Medication Management

We reach out to your existing mental health team during our therapy and medical intake process. We will collaborate care with them throughout the process. If you do not have a therapist or psychiatrist, that is ok, we have a full team of providers who can see you not only for Ketamine Assisted Psychotherapy but also for standard therapy services or medication management. So no formal referral process is necessary to reach out to us to initiate the intake process. Just contact us by providing your information here and we will reach out to you to consult with you and get started.

We don't offer Spravato, and we don't prescribe ketamine for you to take on your own. Both of those exist and both have their place, so here's why we went a different direction.

Spravato is esketamine, a nasal spray, FDA-approved for treatment-resistant depression and often covered by insurance. It's given in a monitored setting, but there's no therapy during the dose, and the dose is fixed once it's given.

At-home programs mail you ketamine lozenges and check in remotely. They're cheaper and easier to get. Nobody is with you while the medicine is working, and the medication lives in your house between sessions. That second part is the real problem. Unsupervised access is how people get into trouble with ketamine, and without the therapy the experience tends to deliver less than people hoped.

We specialize in IV Ketamine Assisted Psychotherapy. The therapy happens, before, during, and after the ketamine infusion, with a therapist trained in KAP and a nurse who can adjust the level in real time. That's a lot more involved and effective than taking a lozenge by yourself on your couch, or sitting for hours in a clinic after recieving Spravato without any support to integrate what you experinced.

Ketamine is a controlled substance and it can be misused. That's true and worth saying plainly.

What creates dependence is high doses, frequent use, and unsupervised access. Our doses are low, sessions are spaced out, and nothing leaves the clinic with you. You never handle the medication yourself.

The structure of KAP works against dependence. The goal is a short course of treatment you finish, not a prescription you keep refilling.

One caveat before it. Ketamine is different for everyone who takes it, and it can feel different from one session to the next even at the same dose.

Often the first few minutes are mostly calming. Anxiety loosens and your body settles. Around eight to ten minutes in, the room starts to feel farther away. Your body may feel heavy, or weightless.. Time perception is often different, sometimes feeling slower or faster than normal. Thoughts can arrive as images more than sentences. Music gets deeper and often is a central aspect of the experience, due to ketamines ability to produce synthesia. Some people describe it as floating, some as watching their own life from a distance. For some people ketamine is profoundly psychedelic, and for some people it is less so. Ketamine can sometimes bring forth emotion, and sometime it can create distance from emotion. Both of these effects can be useful in Ketamine Assisted Psychotherapy work.

We dose ketamine to aim for a level lucid enough to talk with your therapist throughout, but detached enough to be able to more easily tolerate therapy that would normally be too difficult.

You aren't locked into any specific level of ketamine. Your nurse is in the room at your side the whole time and can adjust the IV rate whenever you need. Too much, we bring it down. Barely feeling it, we can bring up the level. Changes to the IV pump take just a minute or two to take effect.

You'll be yourself the whole time. You can speak, you can move, and you'll generally be able to remember the experience.

Here is a video that our nurses discuss the most commonly asked questions - Frequently Asked Questions about Ketamine Assisted Psychotherapy at Transcend

Here is a podcast we did answering random questions from r/theraputicketamine. -> Podcast

Ketamine Assisted Psychotherapy is ideal for people suffering from treatment resistant mental health conditions. Those who have depression, anxiety, suicidal ideations, OCD, PTSD and have had limited or no relief from psychiatric medications or therapy.

Ketamine is short acting. Almost anything you feel during a session fades once the infusion stops.

A slight rise in blood pressure and heart rate is normal. A small number of patients feel nauseated during or right after. If either comes up, we treat it with IV medication right there in the room.

Two things prevent most nausea: don't eat for three hours beforehand, and keep your eyes closed or wear an eyeshade during the infusion.

What about the dissociation? That's the part most people are really asking about. At these doses you can expect to feel separated from your body, and time can stretch or fold. Some people find it strange at first. It isn't a complication. It's the effect we're working with, and it ends when the infusion does. Someone stays with you the whole time.

You may feel unsteady or foggy for an hour or so afterward. Plan on a ride home.

At high doses, or with very frequent use, ketamine can irritate the bladder. KAP doses are low, and most patients come once or twice a week. At that dose and frequency the risk is very low.