Ketamine therapy is the newest “off-label” pharmacological approach in the field of psychiatry. I offer ketamine therapy in Monmouth County, New Jersey as it shows great potential in the treatment of numerous psychiatric conditions, including depression, anxiety, PTSD, and OCD. Ketamine produces rapid relief of symptoms, sometimes immediately, even in treatment-resistant cases.
About 70% of patients with treatment-resistant depression respond favorably after a single treatment; and 30-60% of treatment-resistant depression patients can achieve considerable degrees of remission of their depressive symptoms for variable lengths of time. The benefits can be lasting after only a few treatments, while others may need a series of maintenance treatments as a “booster” if and when symptoms recur.
How can Ketamine Therapy help you feel better? Watch this!
Whereas Western medicine has a tendency to rely on suppressive therapies (those that delay or avoid unpleasant memories), ketamine-facilitated psychotherapy is an evocative technique that allows for the identification and understanding of more deeply rooted causes of psychiatric symptoms.
In the state of NJ, ketamine therapy is very rare. Those who have the most enduring response to ketamine therapy tend to be the ones that understand that ketamine is not the healing agent, but rather, it can be a catalyst that facilitates transformation, self-healing, and over time, sustained wellness.
- What conditions can ketamine help?
- Ketamine is a Schedule III medication that has long been used safely as an anesthetic and analgesic agent now used for treatment of Depression (unipolar & bipolar), Anxiety, Post-Traumatic Stress Disorder (PTSD), Obsessive Compulsive Disorders (OCD), Substance Use Disorders, and pain syndromes such as fibromyalgia and complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD).
- How does ketamine work?
- Countless scientific publications have demonstrated that ketamine appears to target a specific neurotransmitter, known as glutamate, which may be central to the development of numerous psychiatric conditions. Ketamine is an NMDA-receptor antagonist, which effectively blocks the action of glutamate. This is very different from other psychiatric drugs such as the SSRIs, SNRIs, lamotrigine, antipsychotics, and benzodiazepines, and offers a novel treatment approach.
On a psychological level, ketamine can provide a deeply introspective experience that is open to the hidden aspects of consciousness and emotional turmoil.
Within this framework, the combination of psychotherapy and ketamine therapy maximizes the ability to utilize this new-found understanding of the self for personal growth and transformation.
We take advantage of several key qualities of the ketamine experience, including:
- A relaxation of normal psychological defenses and utilization of a more emotionally accessible state to work through past trauma.
- Experiencing a state of mind that is free from anxiety and past obsessional burdens may allow the mind to be more open and therefore, able to understand positive aspects of the self and its relationship to the world.
- A slowing of mental activity that fosters a heightened awareness and increased ability to move back and forth between states of mind, which allows for the separation of depression, anxiety, and obsessional states from the healthier aspects of the mind.
Utilizing psychotherapy, we take measures to strengthen the liberated mindset that is experienced in the ketamine session, focusing on the retention and repetition of novel insights that may help the patient to remember what it feels like to live free from suffering.
Essential to the ketamine experience is “a pause” from the usual mindset that can torment you with anxiety and obsessional thoughts. This experience typically lasts between 30 to 90 minutes. Prior to your ketamine experience, it is advisable to set an intention for your journey, although you may find that your mind will travel to places you had no idea existed prior to the session. It is important to recognize that you are in a safe environment, supervised by a doctor, thus it is best to let go, embracing the experience and where it takes you. When you return, we will work with you to process the meaning of your journey and its impact upon your outlook.
Beneficial psychiatric effects are usually seen during and immediately following treatment, though some patients will notice effects up to 48 hours later. Undoubtedly, your experience will be unique to you and each of your sessions will be different.
