Ketamine’s effects

Low dose of ketamine patients will likely first experience the anesthetic (decreased pain), decreased anxiety and anti-depressant effects. One session is likely to reduce symptoms from several days to a week. Repeated sessions may be required for more sustained effects, but our practice aims for one. After observing your outcome of a single ketamine treatment, we pair with ongoing therapy with the goal of maximizing the one dose’s impact. Rather than assuming you will need successive ketamine sessions back-to-back over a couple of weeks, each case is considered individually. Some cases may require additional sessions over time. In our practice, over 95 percent are able to experience ongoing relief (months) before they need an additional ketamine session. We ascribe this to the holistic approach of combining ketamine with continuous effective therapy. Traditional talk therapy is introduced through the dissociative lens of the ketamine experience, immediately and after ketamine administration as well as the days and weeks after treatment. Long-term therapy can be with our clinicians or your own established therapist.

At the therapeutic dose (determined by your individual factors including weight and height) effects may then allow you to move towards more insight. Ketamine assisted psychotherapy may help break negative thought and habit loops often leading to sustainable achievement of therapeutic goals.

Ketamine Assisted Psychotherapy

While ketamine’s mood and dissociative effects can be powerful, even lasting for some clients, the goal of KAP is to leverage the drug’s cognitive reset to build more healthy thought and habit patterns.

After your Zoom intake session, if designated as eligible, you will schedule a medical consultation and review with our in-house physician Dr. Truman Milling. (Psychological evaluations require more than one session for therapeutic planning purposes.) After the review, we then schedule your ketamine session to be conducted at Lake Austin Psychotherapy’s offices. We do not allow ride shares for pick ups so please ask a trusted friend or family member for transportation after your infusion. We can also arrange the practice’s private transportation for an additional fee. They are also welcome to accompany you during your treatment if you chose. We ask that you wear comfortable clothing that allow for easy IV access. We ask that you do not eat three hours prior to your infusion to avoid nausea.

The ketamine is ideally delivered intravenously which allows for more predictable blood concentrations. It can also be delivered intramuscularly or intranasally if IV access cannot be obtained. During the actual ketamine administration sessions, your therapist will stay with you in the room and be available to provide you with a sense of security and safety. There is, however, no pressure to “work” with your therapist at this time. Some clients find they may want to share their ongoing experience; others may prefer to relax and remain quiet. As the major effects of the medication wear off, again individual clients may wish to share or not share what they have thought or experienced. Our physician will monitor you for at least an hour after your ketamine session. He and the therapist will also be available by phone after your session should you have post-care concerns. You will also be prescheduled to see your therapist in the days following.

To the best of our abilities and your scheduling realities, we do like to plan for post-ketamine integrative therapy sessions in the days after ketamine administration. This is done via Zoom. While each therapeutic journey is unique, additional sessions may be needed to complete integrative outcomes. This can be achieved with our care providers or your own. With each ketamine session, therapeutic follow up is again advised. We urge you to fully discuss your treatment at all points with your therapist or physician.

Screening for KAP

Before participating in ketamine treatment and KAP, you will be carefully screened to determine if you are eligible and whether this type of therapy is indicated. This will include a medical and psychiatric history interview, a series of basic medical tests (such as blood pressure or additional labs if indicated, not included in the cost of your treatment), and administration of brief psychological tests to assess your state of mind.

While the proven safety record of ketamine makes it physically viable for most, pregnant women, mothers who are nursing, and women who are actively planning on becoming pregnant in the short term should not receive ketamine.

Other specific reasons that you might not be eligible for ketamine treatment include a recent stroke, myocardial infarction (heart attack), recent psychosis (delusions or hallucinations) or recent bladder inflammation. We ask that you openly discuss any factors known to you that may have an effect on your eligibility.

Ketamine potential downsides

The doses administered for KAP sessions are small, and the safety of the medication at these levels is well established. However, as with any drug and as with any therapeutic treatment there are risks you should understand.

Physically the effects of ketamine generally include a rise in blood pressure and heart rate. Initial screening will determine if this creates any additional risk for you and may preclude you receiving the drug. Medication may be offered to combat nausea or severe anxiety should it occur during your session.

Like other hallucinogenic compounds, ketamine does not meet the criteria for chemical dependence. Psychological dependence has been reported only after a history of heavy use. Frequent use of ketamine has been shown to potentially cause urinary tract symptoms and even permanent bladder inflammation in some. (This is why we do not promote “microdosing.”)

Ketamine is a legal medication approved by the FDA subject to Schedule III rules, so there should be no stigma attached to its use. During the ketamine experience itself, the medication can result in profound changes in your mental state and may result in unusual physiological and psychological presentations. These experiences, however, can often prove valuable within your therapeutic goals. They are temporary, and you will not be alone. We will provide psychotherapeutic guidance throughout should you need. In the case of severe agitation or distress, you may be offered medication to help. 

As with any therapy there are inherent risks. It is understood that no therapy or medication can offer guaranteed outcomes. Some may find KAP does not provide the benefit they expected. At Lake Austin Psychotherapy, we consider each outcome individually so we do not require the purchase of a “package” or series of sessions. However, more than one ketamine session may be needed to achieve full effect. You may also experience fatigue, dehydration or insomnia in the days that follow. Please plan your schedule accordingly. All these possibilities should be understood and discussed with your KAP medical consultant or therapist before deciding to proceed.