ketamine treatment

Transforming lives & restoring hope

Up to half of all people with depression are not adequately treated by conventional therapies, or cannot tolerate the side effects of antidepressant medications. Many continue to suffer from what is called treatment-resistant depression. Today, depression is the leading cause of disability in the world, underscoring the great need for better treatment options. Scientific studies done at the National Institute of Mental Health and academic centers throughout the world have found that over ⅔ of people have a successful response to ketamine infusions for treatment-resistant depression. A response is generally considered to be a 50% reduction in symptom severity as measured by depression rating scales. About ⅓ of people have complete remission of their depression. Studies also show that ketamine significantly improves suicidal thoughts. People who do respond to treatment with ketamine have rapid relief of their suffering, and often feel significant and long-lasting improvements in mood and well-being within hours to days.

Posttraumatic stress disorder (PTSD) causes significant morbidity and mortality (from suicide) globally and in the US. The lifetime prevalence of PTSD in the general population is approximately 5%. The incidence of PTSD is increased to approximately 20% among people who are exposed to neglect, abuse, violence, rape or military combat. Despite treatment with current standard medical treatment and psychotherapy, PTSD remains a severe and emotionally painful chronic illness in up to 40% of patients. As such, there is great need for more effective alternative treatments.Scientific studies have shown that single infusions of ketamine significantly reduce PTSD symptoms. Military trauma patients who received ketamine for pain control rather than morphine were 50% less likely to develop subsequent PTSD. Since ketamine also improves depression and suicidality which can often coexist with PTSD, many people find additional relief and have significant improvement in their lives. With the appropriate therapy, ketamine may act to temporarily break the negative thought patterns developed as a result of PTSD, allowing new and more healthy patterns to be built in their place.

Substance use disorders are a serious public health problem. Tobacco, a leading cause of cardiovascular disease and cancer, kills up to half of its users, or approximately 6 million people each year (~ 9% of all deaths globally). Alcohol accounts for over 3 million deaths every year (~6 % of all deaths globally). Alcohol abuse is also directly related to a range of mental health disorders, medical diseases and injuries. Half of all trauma is associated with alcohol, as are over 70% of all suicide attempts.Current treatments for substance use disorders are relatively ineffective. Medical treatment for tobacco use is less than 35% effective at 6 months. For alcohol addiction, the best medical treatment achieves abstinence in only 1 out of 9 patients treated. So despite receiving standard evidence-based treatment, the majority of people with addiction continue to suffer.Ketamine has been used in the treatment of addiction since the 1970´s in Russia. Studies with ketamine treatment followed by psychotherapy suggest that it may be more effective than other currently available treatment, with abstinence rates at one year up to 65% for alcohol and 50% for heroin. Ketamine also significantly improves depression which often coincides with addiction, thereby additionally improving the lives of those suffering from these disorders.


Chronic pain can be a severe and debilitating syndrome. It is often difficult to treat, and can be associated with comorbid depression and the development of substance use disorders. Many treatments such as opiates and anti-inflammatory drugs also have significant side effects. Ketamine has been found to be effective in many types of chronic pain.

Ketamine can play an important role in the treatment of anxiety disorders. Currently, people with anxiety disorders are treated either with an antidepressant, such as an SSRI (selective serotonin reuptake inhibitor), an SNRI (selective norepinephrine reuptake inhibitor), or highly addictive benzodiazepine such as Xanax, Ativan, or Klonipin.  Even when evidence-based nonpharmacologic therapies, such as cognitive behavioral therapy (CBT) or mentalization-based therapy (MBT) are utilized up to 40% of people do not respond to these treatments.Ketamine has been studied and shown [to be] effective with an array of anxiety disorders, including seasonal affective disorder (SAD), general anxiety disorder (GAD) and obsessive compulsive disorder (OCD).  Studies with ketamine have shown improvements in social/work functioning, dose dependent improvement in anxiety scores, and decreased frontal theta brain frequencies when compared to conventional anti-anxiety medications.  In one study, the benefits of a single infusion lasted for 14 weeks (Glue et. al, J Psychopharmacol. 2018)

