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 and adrenaline release as well as 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) are 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, 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 with pediatrics as an anesthetic). It is not safe, in this setting, for persons with history of uncontrolled high blood pressure, myocardial infarction (MI), stroke, or aneurism because it can raise blood pressure. It is also not generally used with clients who are currently experiencing mania (e.g. bipolar I disorder) or thought disorders (i.e. schizophrenia) as more research is needed this item.

At Vitality we offer KAP using intramuscular (IM), Oral, or Sublingual administration of ketamine. This allows us to customize your treatment and dosage based on your symptoms and your chemistry (how you metabolize and respond to the medication).

During your KAP treatment, if your medications require adjustment we will collaborate with your current provider and prescribe the medications if needed (with the exception of 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 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 you are engaged in counseling prior to 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) synaptic branching or neuroplasticity 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 increases the likelihood of long-term symptom reduction and relief.

KAP is not currently covered by insurance as it is considered an “off-label” (per the FDA) use contrary to a growing body of research and data supporting its efficacy. At Vitality, whenever possible, we will provide a super bill and you may be able to receive some reimbursement from your insurance company.  

Though you will be able to leave the clinic between 2-2.5 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 are undergoing KAP will need to 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 KAP sessions: $1350. Clients are reassessed after the initial 3 KAP sessions to determine whether additional sessions may be beneficial.
• 6 KAP sessions: $2700.
• Maintenance KAP session: $375. 
• 50-minute integration sessions: 
• For optimal benefits, we encourage weekly integration therapy post-KAP.
• Vitality provides a 10% discount for first responders (e.g. police, firefighters, EMS), healthcare providers, and veterans for KAP services.