Ketamine Assisted Therapy
The Combined Approach to Better Mental Health
Like all medicines, Ketamine therapy is a treatment, not a cure. At Altasano, we believe that along with psychotherapy and mindfulness training, Ketamine is simply another tool that can be used in the fight against depression.
At Altasano, our practice model follows a combined approach. While the ketamine we administer stimulates neurochemical pathways, your therapist helps guide you through the experience to gain meaning and insight.
What to Expect
Your safety is our primary concern. Ketamine infusions are administered in collaboration with your Primary Physician, Psychiatrist or Psychiatric Nurse Practitioner. We collaborate closely with your own mental health provider and require you to have one throughout treatment. From our perspective, collaboration is critical for your over-all mental and physical health.
This will be an initial evaluation appointment. Prior to your first infusion appointment, we will perform a medical history review. We will ask you to fill out a medical release so we may consult with your physician or psychiatrist. We will then determine if you are a good candidate to proceed with ketamine therapy. The initial consultation can be completed over the phone to help expedite your treatment.
If our team finds that you are a candidate for ketamine infusions you will be able to schedule your 6 initial infusions. Ideally these will fall within a two-week period.
Unfortunately, ketamine infusions are not covered by insurance carriers yet. Until this happens, ketamine treatments are considered an out of pocket expense. You may be able to recover some out-of-pocket expenses. Some insurances cover the cost of psychotherapy before and after the infusions.
Each patient is responsible for submitting their own claims to their insurance company. Altasano can help facilitate this process by providing you with a detailed superbill receipt.
Payment for the infusions can be made at each of the 6 appointments or up front for the entire series. The cost of each infusion is $350.
- Infusion cost includes every aspect of treatment, no added costs.
- We provide a detailed invoice (“superbly”) for submission to your insurance for plan approved reimbursement.
- We accept all major credit cards and cash. No checks accepted.
You will not have any activity restrictions immediately after the treatment, except for driving. Expect to spend about 2 hours at each visit. Please arrange to have a friend or family member drive you home.
Do not eat food or drink anything that has milk in it at least 6 hours prior to your scheduled time. You may drink clear liquids (i.e. water) up to 2 hours prior to your infusion. Please avoid caffeine/nicotine (cigarette/vape) 4 hours prior to your scheduled time. Some people find that good hydration and “clean” eating (minimal processed foods) several days prior to the ketamine infusion helps improve well-being during the process.
Take your normal medications at your regular time on the day of your infusion. We will go over your medications during the initial evaluation.
Bring a valid ID to your first treatment.
Allow yourself 2 hours for the ketamine infusion. Your treatment will start in a quiet, private room that allows you to be free from interruption or exposed to external stimulation. At your first treatment visit, we will again go over the treatment plan and goals, review the risks and benefits of the procedure, and answer any further questions you may have. We will assess your vital signs and then start your IV.
Once the IV has started, your perceptions will change and your sense of your body may alter. You will be with a board-certified registered nurse anesthesiologist while you undergo your infusion. You will not be alone. You will be monitored through the experience. We will seek to maximize the benefits of the inner experience, while at the same time ensure that you are safe.
The ketamine infusion is administered over 40-60 minutes. We have eye shades to minimize external visual input, if you choose. Free Wi-fi, snacks/drinks, and seating are available for loved ones who accompany you.
After the ketamine infusion, plan to rest about 30 minutes post treatment.
For those who respond to Ketamine, the effect is usually noticed within the first few hours of receiving the first IV treatment. 6 treatments are typically done in a two-week time period. After the initial infusions, a booster treatment may be necessary 6-8 weeks later, and then every 6 months or so. It is normal to feel tired the day of treatment, so no driving or operating heavy equipment for the remainder of the day. You’ll need a friend or family member to drive you home.
We expect that you will be able to eat normally but use common sense. Stick with foods that are good for you. Avoid alcohol. Take your normally scheduled medicines. The average person needs a Ketamine infusion booster every 2 to 3 months for continued relief.
Go to the ER if you experience chest pain, hives, shortness of breath, increasing weakness or swelling of your IV site with redness.
Ketamine can help with…
Attention on ketamine in the treatment of severe treatment resistant depression, PTSD, postpartum depression, severe anxiety, and other mental health conditions, has made the pharmaceutical industry rethink its focus on traditional antidepressant medications. Although traditional medications have helped many people, for others, they just don’t work. Worse yet, suicidal ideation is a known side-effect of SSRIs, especially on younger populations.
Ketamine inhibits the N-methyl D-aspartate (NMDA) receptor in our central nervous system. This receptor is activated by a neurotransmitter called glutamate. Glutamate is found at excessive levels with stress, depression, and certain pain conditions. Blocking the effects from this excess can help alleviate symptoms.
