KAP

Ketamine Assisted Psychotherapy

Ketamine is a medication that is commonly used as an anesthetic and pain reliever. It is also used off-label to treat depression, anxiety, and other mental health conditions. It was first developed in the 1960s and was primarily used as an anesthetic for animals and humans.

What is Ketamine and what is it used for?

Ketamine is known for its ability to induce a trance-like state, causing a feeling of detachment from one’s surroundings and a sense of disconnection from one’s body. In recent years, ketamine has gained attention for its potential therapeutic use in treating mental health conditions such as depression, anxiety, and post-traumatic stress disorder (PTSD).

The exact mechanism of how ketamine works to alleviate symptoms of these mental health conditions is not fully understood, but it is believed to involve the modulation of the brain’s neurotransmitter systems.

How does Ketamine work?

Ketamine works by blocking the action of a neurotransmitter called glutamate, which is involved in many brain functions, including mood regulation. By blocking glutamate, ketamine can help increase the levels of another neurotransmitter, called serotonin, which is often low in people with depression and anxiety.

Ketamine works by blocking the action of the N-methyl-D-aspartate (NMDA) receptor, which is a type of glutamate receptor in the brain. By blocking this receptor, ketamine can produce a dissociative state and provide analgesia and anesthesia. However, the exact mechanism of how ketamine works in treating mental health conditions such as depression, anxiety, and post-traumatic stress disorder (PTSD) is not fully understood.

It is believed that ketamine’s effects on other neurotransmitter systems, such as the glutamate and GABA systems, may play a role in its antidepressant and anxiolytic effects.

What are the different ways to take Ketamine?

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Ketamine can be prescribed in several different ways. Ketamine is available in a lozenge (troche) form which is ingested orally and sits in the mouth of the patient without swallowing for about 10-12 minutes or as your provider prescribed. This allows the ketamine to be absorbed through the oral mucosa. Oral troches are mainly used in “Ketamine Assisted Psychotherapy” treatment courses where you are conscious and speaking to your mental health provider throughout the ketamine medicinal experience and receiving therapy simultaneously.

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Ketamine can also be administered through an IV pump. When ketamine is administered through an IV pump, the patient can expect to have more intensive/transformative experiences and may be unable to orally communicate or move while under the effects of the infusion during its peak time. An important note to remember is that when Ketamine is administered through an IV the provider is able to adjust the dosage in real time to get maximum benefits with minimal side effects. Please also note Ketamine infusions involve only one needle “stick” to start the IV. Ketamine infusions are the most popular given that they have “100% Bioavailability”. Bioavailability refers to how much medication is actually absorbed. This means that when you have an IV infusion of ketamine, your body and brain are getting the maximum benefit and absorption from the medication.

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Ketamine can be prescribed in a nasal spray form. When prescribed nasally, the patient will apply the prescribed amount of “sprays” in each nostril. Intranasal drug administration delivers drugs directly to the central nervous system, bypassing the blood brain barrier and is associated with a fast onset of action. This form of ketamine is also called “esketamine” or “Spravato” and it is the only form of ketamine that can be covered by insurance for treatment resistant depression (TRD). There are not many benefits of taking ketamine intranasally over the other available routes. The bioavailability of the nasal spray sits at about 48%. This means, when you spray the ketamine up each nostril, your brain/body is only absorbing about 48% of that medication each time, which may cause a need for increased dosages.

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The final way Ketamine can be administered is through an intramuscular injection. Intramuscular injections are not as popular as the oral or IV route and may require more than one needle stick during a single session. IM injections of Ketamine are usually given very carefully as once the injection is performed, there is no going back or reducing the dosage. Patients can find this experience extremely intensive with no way to counteract the ketamine from being in their system and they must let the medicine “ride it’s course”, the reported “comedown” on intramuscular injections takes longer than the oral, NI, or IV route. This means you may take longer to recover and feel back to normal or “baseline”.

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FAQs

How does Great Salt Lake Wellness administer/prescribe ketamine?

Great Salt Lake Wellness is happy to provide/prescribe our qualified patients with oral troches for Ketamine Assisted Psychotherapy. Our sister company, Affordable Ketamine Clinic is happy to provide Ketamine infusions to qualified patients. Great Salt Lake Wellness/Affordable Ketamine Clinic do not administer Intramuscular Injections.

Who qualifies for Ketamine Assisted Psychotherapy?

You may want to consider KAP therapy if you are someone who has treatment resistant depression (TRD) or if you have tried multiple antidepressant medications with unwanted side effects and experiences. KAP can also be used to treat patients with different anxiety disorders; generalized anxiety disorder (GAD), social anxiety disorder, and post-traumatic stress disorder (PTSD). KAP is also used in individuals to reduce cravings of unwanted or habit forming substances.

What does a Ketamine Assisted Psychotherapy session look like?

At Great Salt Lake Wellness we have providers who are specialized and specifically trained in Ketamine Assisted Psychotherapy. One of our highly skilled providers will prepare you for your Ketamine Assisted Psychotherapy treatment course by conducting an assessment to ensure you are eligible for the treatment before the medication is prescribed. After your KAP assessment, you will be referred to our prescribers who will do a medical evaluation to ensure you do not have any contraindications. The ketamine lozenges (troches) will be prescribed to a local compounding pharmacy that is most convenient for you. You can have the prescription mailed to you by the pharmacy or you may choose to pick up the medication.

You will bring your medication to each KAP session you have with your provider. Before taking the medication you will meet with your KAP provider 1-2 times to come up with a treatment plan that includes what intentions you have for KAP therapy and goals you want to work on. Our KAP providers are available to meet with your therapist as well to give you a cohesive and seamless treatment plan. Our KAP program provides you with 6 medicine sessions that are 3 hours long each. Within 24-48 hours of each medicine session you will have a 60 minute long integration session. This will occur for all 6 sessions. Typically patients complete the program within a 2-4 week window, following the FDA protocol. You can expect your provider to engage you in meditations, yoga, breath work, and intention setting to get you feeling grounded prior to taking the medication. Once the grounding work is complete, you will take your medicine orally. It can take about 10-20 minutes for the effects to kick in. For the first hour, you will typically be very “deep” in the medicine when it is at its strongest “peak”. Your KAP provider will be monitoring you the entire time. Once you are cognisant, your provider will talk with you about what your experience was like to gain a better understanding of any impressions, emotions, or thoughts that really impacted your experience. Ketamine is a fast acting antidepressant but patients should be aware that ketamine can bring up strong negative emotions or past trauma that may feel upsetting. Your KAP provider is there to help you work through any difficulties you may have in your medicine or integration session.

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Ketamine is a very powerful and amazing medicine that allows our brains to see things from a different perspective and it can help you feel different about yourself, your peers, and the world wholeheartedly. It can also help you with negative core beliefs you may be sitting with or any “stuck” points you have been dealing with.

Great Salt Lake Wellness is here to help you each step of the way. Please contact us to set up an appointment with one of our KAP providers.

KAP