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.

-You’ve already tried different medication combinations or dosages without any relief in your symptoms

-You’ve tried other therapies

-You haven’t responded fully to a group or individual CBT or therapy

-You are in active substance abuse recovery and have maintained sobriety for at least 2 months

-You don’t have any of the contraindications (listed in the next section)

According to the American psychiatric Nurses Association, individuals may not be eligible for ketamine therapy if they:

-Are pregnant

-Have uncontrolled hypertension

-Have acute cardiovascular disease

-Have a history of psychosis, or increased intracranial pressure

-Your substance abuse is active and you have not been able to abstain from substances for longer than 1 month

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 subside, 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 happens during the experience, patients feel like the insights gained are clear.

If/when we decide KAT is an appropriate treatment for you, you will begin with an initial consultation with Journey Clinical.

Once you receive you ketamine lozenges, we will schedule time together for our KAP preparation, dosing and integration sessions.

The following steps will be performed following the preparation phase:

Dosing Sessions: 1-2 hour sessions where I will support you in holding space to process.

Integration Sessions: Therapy sessions where we will review memories, thoughts, and insights.

Follow-Up Consult with Journey Clinical: Review progress and set you up with a custom treatment plan.

Integration Sessions

A typical ketamine dosing session lasts between 1-2 hours and can take place either in-person at my office, or remotely via telehealth.

During a dosing session, you will self-administer your ketamine lozenge either in my office or in your home. You will be in 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 will be present with you the entire time to hold space and provide support as needed.

Ketamine-Assisted Psychotherapy is an affordable, accessible modality. Although the medical intake and follow-ups are not covered by insurance, they are eligible for out- of-network reimbursement.

• Each session is $150 per intakes and integration sessions (50 therapeutic minutes) and $350 per 2-2.5 hour dosing session.

In addition, please consider the additional costs through Journey Clinical Medical:

• Medical Intake: $250 (One time fee, reimbursable through out-of-network)

• Follow-up Sessions: $150/Session (minimum of 1/quarter, reimbursable through out-of-network)

• Cost of Ketamine Lozenges: approximately $75 for 4-6 doses

1. Paradigms of Ketamine Treatment by Raquel Bennett, Psy.D. for MAPS

2. Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy - research study by Jennifer Dore et al, 2018

3. Ketamine for Depression and Mood Disorders by Erica Zelfand, ND for Townsend Letter

4. Ketamine-Facilitated Psychotherapy for Trauma, Anxiety, and Depression by goop

5. Ketamine Assisted Psychotherapy with Jonathan Sabbagh of Journey Clinical - Psychology Talk Podcast