Ketamine is a drug that has been used for over 50 years, traditionally as an anesthetic by anesthesia providers, emergency physicians and surgeons. In 1985, the World Health Organization added Ketamine to its list of essential medicines. In 1990’s, Yale University began studies on Ketamine and it’s use in psychiatry. In 2006, ketamine began being studied in its effects on treatment-resistant depression. A 2009 study of ketamine conducted by Price, Charney, Knock, and Matthew, showed a correlation between ketamine and the alleviation of depressive symptoms as well as a reduction in suicidal thoughts. Current studies are showing beneficial effects in other psychiatric disorders such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), anxiety, and alcohol/substance abuse.
Yes, Ketamine is safe when used responsibly. Ketamine does not slow down vital bodily functions such as respiration rate. Ketamine can increase blood pressure and heart rate for some patients, but this is a very temporary and transient effect. Like so many drugs, Ketamine has also been abused. We collaborate closely with your own mental health provider and require you to have one throughout treatment. Comprehensive centers, like Altasano, place a priority on your bodily health and as well as your mental well-being. LEARN MORE
Insurance companies do not pay for medications that are given for “off-label use”. Research on Ketamine in the early 1960’s led to the FDA approval of Ketamine for anesthetic use. Further research on Ketamine in the 1990s began to focus attention on its therapeutic benefits on the treatment of depression and chronic pain. “Off-Label” use of a medicine is legal, but because Ketamine is being used for something else other than what it was originally studied to do, insurance does not cover the cost. Many studies are underway, but currently the FDA has not approved Ketamine for the treatment of depression.
IV Ketamine therapy remains the gold-standard of TRD treatment, however the FDA is expected to approve Johnson & Johnson’s esketamine nasal spray that will be marketed as Spravato. The drug is basically one half of the original ketamine molecule. The attempt was to split the drug to remove the psychedelic effects of the medicine. We understand that the concept of a transcendental experience is not part of mainstream Western medicine, but it is a part of our culture. We feel that the transcendental experiential effects of a ketamine infusion is an essential part of the treatment. The nasal delivery of the drug is certainly more desirable, however it may not be as effective, as dosing and absorption will be less precise. Studies are showing that this nasal spray form of the drug is not as potent as the IV form of Ketamine. The benefit of FDA approval of esketamine is that insurance companies may cover its higher cost, estimated to be $590-885 per dose. Spravato will not be dispensed to patients to take home like ketamine trouches. It will only be available in approved and certified treatment centers.
At Altasano, ketamine infusions are administered through an IV, with an infusion pump over 40-60 minutes. Intramuscular ketamine is a popular route of administration for those who may not be as comfortable with IVs, however receiving ketamine IM, means that the dosing and effect is less predictable and it cannot be stopped. Once an IM dose is given, the drug must take its course. Whereas, with an IV route, the infusion can be given slowly and the effects can be dealt with gradually. The IV can also be stopped at any time.
For those who find traditional antidepressants ineffective, the recommended initial “Induction Series” of six low-dose ketamine infusions is administered in an effort to break the cycle. Most clinical trials have consistently shown a 70% success rate with this approach. The treatment does require booster infusions as time passes to keep the effect going. These single “booster infusions” are given at varied intervals for the same 40-60 minute duration, but are single infusions rather than in a series. However, at Altasano, depending on your experience while receiving a ketamine infusion for TRD, we may progressively increase or decrease the doses outside of the “NIH Protocol” in order to optimize the experiential therapeutic effect of Ketamine.
Studies have shown that at infusion doses and frequency, Ketamine is not addictive. The drug itself does not cause physiological “addiction” but, people can become habituated to the experience.
Less than 2% of people will experience side effects. However, some common side effects are: drowsiness, nausea, dizziness, poor coordination, blurred vision, and feeling strange or unreal. Most of these symptoms go away within an hour of the infusion
Anyone with a history of uncontrolled high blood pressure, heart disease, kidney disease, a history of psychosis, or bipolar disorder, history of failed Ketamine infusion treatment, current substance abuse or dependence (patients will undergo a screening process) will not qualify for Ketamine infusion treatments. People with a history of interstitial cystitis (bladder inflammation) will require further screening and preparation.
Unfortunately, there are no predictors for the duration of antidepressant effect after the initial loading series. Everyone is different. The studies show that the variance can be 2 weeks to indefinitely.
Unfortunately, we cannot give guarantee that this will work for you. Studies have shown that 70% of people with Treatment resistant depression will find relief. After the first 3 infusions, if you are not experiencing any improvement, we will work with you on staying the course, increasing the dosage of the infusion, or decide to stop the series.
Yes. You can and should continue to take your prescribed medication. Though some people find that they can reduce their prescription meds or eliminate some altogether, it can be dangerous to stop taking your medications without the care of your doctor or therapist. People have the best outcomes when they combine ketamine infusions with psychotherapy.