Corvallis Family Medicine is excited to bring Ketamine Assisted Psychotherapy (KAP) treatments to our community! Dr. Christopher Leesman has been trained and certified to bring this highly effective, rapid, safe, and transformative therapy to help those suffering from treatment resistant depression, PTSD, bipolar depression, suicidality, OCD, addiction, psychological reactions to physical illness, pain, and end of life anxiety.
If you are interested, you can fill out a screening form.
What is Ketamine?
Ketamine was approved by the FDA in 1970 for use as an anesthetic and has been used worldwide ever since. Ketamine is classified as a dissociative anesthetic, meaning a sense of disconnection from one’s ordinary reality and usual self. It is an “essential” medication according to the World Health Organization. As a DEA schedule III-controlled substance, physicians and other medical providers have been prescribing it in both hospital, clinic, and internationally in field hospital/battlefield settings. Throughout its use, it has shown an excellent safety profile.
The administration of ketamine in lower, sub-anesthetic doses to treat depression, PTSD, addiction, pain or other psychiatric diagnoses is a newer, off-label use of ketamine and being increasingly utilized due to the remarkable effectiveness. Psychiatric use of ketamine has become relatively widespread in recent years and has been studied and promoted by researchers at the National Institute of Mental Health, with research continuing and confirming its effectiveness. Often, it has been used after other treatment approaches have been unsuccessful.
Ketamine can be administered intravenously, intramuscularly, intra-nasally and sublingually/orally to produce its effects; and can have a cumulative effect (more effective with repeated doses). At lower doses, you will most likely experience anxiolytic, antidepressant and, possibly psychedelic effects. However, with higher dose IM treatments, one may experience full psychedelic and transpersonal (spiritual, religious, mystical) effects.
Experience has shown that psychedelic or dissociative experiences may well be instrumental in providing a more robust effect. This may well include a positive change in outlook and character that we term a ‘transformative’ response.
Fundamental to its outcome is a suspension of usual experience, usually 30 minutes to 2 hours, that tends to be dose and method of administration related. Relaxation from ordinary concerns and usual mind, while maintaining conscious awareness of the flow of mind under the influence of ketamine is characteristic. This tends to lead to a disruption of negative feelings and obsessional preoccupations. It is our view that this relief and the exploration and experience of other possible states of consciousness are singularly impactful. These experiences are then coupled with integrative therapy sessions, to process and make sense of your experiences and may allow for greater meaning, efficacy and longer duration of benefit.
How is Ketamine Assisted Psychotherapy (KAP) Different than other “Ketamine Clinics”?
Rather than relying only on the medication effects (which are important and powerful by themselves), KAP recognizes the inherent wisdom within the individual and allows ketamine to act as a tool to unlock and gain access to that wisdom. We support the person in creating the framework for set (mindset, intentions, goals) and provide a nurturing and warm setting to promote healing and transformation. Your ketamine experience then is further supported using eyeshades to minimize distractions, promote the focus inward, and enhance the visualizations. We also provide supportive music that helps to guide the journey. Upon coming back into your regular state of consciousness, you are encouraged to share details and write them down. Through the integrated therapy, your trained therapist helps you provide meaning and context, which will fully unlock the power of your journey.
How Long Will It Take Before I Might See Beneficial Effects?
One of the most important aspects of ketamine is the rapidity of alleviation of symptoms, regularly in a matter of hours to days. As such, you may experience important changes in personality, mood, and cognition during treatment, immediately after, and in the days and weeks that follow. The ketamine experience itself is designed to enable your own healing wisdom to be accessed and beneficial to you. The psychotherapy support you will receive will aid you in making your experiences valuable and understandable to you. We will aim to assist you in changing patterns of mind and behavior that are of concern and cause you difficulty.
How many sessions should I expect?
Your treatment will be individualized, but typically will consist of twice weekly for six sessions and if required subsequent treatments may be needed based upon effectiveness or relapse.
Who may qualify?
We will only consider individuals that have a mental health provider with an indication for treatment, although developing a new relationship with our partnered therapists can be done prior to ketamine sessions.
Before participating in ketamine treatment, you will be carefully interviewed to determine if you are eligible for ketamine therapy, including a medical/psychiatric history, review of your medical/psychiatric records if necessary, and administration of brief psychological tests to assess your state of mind.
Indications and Contraindications
Indications (off label): Patients aged 21 years and older. Treatment resistant depression, bipolar depression, suicidality, anxiety, PTSD, OCD, addiction, psychospiritual exploration, psychological reaction to physical illness, end of life, chronic pain conditions.
Contraindications: Cardiovascular disease, untreated hypertension, hyperthyroidism, arrhythmias, migraines (relative), borderline personality disorder, schizophrenia, active substance use disorders, pregnant women and nursing mothers.
What are the potential risks of ketamine?
Ketamine has a long history of safety. Side effects are generally quite mild and tolerable and short lived. Most are expected with the inherent psychedelic properties of the medication. Some experiences may be temporarily disturbing to you.
You will be asked to lie still during the ketamine administration because your sense of balance and coordination will be adversely affected until the drug’s effect has worn off–generally two and up to four hours after the administration. It is possible you may fall asleep, though this is a rare event. Other possibilities for adverse effects include blurred and uncomfortable vision (you are advised to keep your eyes closed until the main effects have worn off), slurred speech, mental confusion, excitability, altered visual perception, diminished ability to hear or feel objects accurately including one’s own body, anxiety, nausea and vomiting. Visual, tactile and auditory processing are affected by the drug. Music that may be familiar may not be recognizable. Synesthesia—a mingling of the senses may occur. Ordinary sense of time will morph into time dilation.
Ketamine generally causes a significant but not dangerous increase in blood pressure. Agitation may occur during the course of a ketamine session. If your agitation is severe, you may be offered lorazepam orally or by injection to help you relax. This too is a rare event in our experience.
Driving an automobile or engaging in hazardous activities should not be undertaken until all effects have stopped–and for this reason you will be required to have someone pick you up from each ketamine session.
In terms of psychological risk, ketamine has been shown to worsen certain psychotic symptoms in people who suffer from schizophrenia or other serious mental disorders. It may also worsen underlying psychological problems in people with severe personality disorders and dissociative disorders.
During the experience itself, some people have reported frightening and unusual experiences. These frightening experiences, however, may be of paramount value to your transition to recovery from the suffering that brought you to your KAP work. They will stop! You will receive psychotherapeutic help and ongoing guidance from your therapist.
Who are the providers?
If you are interested in Ketamine Assisted Psychotherapy, you can fill out a screening form here.