Ketamine is medicine prescribed to you by a doctor or nurse practitioner. I have a wonderful provider that I work in partnership with to provide with the best care. Once we make the decision to begin KAP you will be directed to the provider for a medical intake and prescription.

Ketamine is now an “off-label” treatment for various chronic “treatment- resistant” mental conditions. Ketamine is a Schedule III medication that has long been used safely as an anesthetic and analgesic agent. Also, it is now often used effectively for treatment of depression, addiction, PTSD, chronic pain, and other psychiatric diagnoses as well as for existential, psychological, and spiritual crises and growth.

The current and most probable understanding of ketamine’s mode of action is as an NMDA receptor antagonist (inhibitor) working through the glutamate neurotransmitter system. This is a different pathway than that of other psychiatric drugs such as SSRIs, SNRIs, anti- psychotics, benzodiazepines, etc.

Ketamine is classified as a dissociative anesthetic, meaning one can dissociate or disconnect from one’s ordinary reality and usual self. At the dosage level administered to you, you will most likely experience mild anesthetic, anxiolytic, anti-depressant, and, potentially, transformative or psychedelic effects.

Recent work has demonstrated the possibility of an antidepressant response to low doses of ketamine administered intravenously, intramuscularly (IM), intra-nasally and sublingually (orally) that produce minimal psychedelic effects. This effect tends to be cumulative or more sustained with repeated use. It is our view that the psychedelic or dissociative experiences may well be instrumental in providing a more robust effect. This may well include a positive change in outlook and character that we term a transformative response. We employ only the sublingual modalities.

Essential to all methods are “time-outs” from usual experience and vary in duration, usually between 20 minutes to 2 hours. This tends to be dependent on dose and route of administration. Relaxation from ordinary concerns and usual mind, while maintaining a conscious awareness of the flow of mind under the influence of ketamine, is characteristic. This tends to lead to a disruption of negative feelings and obsessional preoccupations.

It is our view that this relief and the exploration of other possible states of consciousness are impactful. I will be acting as a guide to the experience to help you process before and after the sessions.

Your experience will be unique to you. If we decide to have additional sessions, each of your sessions will be different. There is however, no way for us to predict the effect or to guarantee a response. The number of sessions varies based on personal needs and treatment responses. We cannot pre-program your experience. I will do my best to give a prognostic view as I learn with you how ketamine affects you.

All ketamine journeys are adventures and can vary in intensity. They evolve from your own being in relation to the substance. While it is best to form an intention for your journey, you may or may not be able to hold onto that. Indeed, not holding on is best and the journey will flow whether or not you hold on and resist. Relax into it, trust the process and follow the path that unfolds before you. Breathe deeply and surrender softly into the experience. Holding on too tightly is the main source of anxiety. A ketamine session can be light, dark, or both. There will be concepts, visions, encounters, and you may well deal with your own death, mortality and immortality. Some journeys are enjoyable and filled with awe and some are difficult, but everyone grows from their experience.

A sublingual ketamine lozenge is a small tablet that dissolves under the tongue, allowing ketamine to be absorbed directly into the bloodstream for faster effects than oral pills. In our sessions, I will guide the process, ensuring the correct dose and supporting you throughout. This method is convenient, non-invasive, and designed to be safely incorporated into a structured, professionally supervised treatment plan.

I will generally begin treatment with you by assessing responsiveness to the lozenges. This enables us to make a decision about the effectiveness of the lozenge and to adjust the dose.

Clients can expect to experience a range of benefits, including:

• Profound shifts in perspective on self, relationships, and worldview

• Decrease in negative or obsessive thoughts and negative self-talk

• A more positive outlook on challenging life situations and relationships

• Increase in self-esteem and self-compassion

• Enhancement of creative problem-solving abilities

• Greater motivation for lifestyle or behavior changes

• Relief from existential distress

• A “time out” from ordinary mind and reality

• Potential of having a spiritual or mystical experience

The literature indicates a response rate to treatment-resistant depression of 40-50%. This information is coming primarily from using the low-dose IV drip method. Relapses do occur and may require periodic additional sessions. Over time, a certain small number of clients may become unresponsive to further ketamine sessions.