We follow the ketamine treatment protocol that has been studied most in the treatment of depression. This is commonly referred to as the National Institute of Mental Health (NIMH) protocol. Depending on the condition, we may tailor the treatment to your specific needs. The ketamine treatment takes about an hour. When you arrive, your vital signs will be checked, and an IV will be placed. Ketamine is then administered intravenously slowly over 40 minutes. After about 20 minutes, you may notice changes in your perception, altered thought patterns, and the feeling of being in a dream-like state. By the end of the 40 minutes you may feel a sense of being outside of your body. Most people describe the experience as pleasant or euphoric. You will be awake, but people often find it challenging to communicate. We recommend resting comfortably with eyeshades and calming music of your choice.

Up to half of all people with depression are not adequately treated by conventional therapies or cannot tolerate the side effects of antidepressant medications. Many continue to suffer from what is called treatment-resistant depression. Today, depression is the leading cause of disability globally, underscoring the great need for better treatment options. Scientific studies done at the National Institute of Mental Health and academic centers worldwide have found that over ⅔ of people have a successful response to ketamine infusions for treatment-resistant depression. A response is generally considered to be a 50% reduction in symptom severity as measured by depression rating scales. About ⅓ of people have complete remission of their depression. Studies also show that ketamine significantly improves suicidal thoughts. People who respond to treatment with ketamine have rapid relief of their suffering and often feel significant and long-lasting improvements in mood and well-being within hours to days.

Post-traumatic stress disorder (PTSD) causes significant morbidity and mortality (from suicide) globally and in the US. The lifetime prevalence of PTSD in the general population is approximately 5%. The incidence of PTSD increases to approximately 20% among people exposed to neglect, abuse, violence, rape, or military combat. Despite treatment with current standard medical treatment and psychotherapy, PTSD remains a severe and emotionally painful chronic illness in up to 40% of patients. As such, there is a great need for more effective alternative treatments. Scientific studies have shown that single infusions of ketamine significantly reduce PTSD symptoms. Military trauma patients who received ketamine for pain control rather than morphine were 50% less likely to develop subsequent PTSD. Since ketamine also improves depression and suicidality, which can often coexist with PTSD, many people find additional relief and have significant improvement in their lives. With the appropriate therapy, ketamine may act to temporarily break the negative thought patterns developed as a result of PTSD, allowing new and more healthy patterns to be built in their place.

Substance use disorders are a serious public health problem. Tobacco, a leading cause of cardiovascular disease and cancer, kills up to half of its users, or approximately 6 million people each year (~ 9% of all deaths globally). Alcohol accounts for over 3 million deaths every year (~6 % of all deaths globally). Alcohol abuse is also directly related to a range of mental health disorders, medical diseases, and injuries. Half of all trauma is associated with alcohol, as are over 70% of all suicide attempts. Current treatments for substance use disorders are relatively ineffective. Medical treatment for tobacco use is less than 35% effective at six months. For alcohol addiction, the best medical treatment achieves abstinence in only 1 out of 9 patients treated. So despite receiving standard evidence-based treatment, most people with addiction continue to suffer. Ketamine has been used to treat addiction since the 1970s in Russia. Studies with ketamine treatment followed by psychotherapy suggest that it may be more effective than other currently available treatments, with abstinence rates at one year up to 65% for alcohol and 50% for heroin. Ketamine also significantly improves depression which often coincides with addiction, thereby improving the lives of those suffering from these disorders.

Chronic pain can be a severe and debilitating syndrome. It is often difficult to treat and can be associated with comorbid depression and the development of substance use disorders. Many treatments, such as opiates and anti-inflammatory drugs, also have significant side effects. Ketamine has been found to be effective in many types of chronic pain.

