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. 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 modalities KAP is not a magic bullet, 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.
Ketamine is believed to have a unique mechanism of action (MOA). Unlike the majority of psychotropic medications available in the United States, ketamine has been found to 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 as it also targets pain brain cell receptors. Research for how, what (e.g. other conditions), and why ketamine helps with these conditions is the focus of ongoing research.
Betterment utilizes approaches very similar to the 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) 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 of psilocybin and MDMA for clinical use. Betterment incorporates techniques (e.g. attention to music, setting/environment, eye covers, integration, etc.) used in psychedelic-assisted psychotherapy.
Most clients experience a reduction in anxiety and a meditative or trance-like state with lower doses of ketamine; in moderate doses the experience is more transformative or consciousness expanding (entheogenic), and in higher doses (commonly used for anesthesia) there is lack of consciousness or awareness. For many clients, a transformative experience results in a stronger sense of connection compared to pre-treatment a renewed sense of connectedness. With integration [therapy] work, KAP can be a catalyst for improved well-being. KAP requires low to moderate doses of ketamine based on individual client needs and each person’s unique chemistry. Research continues with this “old” medication, however, its novel use continues to offer relief for many with treatment-resistant depression and trauma-related (PTSD) symptoms such as anxiety, hopelessness, disordered eating, and poor sleep. Please take a look at our FAQ below for more information and schedule a consultation to learn if KAP is right for you.
At Betterment, we offer KAP using intramuscular (IM) 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).
Ketamine is considered safe for most adult patients (and with pediatrics as an anesthestic). 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.
Though you will be able to leave the clinic between 2-3 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 are required before consideration for KAP.
*For optimal and long term benefits, we recommend weekly therapy for 8-12 weeks post-KAP with a knowledgeable integration therapist.