KETAMINE-ASSISTED PSYCHOTHERAPY (KAP)

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In conjunction with other techniques, I offer a therapeutic modality called Ketamine-Assisted Psychotherapy (KAP) in partnership with an organization called Journey Clinical.  Ketamine-Assisted Psychotherapy (KAP) is a holistic modality in which ketamine is used as a complement to psychotherapy to help eligible patients experience more frequent breakthroughs and sustained improvement in symptoms. Journey Clinical provides a medical team that is there to support clients on all medical aspects. The medical team determines eligibility, develops a custom treatment plan, prescribes the medicine and monitors outcomes.
 
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Ketamine blocks glutamate, a neurotransmitter associated with stress, while most antidepressants act on the neurotransmitters serotonin, dopamine, or norepinephrine. Ketamine has also been shown to help stimulate the regrowth of neurons in a brain stressed by depression.  -Moda-Sava RN et al. Sustained rescue of prefrontal circuit dysfunction by antidepressant-induced spine formation. Science 2019; 364: 1–11.

 ABOUT KETAMINE

What Is Ketamine?
  • 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 hrs. 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 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 with Journey Clinical we only use the sublingual lozenge form.
How Does Ketamine Feel?

The effects of ketamine, which most patients 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 subsided, we’ll spend the remainder of our appointment giving you space to process and discuss your experience. While it may feel hard to articulate what happened during the experience, patients feel like the insights gained are none-the-less clear. Studies have shown that the benefits to mood and neurological growth can last up to two weeks after the Ketamine experience.


 KAP PROCESS

STEP 1: Initial Consultation With Medical Team
  • I’ll work with you to schedule a virtual initial evaluation with the Journey Clinical medical team.  Your medical and psychiatric history is reviewed and treatment education is provided to determine if you are eligible for KAP.
  • If the medical team determines you are eligible, they develop a personalized prescription and outcome monitoring plan.
  • The medical team then writes a ketamine prescription, and a small amount of oral ketamine will be sent to your home.  This is enough for the first 2 KAP sessions. You are taught how to take your vitals and self-administer the ketamine lozenges by the medical team in advance of KAP sessions.

STEP 2: Preparation Sessions

Once you receive your ketamine lozenges, we will schedule a preparation session(s).  This is scheduled just like regular therapy sessions but must be done prior to the dosing session (step 3). The goal is to align on the process and set intentions for KAP.

STEP 3: Dosing Session    

  • A typical ketamine dosing session lasts between 1-2 hours and can take place either at my office, or remotely via telehealth.
  • You will self-administer your ketamine lozenge and will settle into a comfortable, reclining position wearing an eye mask and listening to calming music. Although a KAP dosing session may be largely an internal experience, I am present with you the entire time to hold space and provide support as needed.

STEP 4: Integration Session    

  • After the dosing session, I will meet with you for multiple integration therapy sessions to review the memories, thoughts & insights that arose during the dosing session, and we will prepare for the next dosing session.

STEP 5: Follow-up Consultations With The Medical Team    

  • After the first KAP session, Journey Clinical’s medical team schedules regular follow ups with you to monitor outcomes and prescribe ketamine lozenge refills, as appropriate. The frequency of follow ups depends on your unique treatment plan, at a minimum of once per quarter.


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