strengthen new connections, for lasting symptom improvement.

Ketamine can be administered in a variety of ways, including IV infusion, intramuscular injection, via nasal spray and using sublingual lozenges. In my work, I only use the sublingual lozenge form. 

I refer clients interested in learning more about ketamine, its safety profile, and its uses in mental health treatment to this client education page on the Journey Clinical website. I have partnered with this organization for managing the medication side of the Ketamine-Assisted Psychotherapy process.

Ketamine assisted psychotherapy, or KAP, is a holistic treatment that combines the use of ketamine, a prescribed medication that clients receive from a pharmacy and self-administer as a sublingual lozenge, and traditional talk therapy.

The process begins with a consultation with me, then I refer the client to a ketamine prescriber who will evaluate the client and, if appropriate, prescribe the medication. The prescriber will charge their own fees separate from the cost of KAP treatment with me. The prescriber fees may be covered under some insurance plans, and the cost of the medication is included in the fee paid to the prescriber.

There will be one or two preparation sessions, which are usually 45 minutes in duration and may be covered by insurance if I’m in-network with the client’s insurance carrier. After preparation, the KAP treatment begins with a dosing session. These may be 2-3 hours in duration and are not covered by insurance. Please visit the Insurance and Fees page on this website for further information on the costs of KAP treatment.

Following each KAP dosing session, there will be 1-2 integration sessions (45 minutes) before the next KAP session. These integration sessions, like the preparation sessions, may be covered by a client’s insurance.

A full course of KAP treatment will usually involve 6-8 dosing sessions along with the preparation sessions prior to treatment and integration sessions between each dosing session.

KAP has been shown to have positive therapeutic impacts on depression, anxiety disorders, and PTSD. It is also being studied currently as a treatment for other mental health problems. Because the ketamine itself enhances neuroplasticity, clients with other concerns may benefit from a course of KAP treatment if they have learning or behavioral goals that they have struggled to maintain consistent progress with.

Ketamine may also block fear memory reconsolidation, which is believed to be part of the way that PTSD symptoms are reinforced and sustained over time. When ketamine is administered, it may be more possible for clients with PTSD to revisit memories of trauma without the same fear response that typically occurs in a client’s life. This can lead to a new perspective on traumatic memories that were too hard to face before, and it can in some cases reduce the intensity of fear responses to PTSD triggers even long after the effects of the ketamine wear off.

The psychotherapy sessions complement the dosing sessions. Integration sessions, which are held after a KAP session, can help sustain positive change over a longer period of time and help a client use the ketamine experience to greater effect in treating their symptoms.

The process begins with a consultation, and if I believe that a client who is interested in KAP is an appropriate candidate, I will refer them to a KAP medication prescriber who conducts an evaluation (online/virtual) to confirm that the client is a good candidate for this modality of treatment and to provide the prescription and treatment plan. If the medication is prescribed, clients will receive enough medication for the first two dosing sessions through the mail from a pharmacy. After the first two KAP sessions, there is a follow-up visit with the prescriber, and additional doses may be prescribed for ongoing KAP treatment. In most cases, I recommend 6-8 total sessions of KAP to clients, which is typically enough time to see positive and durable results.

Then there will be 1-2 preparation sessions with me, in which goals and intentions may be discussed and clients are told what to expect during the dosing sessions and afterward. These sessions may be covered by insurance if I’m in-network with a client’s insurance carrier.

After the preparation session(s), the first dosing session will be scheduled. The frequency of dosing sessions will be determined between the prescriber, the therapist, and the client. Usually, I conduct the dosing sessions with clients every two weeks for the duration of KAP treatment.

In a KAP session, which may be held remotely, in my office, or in a client’s home, the client self-administers the ketamine lozenges in my presence, there is a period of acute effects, and then after these effects begin to subside, there is additional time available so clients can discuss their experiences with me and I can ensure the client is ready to leave the session.

The effects of ketamine, which most clients find pleasant, last for approximately 45 minutes. These effects can make you feel “far from” your body, and facilitate shifts in perception that can often feel expansive in nature. Your motor and verbal abilities will be reduced, so you’ll be lying down in a comfortable position during the experience. Once these effects subside, we’ll spend the remainder of our appointment giving you space to process and discuss your experience. Studies have shown that the benefits to mood and neurological growth can last up to two weeks after the ketamine experience.

During the week after a KAP session and before the client’s next KAP session, we will have 1-2 integration sessions to promote the sustainability of relief obtained from the medication.

KAP integration sessions are conducted during the week(s) following each dosing session. In these sessions, insights and emotional experiences that occurred during the KAP session are explored, generalized to a client’s life, and integrated into their overall treatment plan. These integration sessions are important to maintaining the positive effects of the ketamine experience beyond the 1-2 week period that follows each KAP session.

Because ketamine enhances neuroplasticity, the brain’s ability to form and strengthen new connections, for 1-2 weeks after administration, there may be an increased ability to learn and establish new habits or behavior changes that may have been difficult for the client to sustain prior to KAP treatment.

Additional KAP sessions are usually recommended because each subsequent administration of ketamine adds to the durability of positive effects. Usually, I will recommend a total of 6-8 KAP sessions to clients, but that decision is made between the prescriber, me, and the client after we assess the results of the first two KAP sessions.

Clients interested in ketamine assisted psychotherapy who are new to this form of treatment often have many questions about it. If you would like more information on the KAP services I offer and how it works, please use my Contact form or call me at (203) 305-9594 to schedule a free phone consultation.