Oral Ketamine

By 333 Therapeutics Consulting LLC

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The history of Ketamine

Ketamine was first discovered in 1960s as an anesthetic, and it’s still being used in emergency rooms and surgeries all over the world. Its safety profile is excellent (meaning that even as an anesthetic, it doesn’t impair the respiratory system so it’s regularly used even in surgeries with children). The World Health Organization has repeatedly recommended that ketamine be considered an “essential” medicine and not monitored as a dangerous substance.

Around the turn of the century, the medical community began discovering the antidepressant potential of ketamine, when people who received the medicine medically began reporting reductions in depressive and even suicidal symptoms.

Frequently Asked Questions

What is ketamine?
‍Ketamine is an alternative medicine for depression and anxiety and also used in treatment of other mental health diagnoses. It doesn’t carry the same side effect profile as more traditional antidepressants - serotonin selective reuptake inhibitors (SSRIs). Many people who’ve had and failed SSRIs, ketamine may be a better option. It works faster than traditional antidepressants, and the neuroplasticity effects are strong, meaning the results are deeper than surface-level symptom relief. It is well known to produce new connections in the brain resulting in improved mood and depression symptoms. That is, ketamine can help to get at the root cause of the psychological pain and depression rather than just at the symptoms that arise as a result.
‍Why low dose ketamine?
‍You may have heard of ketamine in the context of psychedelics. However, our dosing is different from psychedelic and carries different benefits. The doses we prescribe are low dose meant for the treatment of treatment resistant depression and other mental health diagnoses that have not responded to treatments in the past. This means that it produces an immediate state of calm and ease, and a sense of mental spaciousness.
Ketamine is in the “dissociative” class of medication, which means that people can experience their difficult emotions with a sense of psychological space and without a sense of being overwhelmed. There are a few key benefits: First, unlike psychedelic experiences, psycholytic ones are less likely to be intense. Second, because they’re much less emotionally draining, people can take these doses regularly, and maintain a consistent level of medicine in their brain over time, leading to more stable results. Third, with psychedelic dosing, you may not be clear headed enough to engage in therapy, meditation, or other practices, whereas with psycholytic therapy, you’re able to more effectively due to the sense of openness and calm. In combination with ketamine’s known neuroplasticity, this may mean an opportunity for greater impact of therapeutic or meditative approaches. Although with low doses or microdosing you are less likely to experience the dissociative responses that can occur with higher doses.
‍How does ketamine work in the brain?
‍Ketamine’s effects in the brain are still being actively studied by many researchers around the world. There are multiple ways in which ketamine works in the brain. Some of the most well known mechanisms involve the neurotransmitters Glutamate and GABA. There are many different kinds of neurotransmitters (chemical messengers) in the human brain, but Glutamate and GABA are the most common ones because they are the top excitatory (promoting neurons firing) and inhibitory (blocking neurons firing) neurotransmitters, respectively. Ketamine is an antagonist (meaning, it blocks) a neurotransmitter receptor called NMDA, which is found on both GABA and Glutamate neurons. It’s thought to block the GABA receptors more effectively, meaning that GABA doesn’t inhibit neurons firing as often if ketamine is taken - this leads to an overall increase in neural activity in the prefrontal cortex. Ketamine is also known to interact with another neurotransmitter receptor - AMPA, which may be responsible for a sequence of molecular events that include proteins that promote neuroplasticity through new connections (proteins like Brain-Derived Neurotropic Factor, or BDNF as well as others like mTor, eEF2, and GSK-3). In all, we are still learning about the complex behavior of ketamine in the brain, but we do know that it promotes new neural connections, which are probably at the root of its antidepressant and anti-anxiety effects.

Is ketamine covered by insurance?
333 Therapeutics Consulting LLC does not accept insurance for any ketamine treatments at this time. Some insurance companies may provide reimbursement for out of network treatments. We recommend speaking with your insurance first about out of network coverage. The initial evaluation with a provider is $250 for 60 minutes and follow up visits are $200 for 30 minutes for medication management. Ketamine assisted psychotherapy (KAP) is and can be provided by our therapists and is recommended to help with ongoing progression of your treatment. This is $150 for 60 minutes and is recommended and you see one of our KAP therapists at least biweekly to monthly to help with your progression.

Are you a good candidate for ketamine therapy?
333 Therapeutics Consulting LLC wants you to know that you may be a good candidate for this treatment if you want to take control of your depression and anxiety symptoms. Whether past treatments have not proven to be beneficial to you or you want to enhance your current treatments 333 Therapeutics Consulting LLC can discuss a treatment plan that is appropriate specifically for you.

Although many individuals are good candidates, not all are. We will make sure that your health is our first priority.

Can I continue taking my medications while receiving ketamine therapy?
Yes. Ketamine can be used safely with many medications including antidepressants and other mental health medications. Always discuss medication plans and changes with your primary physician to determine if any adverse effects may be possible. You can also discuss this with your clinical team at 333 Therapeutics Consulting LLC.

In which states is ketamine therapy available?
Currently we are only offering this treatment in Ohio, but will be expanding this opportunity to other states as our need expands.