Ketamine Treatment
Ketamine-Assisted Treatment for Psychological and Pain Conditions
Office Hours
Monday to Friday
9am to 5pm by Appointment
450 Sutter St. Suite 840
San Francisco, CA 94108
Off-Label Uses of Ketamine to Augment Psychotherapy
Chronic mood disorders and other mental health conditions can be severe, recurring, disabling, and even life-threatening. These include:
- Depression
- Obsessive-Compulsive Disorder (OCD)
- Anxiety Disorders
- Post-Traumatic Stress Disorder (PTSD)
Many current medical treatments for these conditions are limited by side effects, slow onset of action or lack of efficacy. Although ketamine has been used as an anesthetic agent for over 40 years, it’s application as an adjunct to psychotherapy and other medications is relatively new and "off label." Based on our review of available research coupled with our own clinical experience, have found that when used appropriately, ketamine-assisted psychotherapy can quickly and safely decrease the effects of depression and other “stuck” mental states, even in cases that have been deemed “treatment-resistant.”
The medical and psychiatric use of ketamine parallels a larger movement to re-introduce psychedelic agents into medical practice, such as recent academic efforts to study MDMA for PTSD or psilocybin for anxiety around life-threatening illness. However, these studies will take many years to result in useful treatments available to those who need them, whereas ketamine is available right now with many of the same potential benefits.
Note: Ketamine also has "dark side" and is commonly used outside of medical care without a prescription. This has become a silent epidemic especially among highly-intelligent young people in the United States. Here's an article on this including an interview with our medical director Paul Abramson MD: https://doubleblindmag.com/does-ketamine-have-a-dark-side/
We always screen potential patients for risk of self-administration of ketamine, and advise that no person ever self-administer ketamine outside of a medical content
Ketamine for Treatment-Resistant Depression
Ketamine for Other Psychological Conditions
Ketamine may also be useful as an adjunct in other severe and treatment-resistant conditions where first-line treatment has not been successful. These include obsessive compulsive disorder (OCD) which is characterized by constant intrusive thoughts and accompanying repetitive behavior, Post-Traumatic Stress Disorder (PTSD) with or without depressive symptoms, and severe anxiety disorders.
Ketamine and OCD: Rodriguez et al., Neuropsychopharmacology, 2013
Ketamine and PTSD: Feder et al, JAMA Psychiatry, 2014
Ketamine for Chronic Pain and Treatment-Resistant Headaches
We also have experience using ketamine as an intervention for serious cases of neuropathic pain, complex regional pain syndrome (CRPS), and refractory headaches. See our Integrative Pain Management page for further details on this and other options we combine to help those seeking more comprehensive and humanistic solutions than provided by conventional pain management clinics. When ketamine is chosen as an adjunct, it is typically given as a series of intravenous infusions, according to our evidence-based protocols.
Our treatment team will work with you during the evaluation phase to determine the best possible treatment plan for your situation, which may or may not include ketamine-assisted therapies.
Our Process
We are currently accepting ketamine treatment patients who are directly referred by a treating medical doctor, psychiatrist or psychologist who can verify their diagnoses, coordinate with us, and provide follow up care after ketamine sessions.
Our process also includes a medical evaluation and laboratory testing. Subsequent to the evaluation, we will determine if off-label use of ketamine is a clinically appropriate part of the treatment plan. If ketamine treatment is prescribed, all scheduled treatments are attended by a qualified professional under close physiologic monitoring. After treatment, the patient may return to their usual care team, or choose to continue care with our clinical team on an ongoing basis. The framework for ketamine-assisted therapies is structured to insure an integrated and effective experience.
We have chosen to err on the side of safety by using more stringent exclusion guidelines than our purposes require when deemed necessary. We reserve the right to refuse treatment based on our clinical impression.
Fees
Standard ketamine protocol for mood disorders can be intravenous or intramuscular (depending on diagnosis and individual assessment), and can range from 1-6 sessions for initial course, followed by intermittent sessions for maintenance if needed.
Our infusion protocols for chronic pain conditions and headaches are usually longer in duration and include other adjunctive medications.
Intake evaluation, laboratory testing and assessment: Costs vary depending on your situation and records provided to us. Lab testing is usually covered by insurance. Parts of the ketamine treatments may be reimbursable by your insurance company to you out of network, and we can give you a superbill to submit after your sessions are complete.
Other services and additional time spent on medical care or care coordination is billed according to our standard fee schedule.