Ketamine can play an essential role in the treatment of anxiety disorders. People with anxiety disorders are currently treated either with an antidepressant, such as an SSRI (selective serotonin reuptake inhibitor), an SNRI (selective norepinephrine reuptake inhibitor), or highly addictive benzodiazepine such as Xanax, Ativan, or Klonipin.  Even when evidence-based nonpharmacologic therapies, such as cognitive-behavioral therapy (CBT) or mentalization-based therapy (MBT), are utilized, up to 40% of people do not respond to these treatments. Ketamine has been studied and shown [to be] effective with an array of anxiety disorders, including seasonal affective disorder (SAD), general anxiety disorder (GAD), and obsessive-compulsive disorder (OCD).  Studies with ketamine have shown improvements in social/work functioning, dose-dependent improvement in anxiety scores, and decreased frontal theta brain frequencies compared to conventional anti-anxiety medications.  In one study, the benefits of a single infusion lasted for 14 weeks (Glue et. al, J Psychopharmacol. 2018)

Bipolar disorder can be a debilitating and difficult to treat illness. Similar success rates are observed for treating bipolar depression as those with unipolar depression. Scientific studies done at the National Institute of Mental Health and academic centers worldwide have found that over ⅔ of people have a successful response to ketamine infusions for bipolar depression. A response is generally considered to be a 50% reduction in symptom severity as measured by depression rating scales. About ⅓ of people have complete remission of their depression. Studies also show that ketamine significantly improves suicidal thoughts. People who respond to treatment with ketamine have rapid relief of their suffering and often feel significant and long-lasting improvements in mood and well-being within hours to days. Although ketamine does not cause or precipitate hypomania or mania, people in a current manic phase of bipolar disorder should not take ketamine as it could temporarily exacerbate those symptoms. How long the treatment effects last depends on the individual. Clinical experience suggests that the impact of the recommended entire course of 6 infusions usually lasts from weeks to months. It has been observed that people with a family history of alcohol abuse have much longer-lasting effects. This benefit can be sustained by doing a single booster infusion as needed and determined by your individual response. Some people even find that they no longer need to take antidepressants. To solidify the gains you have from your treatment and ensure long-lasting success, it is essential to continue seeing your primary physician or mental health care provider.

methods of administration

Intravenous Infusion is the most common method for administering ketamine. A catheter is inserted into the patient’s vein and a small amount of ketamine is delivered directly into the bloodstream. A treatment session takes place in a tranquil environment with dim lighting; an experienced medical professional is available to monitor the patient and adjust their dosage as needed.

Intramuscular (IM) injections are administered into the thick muscles of your arm, hip, thigh, or buttocks. We seldom use this route of administration for several reasons. Absorption into the bloodstream is unpredictable. It is difficult to adjust the dose once administered - once injected into the muscle, you can't take it away. Also, the duration of the "ketamine experience" is quite variable from person to person. With those caveats in mind, Dr. Rosen has been using IM ketamine in the emergency setting for 20+ years and will do so in the clinic in selective cases - for those with no IV access or who are severely needle-phobic.

Ketamine can be administered orally by taking a lozenge. The patient places a ketamine lozenge under their tongue and allows it to dissolve for ten to fifteen minutes. Lozenges are an inexpensive addition to infusions as they don’t require specialized equipment or a physician trained in anesthesiology. With the permission of a doctor, patients may even administer the treatment themselves. Lozenges may be used to supplement IV infusions, prolonging their effects and increasing the time between “booster” sessions.

PLEASE BE ADVISED: AS KETAMINE IS A CONTROLLED SUBSTANCE, WE CANNOT REFILL/MODIFY PRESCRIPTION SCHEDULES AHEAD OF REFILL DATES WITHOUT AN APPOINTMENT/CONSULTATION.

Ketamine-Assisted therapy

Blue Sky Ketamine is working with Santa Fe Psychotherapy & Consulting, LLC to provide ketamine-assisted psychotherapy (KAP). This type of therapy is a unique therapeutic method used to address various mental health conditions, including depression, post-traumatic stress, chronic pain, obsessive-compulsive disorders, and addiction. It involves using ketamine to enhance and deepen the therapeutic process and the use of psychotherapy and other integrative forms of treatment to amplify and prolong the curative effects of ketamine. In low doses, ketamine can serve as a supportive adjunct to psychotherapy. It provides an opportunity to temporarily soften the psychological defenses, allowing for deeper self-reflection and psychotherapeutic processing. In moderate doses, ketamine has psychedelic effects, which have been shown to facilitate profound transpersonal experiences. These types of experiences can help people in a variety of ways, offering important clarity and insight into one’s struggles, adding a spiritual dimension to ongoing therapeutic work, and facilitating a sense of meaning and interconnectedness.

