Ketamine Infusion Therapy & KAP

There are several routes of administration for ketamine, including intravenous (IV), intramuscular (IM), sublingual, oral and intranasal. Being Health uses ketamine infusion therapy (i.e., IV ketamine) because this form of ketamine treatment has the most robust scientific evidence supporting its use in treating mental health conditions, particularly treatment-resistant depression. In addition, IV ketamine provides certain other advantages, including being able to slow or stop an infusion during treatment if needed and its high bioavailability, meaning that we know very accurately the amount of the medicine that enters your bloodstream.

Ketamine therapy is generally very safe and well-tolerated, particularly when provided in a monitored and controlled setting. Most of ketamine’s side effects are mild and short-lived, including nausea, dizziness and blurry vision. Ketamine also causes dissociation (an out of body experience) at higher doses that can be distressing in a non-medically supervised setting, which is why we provide a safe and therapeutic environment for all treatment sessions. In addition, ketamine typically causes an elevation in heart rate and blood pressure, which can be dangerous for people with conditions such as severe heart disease, aneurysms or history of a stroke. For this reason, we do a thorough medical screening for these and other potentially problematic conditions when considering whether ketamine treatments are appropriate for a given individual. 

Treatment with ketamine does not require tapering or discontinuing antidepressant medications such as SSRIs because it works through a different mechanism in the brain. Ketamine does have some interactions with medications, including benzodiazepines, and some substances, that are not a contraindication to ketamine therapy, but would be discussed with you as part of treatment planning.

Ketamine is considered to have psychedelic properties, although it works in a different way than more “classic” psychedelics such as psilocybin, ayahuasca and LSD. Although other psychedelic drugs are currently being studied to treat mental health conditions, ketamine and esketamine are currently the only drugs in this category that can be prescribed legally (outside of clinical trials).

Apart from intranasal esketamine (Spravato®), which Being Health does not currently offer, ketamine infusion sessions are not covered by insurance at this time. This is largely a result of ketamine not being FDA approved for treatment of mental health conditions. As such, its use for mental health conditions is considered “off label.”

However, if you have out-of-network benefits, we recommend you check with your insurance provider to determine if you are able to be reimbursed for your initial ketamine consultation, as well as your ketamine assisted psychotherapy (KAP) sessions.

Ketamine has been most well-researched and well-studied for depression that has not responded to other forms of treatment, and this is the most common and strongest indication for ketamine treatments. For this reason, treatment-resistant depression is the condition for which Being Health offers ketamine treatments. 

At the same time, some research has been done into the potential benefits of ketamine treatments for conditions, such as anxiety disorders, PTSD and OCD. That said, research is rather limited. For this reason, consideration of ketamine treatments for these conditions would be made on a case-by-case basis and particularly in the context of ongoing psychotherapy that is oriented toward treatment of these conditions.

One form of Ketamine called esketamine (Spravato®), which is administered intranasally is FDA-approved as of 2019 for depression.  Being Health is not offering intranasal ketamine at this time.

While ketamine infusion therapy has been shown to be effective in numerous studies for treatment-resistant depression, it is not yet FDA approved for the treatment of mental health conditions. As such, its use in the treatment of mental health conditions is considered to be “off label.” However, “off label” use of medications is common in the United States.

Ketamine-assisted psychotherapy (KAP) refers to psychotherapy that is provided in conjunction with ketamine and adapted for use with ketamine’s therapeutic effects. Sometimes, this may refer specifically to psychotherapy sessions conducted while an individual is under the influence of ketamine, usually at a low dose.  Other times, such as at Being Health, KAP refers to the overall process of psychotherapy sessions that are provided in conjunction with ketamine treatments, including preparation and integration sessions.

At Being Health, KAP is a psychotherapeutic process focused on enhancing the treatment experience from ketamine in conjunction with other psychotherapeutic modalities, such as cognitive behavioral therapy (CBT), psychodynamic psychotherapy, acceptance and commitment therapy (ACT) and others, depending on the clinician’s training and the patient’s specific needs.