Ketamine Therapy

Ketamine was developed as an anesthetic that works by blocking NMDA receptors and is known for its safety of use. Unlike other anesthetics, it does not depress breathing or blood pressure. There is no withdrawal state after a ketamine experience or risk of physical dependency. The only common side effect associated with ketamine is transient (and preventable/treatable with medication) nausea in some patients. A therapeutic advantage of ketamine compared with other psychedelic agents is that its effect lasts only 45-60 minutes.

In 2019, intranasal esketamine (the S-enantiomer of ketamine) was approved by the FDA for use in treatment-resistant depression in a patented proprietary form. Racemic ketamine as prescribed at Acheron has been used “off-label” for decades to treat various mental health conditions.

Patients have understandable concerns about safety when it comes to ketamine. It is not everyday that one receives an intramuscular injection in one’s outpatient psychiatrist’s office. There may be some misplaced associations of ketamine with either illicit party drugs, or commonly misused prescription medications like opiates.

Despite all of these concerns, the reality is that ketamine is very safe. Ketamine is frequently used to treat children with analgesia/anesthesia needs in emergency settings. It does not suppress respiration. Ketamine is appreciated within medicine not only due to its effects, but also due to its minimum of side effects.

From a psychological perspective, Acheron’s clinical process is designed to help you feel psychologically prepared and emotionally safe for the psychedelic component of treatment. Your intake and preparation session(s) includes psychoeducation on what to expect, the opportunity to ask questions and share specific concerns you may have, and time spent discussing what you would like to explore. During the ketamine session, your therapist will be present to offer guidance, reassurance and assistance as needed.

Research shows that KAP is an effective treatment option for a variety of mental health conditions, including depression, post-traumatic stress disorder, anxiety, and obsessive thought patterns. KAP is unique among treatment options for these conditions in that its effective use can be both fast-acting and time-limited.

• Ketamine Assisted-Psychotherapy (KAP) may be the best option for patients who haven’t responded well to conventional psychiatric medication, including treatment-resistant depression (TRD) patients and those experiencing suicidal ideation. KAP is also used to treat anxiety conditions, including PTSD, OCD, and social anxiety; addictive illnesses; and chronic pain and psychosomatic symptoms (mental health conditions that affect or manifest in the body).

• KAP also may be a particularly good treatment option for patients who had previous psychotherapy that did not go deep enough to work through, transform and resolve the experience of core, anxiety-provoking topics so that their best, authentic self could emerge and creatively engage with life. 

• It may also be suitable for patients new to psychotherapy and feeling overwhelmed at the process of confronting deep and core issues, who would like the assistance of a medicine to make therapy more tolerable, as well as optimally productive for deeper and expanded conscious awareness and creative insight.

KAP is not appropriate for individuals with acute mania or psychosis, or with a recreational interest in ketamine. It is not for those with uncontrolled hypertension, uncontrolled hyperthyroidism, increased intracranial pressure, cystitis, evidence of liver disease, or for those who are pregnant.

It is also not recommended for those who only want medication management and are not interested in psychotherapy. One exception is severely depressed patients who initially may lack the ability to engage in therapy, yet may respond to ketamine.

Side effects may include nausea, which can be treated with anti-nausea medicine available in the clinic prior to ketamine treatment for those who are concerned, or can be administered during the treatment.

Gait is typically impaired during higher dose psychedelic ketamine treatments; patients are recommended not to walk around on their own during this time.

We typically recommend 3-6 ketamine sessions over the course of several weeks or months. Low dose ketamine sessions typically last 45 minutes, whereas higher dose psychedelic sessions usually require a two hour time commitment.

Evaluation sessions are 2 hours, with a price of $700.

If you are a candidate for KAP and consent to treatment, there is an initial minimum price of $1600, which includes two KAP sessions each lasting 90-120 minutes that may involve low-dose ketamine or psychedelic doses according to the treatment plan that is agreed upon between you and your treatment team.

The price of additional KAP sessions is $800/session.

Our KAP goes beyond the scope of services currently covered by health insurance. Our administrative team may be able to assist you in obtaining insurance reimbursement for some aspects of treatment, e.g., using your out of network benefit.