KETAMINE ASSISTED PSYCHOTHERAPY (KAP) TREATMENT INFORMATION

Commonly Asked Questions

WHAT IS KETAMINE?

Ketamine is a unique medication that has been used safely in medical settings for over 50 years. Originally developed as an anesthetic, it is now recognized for its rapid-acting antidepressant effects and its potential to facilitate deep psychological healing. Ketamine is classified as a "dissociative anesthetic," meaning it can create a sense of detachment from one's thoughts, emotions, or body, which can be therapeutically beneficial when guided in a structured setting.

Today, ketamine is used off-label to support individuals struggling with treatment-resistant depression, anxiety, PTSD, and other mental health conditions. It works through a different mechanism than traditional psychiatric medications, primarily by modulating the glutamate system, which plays a key role in neuroplasticity—the brain's ability to adapt and form new connections. Many individuals report increased mental flexibility, a sense of emotional relief, and access to new perspectives following ketamine treatment.

WHAT IS KETAMINE ASSISTED PSYCHOTHERAPY (KAP)?

Ketamine-Assisted Psychotherapy (KAP) is an integrative mental health approach that combines the effects of ketamine with psychotherapy to promote deep healing. Rather than merely alleviating symptoms, KAP facilitates an expanded state of awareness that allows individuals to access and process emotions, thoughts, and past experiences in new ways. This approach is grounded in the belief that each person has an innate ability to heal, and ketamine can serve as a catalyst in this process.

At our practice, we emphasize safety, intention, and integration. Treatment involves preparation, the medicine session itself, and post-session integration, where insights gained during the experience are explored with the support of a therapist. We create a setting that is supportive, calming, and conducive to deep introspection, often incorporating music, mindful breathing, and other grounding techniques.

HOW DOES KETAMINE WORK?

Ketamine is believed to promote healing and transformation through several key mechanisms:

Neuroplasticity: It enhances the brain’s ability to form new neural connections, which may support changes in mood, thought patterns, and behaviors.
Dissociation: By creating a temporary detachment from ordinary consciousness, ketamine can help individuals access different perspectives, allowing for breakthroughs in therapy.
Reduction of Negative Thought Loops: Many individuals report a temporary interruption of negative, ruminative thought patterns, providing relief from depression and anxiety.
Access to the Subconscious: Some people experience vivid imagery, deep emotional insights, or mystical-type experiences that can aid in self-exploration and healing.

WHAT ARE ROUTES OF KETAMINE ADMINISTRATION?

There are several ways to administer ketamine, each with distinct pharmacokinetics, duration of action, and subjective experience. We primarily use intramuscular (IM) and subcutaneous (SC) injections, which provide a predictable and efficient absorption of ketamine, but other routes are also commonly used in clinical settings.

Intramuscular (IM) Injection: Ketamine is injected directly into the muscle, typically in the deltoid or gluteal region. The effects begin within 3-10 minutes, peak within 20-40 minutes, and then gradually subside. IM ketamine tends to produce a deeper dissociative experience compared to other methods, making it useful for psychedelic-assisted therapy.
Subcutaneous (SC) Injection: In this method, ketamine is injected into the fatty tissue just under the skin, often in the abdomen or upper arm. SC administration has a slower onset than IM (5-15 minutes) and produces a gentler, more gradual experience that may last slightly longer. Some individuals prefer SC injections for their smoother transitions in and out of the ketamine state.
Sublingual (SL) or Oral Administration: Ketamine lozenges or dissolvable tablets can be placed under the tongue (sublingual) or swallowed (oral). The onset is slower, taking 20-30 minutes to take effect, with a duration of 60-90 minutes. While convenient, absorption can be inconsistent, and the psychedelic effects tend to be milder than IM or SC administration.
Intravenous (IV) Infusion: IV ketamine is delivered directly into the bloodstream via a drip infusion, allowing for precise control over the dose. It produces a rapid onset within seconds to minutes and is often used in medical settings for acute depression and suicidality. While highly effective, it is less commonly combined with psychotherapy due to the continuous nature of the infusion.

Each route has its advantages, and the choice depends on the individual’s needs, treatment goals, and medical considerations.

WHAT ARE THE POTENTIAL BENEFITS OF KETAMINE?

Participation in ketamine therapy can result in a number of benefits, but there is no guarantee that any or all benefits will occur. Although there are now many studies demonstrating its efficacy, use of ketamine is still considered a new and experimental psychiatric treatment. Improvement generally occurs with ongoing administration (often a combination of in-office and at-home sessions) and is most robust when part of an overall psychotherapy treatment program. KAP may permanently relieve an individual’s condition but not always. If symptoms respond to ketamine, a patient may still elect to be treated with other medications and ongoing psychotherapy to reduce the possibility of relapse.

