Ketamine Infusion Therapy & KAP

A patient sitting in a reclining chair experiencing ketamine infusion therapy

Ketamine infusion therapy in conjunction with ketamine assisted psychotherapy (KAP) is a highly effective treatment that can help individuals with treatment-resistant depression achieve rapid relief from symptoms and a greater sense of wellbeing.

What is Ketamine?

Originally developed in 1962, ketamine historically has been used in medical settings for anesthesia because of its dissociative effects. However, at lower doses (i.e., doses much lower than used for anesthesia), ketamine has been highly effective for treatment-resistant depression due its effects on glutamate and its enhancements of neuroplasticity.

Rapid symptom relief and potential for lasting results

Ketamine has been shown in numerous studies to provide rapid improvement in people with depression and to increase neuroplasticity, enabling people to find faster relief from their symptoms and more easily make changes in their lives with potentially long-lasting impacts.

Rapid antidepressant effect

Can offer immediate relief

Decreases suicidal ideation

Can help alleviate suicidal thoughts

Sustained results

Can offer lasting results over time in conjunction with therapy

How does ketamine work?

The therapeutic effects of ketamine fall into three broad and interconnected categories.

Therapeutic Effect
Definition
How it Works

Biochemical

How the treatment functions in the brain

Ketamine is an NMDA antagonist and has demonstrated a rapid and dramatic alleviation of depressive symptoms, whereas antidepressant medications typically can take several weeks to reach full effect.

As it works on the glutamate pathway, which is a different mechanism than traditional antidepressant medications, ketamine is safe to be taken in conjunction with most antidepressant medications.

Experiential

What someone experiences during treatment

Ketamine’s psychedelic properties can enable some people to gain important insights or perspectives about patterns in their lives or achieve a deeper emotional connection to certain areas of their lives.

Not all people will have such experiences with ketamine therapy, however, and it is not necessary for these experiences to occur for ketamine to be therapeutic.

Neuroplasticity

Enhancing the formation of new connections in the brain

Ketamine has been shown to increase neuroplasticity in the brain, enabling the brain to form new connections and pathways.

This is helpful because people suffering from depression often feel “stuck” in certain behavioral and thought patterns that are hard to emerge from.

Therapeutic Effect

Biochemical

Definition

How the treatment functions in the brain

How it Works

Ketamine is an NMDA antagonist and has demonstrated a rapid and dramatic alleviation of depressive symptoms, whereas antidepressant medications typically can take several weeks to reach full effect.

As it works on the glutamate pathway, which is a different mechanism than traditional antidepressant medications, ketamine is safe to be taken in conjunction with most antidepressant medications.

Therapeutic Effect

Experiential

Definition

What someone experiences during treatment

How it Works

Ketamine’s psychedelic properties can enable some people to gain important insights or perspectives about patterns in their lives or achieve a deeper emotional connection to certain areas of their lives.

Not all people will have such experiences with ketamine therapy, however, and it is not necessary for these experiences to occur for ketamine to be therapeutic.

Therapeutic Effect

Neuroplasticity

Definition

Enhancing the formation of new connections in the brain

How it Works

Ketamine has been shown to increase neuroplasticity in the brain, enabling the brain to form new connections and pathways.

This is helpful because people suffering from depression often feel “stuck” in certain behavioral and thought patterns that are hard to emerge from.

Safe, human-centered and  
evidence-based

At Being Health, our approach to ketamine treatments is grounded in scientific evidence, designed with safety in mind, and personalized to each individual.

Being Health providers creating the highest health safety standards
Highest health safety standards

Safety standards established by psychiatry and anesthesiology experts to create gold standards of care for ketamine infusion therapy.

Healing environment

A Being Health nurse anesthetist (CRNA) administers and monitors ketamine infusions at our New York City clinic. We ensure a Being Health clinician is with you at all times to maximize your comfort.

Being Health provider sitting with a patient undergoing ketamine infusion therapy
Being Health provider guiding patients through their personalized mental health journey
Personalized care

We tailor treatments to the individual with the goal of helping you feel better, from a customized ketamine program to a Wavepaths personalized music experience.

Being Health
Ketamine Program

Our ketamine program involves a comprehensive ketamine evaluation by a Being Health psychiatrist, followed by a KAP preparation session, a ketamine induction series, KAP integration sessions, and ongoing care and maintenance, all of which are personalized to your unique needs.

Ketamine Consultation

75 minutes

Ketamine Induction Series

3 Weeks

A ketamine induction series is for patients who have never received ketamine treatment before and are experiencing clinical depression.

Ketamine Infusion Sessions

6 sessions

2 sessions/week

Ketamine Assisted Psychotherapy Sessions (KAP)

4 Integration Sessions

1 x KAP preparatory session

3 x KAP sessions

An example of a ketamine treatment program is outlined below, but will be personalized to your unique needs.

