What is Ketamine?

Ketamine is a generic dissociative medication that has a 50 year history of safe use as an anesthetic agent in medical procedures. Recently, ketamine has shown to have great promise as an off-label treatment for Treatment Resistant Depression (TRD), PTSD, OCD, drug and alcohol addiction, and other psychiatric diagnoses. The doses used in psychiatry are a fraction (10-25%) of the doses used in anesthesia procedures.

Frequently Asked Questions about Ketamine Therapy

‌Ketamine Assisted Psychotherapy (KAP) at Wholeness Health

Wholeness Center has been a national leader in the ketamine field for many years. Wholeness was one of the first to offer ketamine-assisted psychotherapy and the use of multiple modalities for treatment. We are the only facility in the region to offer the combination of psychiatric evaluation and psychotherapists trained in this modality. Wholeness Center is the only program in the state of Colorado that employs all four modalities of ketamine use: IV, IM, SQ and oral. We rarely use the nasal inhaler method because of unpredictable response and excessive cost We do not believe in the infusion only model of care, although that can be somewhat cheaper in the short-run. Over time, our providers have found that the benefits of the infusion only method do not seem to endure. We have found that integrating the powerful insights from the ketamine experience with talk therapy are necessary to make lasting behavior and personal changes.

At Wholeness we use the psychedelic psychotherapy format with selected music, headphones and eyeshades to deepen the inward journey and enhance the power found in this medicine. Sessions last about two hours and almost everyone finds the experience positive and helpful for the challenges they face. Over the last ten years we have witnessed an explosion of research that documents the benefits of ketamine for depression, trauma, OCD, addiction and other mental health challenges. Studies document that even treatment resistant depression with many failed courses of therapy and medications responds to ketamine, often very quickly. We think of it as a way to catalyze the benefits of psychotherapy by reducing our defensiveness and sensitivity while enhancing our ability to see our life in a new perspective. As evidence of this, multiple studies now document that ketamine typically eliminates suicidal ideation within hours.

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‌Ketamine Treatment Options at Wholeness Center

Sublingual (oral solution)

Sublingual (Oral Lozenges)

Oral: This method involves holding a ketamine solution in your mouth for 10 to 12 minutes while it is absorbed. Is similar to the lozenge method, but you do not need to wait for the lozenge to dissolve. Forewarning: this solution tastes like medicine, but it can be improved with a small amount of juice. The oral method comes on the slowest and can linger on for a few hours after the session. It is the gentlest form and can be dosed quite low to help with adjustment to this new form of psychotherapy. The oral method has the highest risk of nausea, but this can be reduced by spitting out the solution after the absorption period.

Offered by trained Ketamine Assisted Psychiatrists and Psychotherapists

Intramuscular or Subcutaneous Injections (IM/SQ)

Intramuscular or Subcutaneous Injections (IM/SQ)

Intramuscular (IM) may be the most common route that we employ at Wholeness. This route uses an injection into the deltoid muscle of the arm. It is fast and intense with a powerful peak that occurs quickly. It is effective for breaking up old patterns of thought and experiencing full dissociation that pulls us out of our routine frame of mind and perspective. IM tends to have a clean finish with less side effects than any other method. As this method is the most intense we often will start with oral or SQ as they come

Subcutaneous (SQ) is a newer method that we have imported this technique from Australia, where it is much more commonly used. This involves the injection of a small amount of liquid under the skin of the arm. It is absorbed more slowly than the IM method and offers a gentler and more sustained experience that may lend itself to more time to process and explore in the altered-ketamine state. It tends to have less side effects than the oral method and may come on more predictably.

Offered by trained Ketamine Assisted Psychiatrists and Psychotherapists

Intravenous Line (IV)

Intravenous Line (IV)

Intravenous (IV) is the best established and most expensive route of administration. It requires an IV placed in the arm and close medical monitoring in a special treatment room. We have the ability to turn off the administration if the blood pressure gets too high or other side effects become a problem. We can also speed or slow the drip rate to accommodate personal preference or specific concerns. This method may get the most ketamine into the brain over the 40-minute administration. We generally recommend the IV route to the most severely depressed and suicidal patients.

Offered by trained Ketamine Assisted Psychiatrists and Psychotherapists

Ketamine May be the Right Medicine for You if:

  • ‌Prior psychiatric treatments or therapies have been unsuccessful in reducing your symptoms
  • You would like a time out from your ordinary mind and a broadened perspective of your psychological condition
  • You are open to having a spiritual or mystical experience for the purpose of transformation and symptom reduction

Ketamine Treatment may not be Appropriate if:

  • ‌You are pregnant
  • You have a psychotic disorder
  • You have uncontrolled high blood pressure or heart/liver disease
Appropriateness of Ketamine Assisted Psychotherapy (KAP) for individual clients will be determined by Wholeness Health professionals during an initial screening.

Ketamine Testimonial

 

To Wholeness Center,

 

Thank you for all that you do and for having the strength to do what you do in a world that seems to “know it all”.  It is tough to express how much inner and outer growth I have had over the past year or so (growth that I was unaware of).  I’ve done KAP, Integration sessions, personal work (lots of this)  and a hypnotherapy session.  I’ve come to peace with so many troubling and just under the surface negative feelings that so many live with day to day as that’s what we deserve. I honestly was just living with negative things that could be changed, things that I just accepted were external to me.  I’m fully working with my inner thoughts and your group has given me the support to believe in that and myself doing this work.  I’ve also weaned off of a daily anti-depressant for 4 months now and feel so much better in regards to those side effects and hassle.