The literature indicates a 70% initial positive response rate to ketamine, as well as a 40- 50% remission rate (return of symptoms) for patients with treatment-resistant depression. If a patient responds with mood improvements after six initial treatments, he or she may choose to receive additional booster treatments periodically if determined by the treatment team.

WHAT DOES A KETAMINE SESSION LOOK LIKE?

Ketamine treatment consists of multiple stages, each designed to maximize therapeutic benefits and ensure safety.

Preparation Session: Before your first ketamine session, you will meet with a therapist to discuss your goals, set intentions, and explore any concerns. This session is crucial in building trust, addressing any anxieties, and establishing a framework for integration.
Ketamine Session: On the day of treatment, you will relax in a comfortable setting. You may choose to wear an eye mask and listen to music to deepen the experience. A therapist remains present to offer support and guidance. The experience in our clinic typically lasts two hours, allowing ample time for both the peak effects of ketamine and the transition back to ordinary consciousness.
Integration Session: After your ketamine session, you will process your experience with your therapist. Integration helps translate insights into meaningful changes in daily life. This can involve discussion, journaling, or various therapeutic practices to enhance personal growth.

WHAT DOES KETAMINE FEEL LIKE?

The experience of ketamine varies depending on the individual, the dose, and the setting. Common effects include:

Altered perception of time and space: Time may feel slowed or distorted, and the body may feel light, heavy, or disconnected.
Visual and auditory shifts: Colors may seem more vibrant, and sounds may take on a different quality.
A sense of detachment: Many describe a sensation of floating or existing outside of their usual self.
Mystical or profound insights: Some individuals report deep personal realizations, encounters with subconscious material, or a sense of interconnectedness with the universe.
Emotional release: For some, ketamine facilitates access to deep emotions, allowing for a sense of resolution and healing.

WHAT ARE THE SIDE EFFECTS?

Ketamine has a well-established safety record, especially when administered in a controlled, medical setting. Unlike many anesthetics, ketamine does not suppress breathing or heart function at therapeutic doses. However, there are some considerations to keep in mind:

Common Side Effects: Some individuals may experience mild nausea, dizziness, or an increase in blood pressure. These effects are typically short-lived.
Psychological Responses: While many find the experience pleasant or insightful, some may encounter challenging emotions or confusion during the session. These responses are usually temporary and can be valuable for therapeutic work.
Risk of Addiction: Ketamine does have the potential for misuse when taken frequently in high doses outside of a clinical setting. In medical and therapeutic settings, the risk is significantly reduced due to structured administration and monitoring.
Long-Term Safety: Unlike traditional antidepressants, ketamine does not need to be taken daily, which reduces the risk of long-term dependency. However, frequent high-dose use outside of medical settings has been associated with bladder and urinary issues.
Contraindications: Ketamine may not be appropriate for individuals with uncontrolled hypertension, certain heart conditions, or active psychosis. A thorough screening process is conducted to determine eligibility.

Our team takes careful steps to ensure your safety and well-being throughout the process.

HOW MANY SESSIONS WILL BE NEEDED?

The number of sessions needed is variable, depending on overall treatment goals and responsiveness to the treatment. Current research shows that 70% of patients with treatment resistant depression respond positively to 1-3 administrations, and 30-60% report having a remission of their depression for varying lengths of time. It seems that with repeated drug sessions, and in combination with psychotherapy, there is a cumulative antidepressant effect. KAP may also prove effective at reducing remission rates/frequency for symptoms of other conditions such as anxiety and trauma. KAP may further serve to support and foster lasting positive influences on an individual’s interpersonal relationships, occupational and social relationships, and promote the further maturation of an individual’s positive sense of self, self-agency, and self acceptance.

IS KETAMINE ADDICTIVE?

Ketamine is a controlled substance and is subject to Schedule III rules under the Controlled Substance Act of 1970. Medical evidence regarding the issue of drug abuse and dependence suggests that ketamine’s abuse potential is equivalent to that of phencyclidine and other hallucinogenic compounds that do not meet criteria for chemical dependence. This is because they do not cause tolerance and withdrawal symptoms. However, cravings have been reported by individuals with the history of heavy use of psychedelic drugs. In addition, ketamine can have pleasurable effects on mood (feelings), cognition (thinking), and perception (visual and auditory) leading some individuals to want to use it repeatedly. Therefore, ketamine should only be used under the direct supervision of a licensed physician.

Ketamine-Assisted Psychotherapy is a powerful, innovative approach that can open the door to deep healing. If you are curious about whether KAP is right for you, we invite you to schedule a consultation to discuss your unique needs and goals.