Sample Ketamine Series

A sample ketamine treatment program is outlined below, but will be personalized to your unique needs.

Symptom Tracking

Monthly

Maintenance Ketamine Infusions

As needed

Drop In Group Psychotherapy

Monthly

How it works

How it works

A woman walking into a layered silhouette of a head to represent the biochemical qualities of ketamineA woman walking into a layered silhouette of a head to represent the experiential nature of ketamineA woman walking into a layered silhouette of a head to represent the neuroplasticity of ketamine

Biochemical

A Being Health CRNA with extensive experience administering ketamine will place an IV, administer the ketamine and continuously monitor during and after the infusion.

We recommend six initial ketamine infusion sessions over the course of three weeks, based on the scientific literature.

Experiential

We provide at least one KAP preparation session prior to your ketamine treatments to set goals and intentions for the treatments.

A Being Health clinician will be with you in your private room at all times during your ketamine session to ensure you can feel as safe and comfortable as possible.

Neuroplasticity

To utilize the neuroplasticity “window” provided by ketamine, our model layers in KAP integration sessions between ketamine infusions to identify insights and refine treatment goals. You can opt to add on more sessions as needed.

We recommend scheduling KAP integration sessions at least once a week, either with a Being Health KAP clinician or your existing therapist.

An innovative and evidence-based treatment

Response Rate

64% of patients experienced marked improvements in depression symptoms 24 hours after the first ketamine infusion of an induction series.

Murrough JW, Iosifescu DV, Chang LC, Al Jurdi RK, Green CE, Perez AM, Iqbal S, Pillemer S, Foulkes A, Shah A, Charney DS, Mathew SJ. Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial. Am J Psychiatry. 2013 Oct;170(10):1134-42.

Response Time

Patients may begin to feel better within the first 1 to 2 hours of their first ketamine treatment.

Zarate CA, Singh JB, Carlson PJ, et al. A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression. Arch Gen Psychiatry. 2006;63(8):856–864.

Durability of Response

Durability of an antidepressant response from a ketamine induction series was 60% at 8 weeks post-treatment without maintenance infusions.

McInnes LA, Qian JJ, Gargeya RS, DeBattista C, Heifets BD. A retrospective analysis of ketamine intravenous therapy for depression in real-world care settings. J Affect Disord. 2022 Mar 15;301:486-495

Ketamine with KAP Effectiveness

Evidence demonstrates that when KAP is provided before, during, and following ketamine sessions, it can maximize and prolong ketamine’s antidepressant effects.

Drozdz SJ, Goel A, McGarr MW, Katz J, Ritvo P, Mattina GF, Bhat V, Diep C, Ladha KS. Ketamine Assisted Psychotherapy: A Systematic Narrative Review of the Literature. J Pain Res. 2022 Jun 15;15:1691-1706.

Ask & Answer with the Being Health care team

Being Health’s care team shares what you need to know about ketamine infusion therapy.

How can I get started with ketamine therapy?

Book a ketamine
consultation

Schedule a consultation with a Being Health psychiatrist and complete our digital intake forms.

Meet with a
Being Health clinician

Meet with one of our licensed psychiatrists for a 75-minute session to understand your history and see if ketamine could be a fit for you.

Begin your
healing journey

If it is determined that ketamine therapy is a safe and appropriate option for you, you will meet with one of our expert KAP therapists for a prep session and plan your ketamine induction series.

FAQs

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. 

Being Health’s safety standards and Ketamine Protocols were developed by our Psychiatry and Anesthesiology experts to create the highest safety standard of care for overall health and wellbeing. From our Ketamine consultations which are conducted by seasoned psychiatrists who assess risk from a medical, psychiatric and substance use perspective, to our KAP therapists who are highly trained to ensure the most optimal preparation and integration experience, to our CRNAs who are experts in infusion care, we promise an experience which is safe and reassuring for you and your loved ones.

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.

People suffering from depression and anxiety often feel “stuck” in certain behavioral and thought patterns that can reinforce their symptoms and make it harder to “get out of.” By enhancing neuroplasticity, ketamine can help build new pathways in the brain and allow changes in one’s thoughts and behavioral patterns to occur and be more long-lasting.

If you have received ketamine infusions elsewhere and would like to establish care at Being Health, we will ask that you first meet with a Being Health psychiatrist for a ketamine consultation to review your prior treatment, discuss what you are currently experiencing, discuss risks, benefits and alternatives of ketamine treatment, review your current medications and any recent labs and develop an individualized treatment plan suited to your specific needs and circumstances.

Person taking a step on their path to feeling better

Feeling better is possible.

Book a free 15-minute call with a member of our care team.