Wellness Embodied at 257 Main Street in New Paltz has put together a team of psychotherapists and a medical doctor to offer ketamine assisted psychotherapy (KAP) to clients suffering from depression, trauma, or anxiety. It’s more than talk therapy. While ketamine has been used as an emergency-room sedative or a psychedelic street drug for those looking to go on a hallucinatory journey, it has recently made some inroads into the therapeutic world, particularly for those with severe depression.
“I would say that over the past five years it has become a more widely used and sought after form of treatment,” said Simon Abramson, a psychotherapist and a member of the Wellness Embodied KAP team. “There were the Yale trials, and then a series of studies conducted that looked at the efficacy of its use in treating depression.”
Used mainly on battlefields and in operating rooms or emergency rooms as an anesthetic, or even as a horse tranquilizer, ketamine is a legal drug when prescribed by a physician.
It is not clear exactly why ketamine has been effective in treating some patients for severe depression. According to Abramson, it likely has to do with “increasing the amount of a neurotransmitter called glutamate in the spaces between neurons.” which has shown to be atrophied in people suffering from depression or PTSD.
Trials, tests and treatment
Dr. John Krystal, the head of psychiatry at the Yale School of Medicine, was instrumental in arguing the case that ketamine could have an efficacious result in depression-resistant therapy. The trials and studies he and his colleagues have conducted, showed ketamine produces antidepressant effects “by working on an entirely different brain system than current antidepressants do.”
Traditional antidepressants target serotonin, norepinephrine and dopamine systems in the brain. Ketamine is believed to produce antidepressant effects by “triggering the release of glutamate, which then stimulates the growth of new synapses between brain cells,” according to the Yale Journal of Medicine. “As a result, ketamine is effective in patients with major depressive disorder who are resistant to common antidepressants. It takes effect in a matter of hours rather than weeks.”
Another article, published in the Harvard Health Blog by Dr. Robert Meisner, explained ketamine’s chemical impact this way: “Glutamate then activates connections in another receptor, called the AMPA receptor. Together, the initial blockade of NMDA receptors and activation of AMPA receptors lead to the release of other molecules that help neurons communicate with each other along new pathways. Known as synaptogenesis, this process likely affects mood, thought patterns, and cognition,”
“Imagine a hill that you’re going sledding down. And you slide down the same path over and over and over again. KAP allows you to see the path, but choose a new path down the hill,” said David Schaffer, psychotherapist with Wellness Embodied.
“We use it as an accelerant”
Abramson emphasized ketamine was part of therapy. “It’s not separate,” he said. “We use it as an accelerant.” Ketamine, when effective, can help speed up the process of seeing relief from acute depression, anxiety and trauma.
Doree Lipson, founder and director of Wellness Embodied works as a psychotherapist with KAP clients. She is quick to point out that an involved intake process and full medical examination take place before a client is accepted into the KAP program. “We need to know if there’s a history of psychosis or addiction,” said Lipson. “If there’s support for the individual in this process.”
If the initial session goes well, the client is referred to a medical-team doctor to ensure there are no medical complications.
Dosage and costs
The dosage is very low, lasting 45 minutes spent s mostly in conversation with the therapist. The sessions are three hours long, with an hour of regular therapy, coupled with the ketamine ingestion and then another hour to process what the individual experienced.
The doses, given in lozenges, stay in the client’s mouth so that they’re absorbed through the inner membranes of the cheeks it’s not the Kool-Aid Acid Test, but possibly like having two drinks, said Lipson.
Clients are just a bit more relaxed and able “to see your own thinking,” said Abramson.
The client can lie down on a futon a special ketamine room in the center, or sit up and talk. It’s designed to be a smaller, more contained and peaceful space. The client is given an eye mask so that they can have “an internal experience,” or decide to talk with their therapist about what they’re seeing and feeling. All three therapists said that their clients haven’t reported physical effects, save for an occasional report of some nausea.
“There are places where you can go and get an infusion that is way stronger, and they leave you alone in a room,” said Lipson. “This is done with the supervision of a licensed therapist at a much lower dose.”
According to Abramson, the client is likely to have to repeat this treatment twice a week for two or three weeks, then once a week for a few weeks, and after that periodically, when and if needed.
“Ketamine is most effective those first three days after treatment,” explained Abramson. That’s why it is suggested that treatment is two times a week because it captures six days of direct chemical activity in the brain. The therapists are hoping six days of direct chemical activity in the brain will help break the chain of acute depression and traumatic thought patterns.
There’s no one-size-fits-all prescription. It all depends on the person being treated.
Wellness Embodied is one of the few KAP programs in New York State where the therapist is present throughout the entire treatment. Because it is still relatively new and placed under the umbrella of psychedelic therapeutic treatment, insurance does not cover it. The three-hour session costs $400. In addition, there is a $250 charge for the medical examination, $75 for the ketamine lozenges, and then $125 for the medical follow-up session.
“We’ll do our best to get someone in if there’s a cancellation or to refer them, and we always encourage people to call because we want to help,” Lipson said.
For information on the KAP program go to www.wellnessembodiedcenter.com or call 845-743-6878.
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