Common Questions

Ketamine works on several pathways in the brain. Essentially it allows for certain pathways to become more active that have usually become underactive while depressed. It allows for the fear center to decrease activity, which usually improves anxiety. And it allows for us to access areas of our subconscious.

We do an initial screening to see if you are a candidate for ketamine. After an initial screening, we do a medical assessment with a nurse practitioner to evaluate past medical and family history, and to develop a treatment plan. A preparation session follows this, where we explore intentions, set, setting, integration. The journey is scheduled and completed, with a therapy integration session within the next few days.

Ketamine works for 70-80% of individuals. Some experience improvement during the session, some immediately after, and others within the days following the treatment. It may take several sessions before noticing significant effects. Some may not see significant changes, but may experience small, incremental changes such as better motivation, or seeing moments of improved enjoyment every day.

You are greeted by your guide for the journey. We ask that you urinate beforehand. A checklist is reviewed to ensure safety to take ketamine, and vital signs are taken. We do either a guided meditation or read a poem together to begin to put us in an open mindset. The nurse practitioner then greets the participant to review safety information and ask additional questions. The participant lays on the couch with pillows, a blanket, headphones, and an eye mask. The medication is then administered either through intramuscular injection, or swishing by mouth. Your oxygen is monitored and the guide is with you at all times. You are greeted upon completion of your journey, and allowed time and space to return back to a comfortable state. We offer water and light snacks, and then ensure safe transfer to your arranged transportation home.

Ketamine may cause nausea. If a participant is prone to nausea, we provide a prescription for anti-nausea medication to take an hour before your journey.

We emphasize we are not a ketamine infusion clinic. We use ketamine as a tool to change depressive pathways, process trauma or internal challenges, or to improve anxiety. It is used alongside therapy. Our model is the recovery model, versus the maintenance model. We aim to help patients live fulfilling, independent lives, without needing maintenance medication. We also use the guidelines set forth by the Psychedelic Research and Training Institute (PRATI) as well as the Multidisciplinary Association for Psychedelic Studies (MAPS).

Usually, no. Ketamine works pathways different than SSRIs, SNRI, NDRIs. Patients on lamotrigine (Lamictal) will be evaluated and advised for ketamine treatment.

Physical risks include elevated blood pressure, dizziness, sedation, fatigue, nausea, frequent urination. Psychological risks include heightened emotions, decreased inhibition, disorientation. You may feel exhausted for the day or days following a journey, depending on the processing that occurred. Heavy, chronic use of ketamine may lead to bladder conditions such as cystitis. There is a very rare risk of bronchospasm seen generally with high, anesthetic doses.

Ketamine is generally considered safe, especially in the medical setting. Vital signs are assessed at several points both prior to the ketamine journey, and during. Safety equipment is available nearby at all times. Dosing is considerably lower than when used for anesthesia. Patients receiving ketamine for surgery generally receive 500 mgs +. When used for psychedelic therapy, doses generally range between 30 and 150 mg.

A treatment plan is developed collaboratively between yourself and the nurse practitioner. Journeys may be able to occur weekly, every other week, monthly, or longer. The antidepressant effects generally last 2 weeks.

Ketamine is one of two agents that suppresses the default mode network (DMN), with the other being MDMA which is currently pending FDA evaluation and approval. The default mode network is associated with our automatic thoughts, our sense of self, and our internal dialogue. Ketamine also opens up a critical learning period of 72 hours after administration, allowing for changes in how we think, how we relate to ourselves, and how we relate to the world.

Ketamine can be abused, and is abused by individuals for recreational use. It is rare to see individuals under close medical observation and management, to become addicted to ketamine and to pursue recreational use. A large predictor of this is exploring the journey and relationship to ketamine. Generally, we use ketamine to explore challenging aspects of ourselves or our lives, leading to processing of very difficult emotions. Some individuals may use this as a relief or reprieve from their emotions. These are individuals who *could be at increased risk, and would require close oversight and care.

Some individuals are able to successfully stop daily psychotropic medications after completing psychedelic / ketamine assisted therapy. Each participant has a highly individualized experience. Depending on causes leading up to depression or anxiety, we may be able to resolve them and successfully stop daily medication.

These are uncontrolled hypertension, hyperthyroidism, and pregnancy. Individuals with arrhythmia may require an EKG before starting ketamine assisted therapy.

We ask individuals to set an intention and prepare mentally for their journey approximately 1 week to the appointment. Ensure you sleep well the night before, and give your body healthy nourishment. The day of, meditate or journal several hours before the appointment. Explore how you are going to prioritize the time and the journey, to connect with yourself. When you arrive, please use the washroom to empty your bladder.

The medical evaluation, preparation therapy session, and therapy integration session are all billed through insurance. The ketamine journey is not covered by insurance at this time, and costs $600 for 3 hours with the guide.

We are in network with Regence, Premera, Cigna, and Aetna. We offer superbills for those with Kaiser or United for patients to seek out of network reimbursement, after paying cash for the treatments.

Ketamine helps with depression, anxiety, trauma, PTSD, insomnia, bipolar depression, attachment trauma or challenges, low self worth, high criticism of self, and others.

Improvement can look different for many. It is rare to not see improvement in some form. If we don’t see mood lift, we may see small changes in the form of decreased effort needed to do little things, or seeing more joy in little moments. Change can take time. It’s important to allow the healing and growth process occur.

Psychedelic assisted therapy is different than conventional therapy. Psychedelics opens up pathways that are not able to be reached, allowing for growth and processing to occur. It allows us to connect to our subconscious. It also opens up a “critical learning period,” wherein new connections and pathways are able to be established, changing how we think about the world, or ourselves, or both. It allows us to change our thought patterns and create new associations. It is very participant driven as far as pace and direction. As psychedelic therapists, we say we walk alongside you on your journey. It is non-directive, meaning we will not guide the process or redirect the path.

Insurance does pay for the medication evaluation and the therapy before and after your ketamine journey. It does not pay for the ketamine journey itself.

Ketamine is an FDA approved drug. The use of ketamine in this context – for treating depression, anxiety, trauma and others, is not approved by the FDA.

You may want to explore Spravato (esketamine). This is an intranasal medication that uses one isomer of ketamine (S isomer, versus both S and R isomer in intramuscular / IV ketamine). Spravato does not achieve psychedelic effects or dosing, and is not used in conjunction with a guide or with therapy. It is used alongside antidepressants, and is expected as a maintenance (ongoing) medication.