 

Your approach with your awesome people has made a complete shift in my outlook and also enabled me to fully believe in my own outlook. It is such a freeing and refreshing feeling.

 

I look forward to other opportunities to grow, so thank you!  And thank you Sandra and Dawn for your acceptance and clear insights into my personal journey.  I could go on a lot more there.

 

Thank you!
-Ryan

Ten reasons why ketamine is the best entry level agent for psychedelic exploration or psychedelic assisted psychotherapy training

 

  1. It is legal. You can schedule a ketamine session in most major cities in the US. An increasing number of centers like ours have ketamine assisted psychotherapy sessions available. This is the harbinger of a new paradigm in mental health. At Wholeness, we believe that medicine assisted psychotherapy represents the emerging model for enhanced care of the psyche.
  2. Ketamine is anxiolytic. It quiets that part of our central nervous system that worries and frets. Many of the major psychedelic medicines (especially LSD) can have a significant element of anxiety as part of the journey. If you are new to psychedelics this can be intimidating and overwhelming. Research indicates that ketamine is euphoric and mood boosting for most people. Bad trips are possible, but they are much less likely than with psilocybin or LSD.
  3. Ketamine offers a sense of pure non-dual consciousness that introduces folks to a non-cognitive open field of awareness that is unique and awe inspiring.
  4. Both ketamine and the major psychedelics decrease the default mode network, which is our closest neural equivalent to the ego. With the conscious constraints of the constructed self dramatically reduced, the major psychedelics can and will release a tsunami of unconscious material that can be very powerful (and overwhelming). Ketamine does decrease the filter of the self, but it simultaneously decreases the power of cortical awareness and this reduces the unpredictable wave of the unconscious material that is brought to experience. Traumatic experiences may be accessed, but the weight of the new insights are more limited. Ketamine can work as mild introduction to these experiences.
  5. Never mind that ketamine is not a true psychedelic, this experience may be one of the most profound alterations of consciousness that you will ever experience. As a dissociative agent, ketamine disconnects most of our cortical awareness and leaves people with an experience that will astound you. Do not underestimate this experience. For therapists in training it is very important to have a personal experience of a powerful state of non-ordinary consciousness. Ketamine provides this and more
  6. Ketamine modifies the default mode network, disrupts thalamocortical relays and enhances neuroplasticity. Quite simply it offers a new way of thinking, particularly about one’s own life and the big picture of our existence. People come away with a refreshed look at their life journey and their options for change.
  7. Ketamine has a clear dose response curve, so folks can dial in the type of experience they would like to have: mild, verbal and lightly dissociated (somewhat like peyote); moderate, some verbal capacity, but mostly gone (more like psilocybin); high, non-verbal and totally disconnected from this plane (similar to DMT).
  8. The short half-life of ketamine is under 30 minutes. This means that the entire experience lasts less than one hour. Good or bad, the journey is short and manageable. The total time from check in at the office to walking out the front door is typically less than two hours.
  9. The alterations in the default mode network and hippocampal plasticity, while maximal for the hour’s joyride, do linger for a day or so. This offers a practical window for enhanced psychotherapy. Low dose lozenges provide a twilight type of experience that enhances access to painful material and speeds psychotherapy. We tolerate the difficult insights better and can process our wounding at a much deeper level. Ego controls are reduced, but not gone. This catalyzes psychotherapeutic change. It is an anesthetic agent, but used in this manner it opens our process and does not numb. This is because it is dissociative and thus does not diminish our awareness. By comparison, alcohol reduces ego controls, but it reduces clarity and self-awareness simultaneously rendering it useless.
  10. It is legal. This bears repeating. The only other options that might be better involve travel to another country or breaking the law. It is difficult to rationalize a training track for therapists that involves a criminal act or mandates international travel. Years from now we will likely have MDMA, psilocybin and perhaps other legal options. We have ketamine right now.

What is the process at Wholeness Center?

The first step is to call the front office to explore schedule and availability. You will be scheduled for a ketamine clearance with one of our prescribers. This hour-long session helps us to know your background, risks and goals for this treatment. Our clinicians will determine whether ketamine is appropriate for your condition and will then recommend a specific route of administration and dosing strategy based on your treatment goals and psychiatric history. There are some exclusions to ketamine treatment: pregnancy, uncontrolled high blood pressure, cardiac disease and recent stroke among other things. Following clearance, you will be scheduled with a psychotherapist for the ketamine sessions. Typically, there is a prep session to get to know each other prior to the medication guided sessions. In our experience 6-8 sessions are ideal to address most mental health goals. We may recommend that the most depressed and suicidal patients have two session per week for 3 weeks. Less severe cases can be well treated with weekly sessions. Following the medication session many people find an integration session can be useful to pull things together and create clear headed plans for change and growth.

Safety 

Ketamine has been in widespread medical use for over 50 years. It is considered an Essential Medicine by the World Health Organization and may be the most widely used anesthetic agent across the globe. The medical profession has found it to a safe treatment with only rare and mild side effects. The use in psychiatry has been more recent over the last ten years. In psychiatry we employ doses that are a fraction of the dose employed in other medical settings. Given the much lower doses, the safety record in psychiatry is stellar. Uncommon side effects include mild nausea and headache. We also require that someone else drive the patient home after the treatment as the medication after effects of drowsiness or poor coordination can last a few hours.