Ketamine is generally safe when used in a supervised therapeutic setting. Some people may experience temporary effects such as nausea, dizziness, changes in perception, altered sense of time, or a floating sensation. Vision, balance, and coordination can also be affected, so you’ll remain safely monitored during the session and will need a ride home afterward.

Serious side effects are rare in clinical practice. Long-term, high-dose use outside of a supervised setting can affect bladder function or memory, but this is not a concern in our therapy sessions. Psychological experiences can sometimes feel intense or unusual, but I will guide you in making these experiences meaningful and supportive of your healing process.

Medical History

Chronic Medical Conditions:

• Severe cardiovascular issues: Uncontrolled hypertension, Heart disease, Certain arrhythmias (abnormal heart rates)

• Respiratory Disorders that may be exacerbated by ketamine: Advanced COPD, Untreated asthma, Sleep apnea, Pulmonary hypertension, Aspiration risk, Lung infections or pneumonitis, Interstitial lung disease

• Liver or kidney disfunction 

Neurological Conditions:

• History of seizures or epilepsy

• Significant neurological disorders: Multiple sclerosis, or Traumatic brain injury

Substance Use Disorders

• Current substance use disorder that may interfere with treatment

Mental Health Considerations

• Psychotic disorders -Active schizophrenia or other psychotic disorders

• Manic Episodes - A current manic episode in individuals with bipolar disorder.

• Severe cognitive impairment - Conditions affecting cognitive function significantly, resulting in difficulty understanding or following treatment protocols

Current Medications

• Contraindicated Medications:

  • Use of certain medications that may interact negatively with ketamine (e.g. certain antidepressants or antipsychotics).

  • Medications affecting mental status (e.g. sedatives or other CNS depressants or antipsychotics)

Psychological Readiness

• Suicidal Ideation – active suicidal thoughts or intent that are not adequately managed prior to therapy

• Inability to engage – individuals who are not psychologically prepared to participate in group therapy or who may react negatively to group dynamics

Safety and Ethical Considerations

• Pregnancy and Nursing – pregnant or breastfeeding individuals, as the effects of ketamine on the fetal development or nursing infants is not fully understood

• Informed Consent – Inability to provide informed consent due to lack of understanding of the treatment process or the risks involved

• High Risk of Adverse Events – individuals with a heightened risk for adverse reactions to ketamine due to personal or family medical history

Other Considerations:

• Recent Substance Use – individuals who have used recreational drugs shortly before the session

• Non-Compliance – History of non-compliance with treatment protocols or failure to attend prior sessions

• Logistical Issues - Inability to reliably attend sessions due to transportation, scheduling conflicts, or other logistical barriers

Ketamine does have some potential for abuse because it can affect mood, thinking, and perception. Recreational misuse has been reported, but in a clinical setting, risks are minimal. Supervised use with controlled dosing, education on responsible use, and close monitoring make abuse or dependence very unlikely. Ketamine should only ever be used under the guidance of a licensed healthcare professional.

For new clients, a minimum commitment of six sessions is recommended to ensure sufficient exposure to the ketamine lozenge method and to support meaningful therapeutic progress. I will work with you to tailor the number and spacing of sessions to your individual needs.

Routes of administration of ketamine include intravenous, intramuscular, intranasal, and sublingual. I use a sublingual ketamine lozenge method.

Although I am not able to provide intramuscular sessions, the purpose of the intramuscular ketamine experience is to create a non-ordinary or altered state of consciousness in order to facilitate a profound and transformative experience. This experience has been described at times as ‘transcendent”, “mystical”, “spiritual” or a “peak” experience. It has also been referred to as an “epiphany.” This may prove to be auspicious in resolving your existential problems, shifting your relationship to your suffering, accelerating your psycho-spiritual growth, and leading to a deep personal transformation and optimization of your lifestyle. Such change is best facilitated within a structured supportive environment in connection with clinicians who have a view of your struggles, issues, hopes and desires. As a byproduct of your experience, you may well feel improvement in your emotional state and reduction in symptoms that bother you such as depression, anxiety, and post- traumatic manifestations. You may well notice that you are a bit different after a ketamine experience and that difference may well be liberating and allow for new mindfulness and new behavior.