Santa Fe Psychotherapy & Consulting's therapeutic approach has been developed in accordance with the Psychedelic Assisted Therapy model standards of the Multidisciplinary Association of Psychedelic Studies (MAPS) and in consideration of the Ketamine-Assisted Therapy model of Sage Institute.

We will start with a formal intake in which you describe your symptoms, define the issues or concerns you want to address, and determine whether ketamine-assisted psychotherapy might benefit you. If so, you will meet with one of the Santa Fe Psychotherapy & Consulting therapists for a few preparatory sessions before meeting with our prescribing physician, Dr. Rosen, for an initial consultation and with a psychiatrist on a case-by-case basis for a psychiatric assessment. If you qualify for the program after the intake, you will continue to work with your therapist to prepare for your KAP session. There will be a minimum of three preparatory sessions before your first KAP session. In some cases, more than three sessions may be essential to your treatment. In most cases, a series of ketamine infusions will be given to provide immediate relief of symptoms and to allow your system to become accustomed to the medicine.

Some medical and psychiatric conditions need to be treated before you can safely work with ketamine. These conditions include hallucinations, untreated mania, cardiovascular disease, uncontrolled hyperthyroidism, increased intracranial pressure, cystitis, or evidence of liver disease.

resources

  • Bloomberg Business Week
    Is ketamine the best hope for curing major depression?
  • CNN
    Ketamine offers lifeline for people with severe depression, suicidal thoughts
  • Harvard Medical School
    Ketamine for major depression: New tool, new questions
  • The New Yorker
    Ketamine Therapy is Going Main Stream. Are We Ready?
  • The New York Times
    Can We Stop Suicides? It’s been way too long since there was a new class of drugs to treat depression. Ketamine might be the solution.
  • The New York Times
    The Ketamine Cure. The once-taboo drug has been repurposed to treat depression and is even available for delivery. But how safe is it?
  • Oxford Academic
    Racemic Ketamine as an Alternative to Electroconvulsive Therapy for Unipolar Depression: A Randomized, Open-Label, Non-Inferiority Trial (KetECT)
  • Scientific American
    Rave Drug "Special K" Holds Promise for Treating Depression Fast
  • Time
    New Hope for Depression
  • The Verge
    The FDA approved a new ketamine depression drug — here’s what’s next.
  • Vox
    I tried ketamine to treat my depression. Within a day, I felt relief.
  • Wired
    Ketamine Stirs Up Hope—and Controversy—as a Depression Drug
  • Consciousness Medicine
    Consciousness Medicine: Indigenous Wisdom, Entheogens, and Expanded States of Consciousness for Healing and Growth | Author Françoise Bourzat
  • Food of the Gods
    The Search for the Original Tree of Knowledge : A Radical History of Plants, Drugs, and Human Evolution |  Author Terence McKenna
  • How to Change your Mind
    What the New Science of Psychedelics Teaches Us about Consciousness, Dying, Addiction, Depression, and Transcendence | Author Michael Pollan
  • Freethink
    I Use Ketamine for Depression - Here’s How It Works
  • MedCircle
    Here's How Ketamine Actually Works as a Treatment
  • MedCircle
    What It's Like to Do Ketamine Treatment for Depression
  • Medscape
    Is Ketamine Living Up to the Promise for Depression?
  • Ted Talk
    The future of psychedelic-assisted psychotherapy | Rick Doblin
  • Vice
    The Experimental Ketamine Cure for Depression
  • Yale Medicine
    Ketamine & Depression: How it Works - Yale Medicine Explains
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