Ketamine Assisted Psychotherapy (KAP)

If you are unfamiliar with ketamine, here is a brief history of how and why it is being used for  Ketamine-Assisted Psychotherapy. Ketamine was invented in the 1960s and has traditionally been used in higher doses as an anesthetic (for surgery) with children and adults. It has also been used during war times on the battlefield as an effective analgesic (pain medication). In recent years, ketamine has been administered as an “off-label” treatment, per the FDA, for psychiatric conditions that have been resistant to currently available modalities such as medications and/or psychotherapy. 

Ketamine is believed to have a unique mechanism of action. Unlike the majority of psychotropic medications available in the United States, ketamine has been found to primarily target glutamate receptors, more specifically, N-methyl-D-aspartate (NMDA) receptors. Glutamate is an excitatory neurotransmitter associated with numerous neurological functions, including memory and learning; glutamate also moderates anxiety, adrenaline release, and aspects of sleep. Ketamine antagonizes or blocks glutamate receptor transmission. Ketamine is also being used in specialized medical settings for chronic and/or severe pain conditions. Research for how, what (e.g., other conditions), and why ketamine helps with these conditions is the focus of ongoing research.

For many, ketamine has been found to provide rapid, sometimes immediate relief of major depressive symptoms, including suicidal ideation; however, the degree and length of symptom relief is variable from patient to patient, with some requiring few doses and others needing maintenance administration to experience ongoing symptom relief and remission. As with other mental health modalities, KAP is not the ultimate "magic pill"; the client's ongoing personal work (e.g., lifestyle changes & ongoing integration therapy) is integral in the effectiveness of KAP and the duration of experienced improvements.  

iFusion and Vitality Wellness and Integrative Psychiatry utilize approaches very similar to those that are being and have been used in clinical trials of MDMA and psilocybin (e.g., Johns Hopkins studies) but with intramuscular (an injection into a muscle) or oral ketamine; there are no IVs, no tubing, nothing tethered to the physical body. KAP has been used internationally since the 1970s and has gained momentum in the U.S. by psychiatric providers and mental health clinicians over the last 10-15 years due in large part to research on psilocybin and MDMA for clinical use. Vitality incorporates techniques (e.g., attention to music, setting/environment, eye covers, integration, etc.) used in psychedelic-assisted psychotherapy.

Post-ketamine administration clients frequently report a calm, trance-like state, while others report a more expansive, non-physical experience. KAP requires subanesthetic ketamine dosages based on published research and individual clients’ unique chemistry. 

Research continues with this “old” medication; to date, researchers suggest ketamine offers symptom relief in treatment-resistant depression and trauma-related conditions (e.g. PTSD) such as anxiety, hopelessness, disordered eating, and poor sleep. 

Ketamine is considered safe for most adult patients and is used in pediatrics as an anesthetic. It is not safe, in this setting (psychiatric mental health), for persons with cystitis, acute substance use,  a history of uncontrolled high blood pressure, myocardial infarction (MI), cardiovascular disease, stroke, increased intracranial pressure, or aneurysm because it can raise blood pressure. It is also not generally used with clients who are currently experiencing hypomania, mania, or psychosis (e.g., bipolar I disorder) or thought disorders (i.e., schizophrenia), as more research is needed in these areas.

At iFusion, we offer ketamine infusions for depression and anxiety. Although IV ketamine can be used for ketamine-assisted psychotherapy, we use intramuscular (IM), oral, or sublingual administration of ketamine. This allows us to customize your treatment and dosage based on your symptoms and chemistry (how you metabolize and respond to the medication). A comprehensive psychiatric and medical assessment will be done before your session to determine if you are a good candidate for ketamine therapy and customize the route and dose that works best for your needs.

If you are currently working with a mental health provider (psychiatrist, psychiatric mental health nurse practitioner, counselor, or therapist), we encourage you to continue. We can provide ketamine therapy as a consultation service and collaborate with your current provider to enhance your treatment plan and goals. 

We also offer complete psychiatric mental health services under the guidance of our psychiatrist and psychiatric mental health nurse practitioner if you are in need.

During your KAP session, if your medications require immediate adjustment, we will collaborate with your current provider and prescribe medications if needed (except scheduled medications such as benzodiazepines or psychostimulants). 

After the initial 1—or 2-week KAP treatment sessions, you will resume working with your current psychiatric or mental health provider. You may find that occasional maintenance KAP treatments are helpful for continued symptom remission, in which case we would collaborate with your current or established psychiatric provider.

We strongly encourage all of our clients to continue therapy, whether they were engaged in counseling before KAP or not; integration (therapy) throughout and post-KAP is a critical part of this treatment modality. 

Additionally, ketamine continues to promote neuronal (brain cell) growth,  synaptic branching, and neuroplasticity 24-72 hours post-treatment, and therapy is strongly encouraged to maximize these new synaptic connections. 

Remember there is no "magic pill"; the combination of medication, including ketamine, with continued self-exploration and psychotherapy increases the likelihood of long-term symptom reduction and relief..

Intravenous ketamine infusions and ketamine-assisted psychotherapy are not currently covered by insurance as they are considered “off-label” (per the FDA) uses, contrary to a growing body of research and data supporting their efficacy. 

Though you will be able to leave the clinic between 2 and 2.5 hours after your scheduled KAP start time, you will not be permitted to drive post-KAP sessions. Transportation to and from the clinic on days you undergo KAP must be arranged in advance. You will be able to safely and legally drive the day following your KAP sessions and resume your normal activities. 

Psychiatric evaluation and medical record review for medical clearance (required): $300 

• 3 IV sessions: $1350. Clients are reassessed after the initial 3 IV sessions to determine whether additional sessions may be beneficial.
• 6 IV sessions: $2550
• Maintenance IV session: $495. 
• Brief pre- and post-integration sessions.
• For optimal benefits, we encourage you to see your therapist or counselor within 24-72 hours after an IV ketamine or KAP session.
• Vitality provides a 10% discount for KAP services for first responders (e.g., police, firefighters, EMS), healthcare providers, and veterans.