“As a psychiatric medication, ketamine offers a wide range of applications, from mild doses alleviating depression (at least in the short-term) to psychedelic dosages offering the possibility of transpersonal healing. The fact that ketamine is the only psychedelic that can legally be prescribed in the United States makes it unique at this time, and we encourage its responsible use within the medical context for providing access to deep and profound healing experiences that may be difficult, if not impossible, for many to achieve without the aid of such a substance.” – Eli Kolp et al. “Ketamine Psychedelic Psychotherapy: Focus on its Pharmacology, Phenomenology, and Clinical Applications.” The Ketamine Papers. MAPS, Santa Cruz, CA, 2016, (p. 167)
The sublingual method is equivalent in effect to the intravenous (IV) method and much less expensive and cumbersome. We believe that IV infusions needlessly medicalize the procedure; therefore, we overwhelmingly use the sublingual method of administration.
The physiologic effects of sub-anesthetic ketamine provide a large margin of safety in the treatment of psychiatric conditions through the preservation of consciousness, cardiac stimulation, and maintenance of respiratory function and the gag reflex. In addition, ketamine has advantages over other psychedelic compounds because of its rapid onset, and short duration of action.
Blood pressure increases of 5–10 mm/hg diastolic and 5–15 mm/hg systolic are routine while heart rate increases of 10–20 BPM are common.
Ketamine and other dissociative drugs have been reported to exacerbate psychotic symptoms and schizophrenia.
In chronic recreational use of ketamine, lower urinary tract symptoms have been identified as an important adverse effect, but there have been no reported cases of this in controlled treatment at doses typically administered in the course of psychiatric treatment.
- Is treatment provided as an outpatient?
- Yes, ketamine lozenge sessions are provided in a comfortable, home-like environment. During a typical session, you will be asked to lie down on a couch or in a recliner, while the effects of ketamine are experienced. Ambient and classical music plays in the background while you safely relax with eyes closed or wearing eyeshades. You are welcome to have a friend or family member accompany you throughout the sessions.
- Can I drive after the session?
- No, you must arrange for a ride home and are advised to abstain from driving until the following day. You must also avoid operating heavy machinery.
- What if I already have a psychiatrist or therapist?
- We are happy to work along side your existing treatment team to help you conquer your symptoms. It is best to inform your doctor and/or therapist about your plans to pursue ketamine-facilitated therapy in order to maintain a treatment alliance with existing providers.
- How many sessions are typically required?
- Most research has shown that 2 – 3 sessions per week for the first two weeks is ideal, but you may notice some improvement in your symptoms after your first session. Thereafter, maintenance sessions can be used to provide continued benefit, but no more than twice per week. There are no long-term studies that show how long ketamine can safely be used.
- Do I need to stop my medications before taking ketamine?
- Most medications are perfectly safe to continue taking while undergoing ketamine therapy. We are particularly interested in learning if you are taking:
- Wellbutrin (generic name Bupropion) – may cause observed anxiety and mild agitation during treatment, thus we advise that you allow at least 6 hours between taking Wellbutrin and the ketamine session.
- Lamictal (generic name Lamotrigine) – may block the psychological effects of ketamine, thus we advise that you allow at least 6 hours between taking Lamictal and the ketamine session.
- Stimulants–for similar reasons as bupropion and blood pressure elevation.
- Patients taking large doses of benzodiazepines may have a reduced response to ketamine, so we may ask you to skip a dose on the day of your treatment. Some common brand names are Xanax (Alprazolam), Ativan (Lorazepam), Valium (Diazepam), and Klonopin (Clonazepam).
- SSRIs, SNRIs and tricyclic antidepressants do not interfere with ketamine. There is no need to stop them.
- Who should avoid ketamine?
- Ketamine should be avoided if you have any of the following conditions:
- Uncontrolled hypertension
- Untreated hyperthyroidism
- Congestive heart failure
- Other impaired cardiac status
- Severe COPD
- Severe obesity
- Increased intracranial or cerebrospinal pressure
- Schizophrenia and schizoaffective disorder
- Severe or primitive personality disorders
- Pregnant women and nursing mothers
- An active substance use disorder
- Does ketamine cause bladder damage?
- There has been zero link between therapeutic ketamine use and bladder damage, or Lower Urintary Tract Symptoms (LUTS). The only known reports of bladder damage caused by ketamine are based on the abuse of street ketamine at doses 10-20 times the amount we administer, taken daily, over the course of years.
- Is ketamine therapy covered by insurance?
- At this time, ketamine therapy is not covered by any insurance providers.