Intramuscular (IM) Ketamine Treatment

An initial appointment is required for medical evaluation and ketamine prescription,
subsequent therapy sessions will be determined individually.

Is IM Ketamine therapy right for you?

Intramuscular ketamine injections are used as an alternative to IV treatment to help patients heal from chronic mental health conditions such as treatment-resistant depression, anxiety, PTSD, chronic pain and more. 

This method of ketamine therapy is used in office with a qualified provider and can induce a full psychedelic healing experience without the need for a full IV set-up or monitoring.  This is a great treatment option for patients who do not tolerate IV ketamine treatments due to stress or anxiety about the administration of the medication or who may have side effects from oral ketamine treatment.

The bioavailability of intramuscular ketamine is very high at approximately 93% and the onset of action is rapid.  Patients will start to feel the benefit from IM ketamine immediately both during the treatment and within hours after the treatment in most cases. 

IM ketamine also provides flexibility on the frequency and intensity of dosing.  Patients who are choosing not to follow the “gold standard” IV ketamine protocol will be able to make progress based on their response to each treatment and how well they are feeling with the integration process.

FAQ:

How long is an IM Ketamine Session?
The appointment length for IM ketamine injections is 3 hours at our clinic.  That gives the provider and patient plenty of time to prepare, ground, journey and integrate during the session.

What do I need to do to prepare for a session?
A medical intake with one of our doctors is required before any ketamine prescription or treatment is provided. This is a 50-minute appointment to review medications, family history, problem list, or health concerns, and prescribe the medication if indicated. Our providers ask patients to fill out an intake form and several important questionnaires before their first visit, these will allow for documentation of improvement or changes over time.

Will ketamine injections help with my treatment-resistant depression?

Clinical trials have shown that ketamine infusions can produce positive results for patients with acute suicidal depression and treatment-resistant depression within hours of treatment.  In our clinical experience, the vast majority of patients will experience symptom relief early in the course of treatment and we continue to assess and monitor patient safety as well as the efficacy of the treatment plan over time.

What medical conditions could keep me from being able to receive ketamine treatment?

There are certain cardiovascular conditions, vascular conditions, and several others that may indicate a patient is not a good candidate for treatment, please schedule a consultation with us or contact us with your specific question or concern.

Will my current medications interfere with my ketamine treatments or be unsafe with ketamine?

Each patient will receive a medication interaction check during their initial medical intake for treatment with ketamine.  Most medications are safe to continue as prescribed with your ketamine treatment plan, but a few common medication questions/interactions are as follows:

• Antidepressant medications such as SSRIs, MAOi’s and tricyclics do NOT interfere with ketamine, there is no need to adjust dosing if you are taking these medications.

• Muscle relaxers, anti-inflammatory medications do NOT interfere with ketamine treatment and there is no need to adjust dosing.

• Opiates and Benzodiazepines: Patients taking large doses may have a reduced response to ketamine treatments. This does not mean that you cannot receive ketamine treatment or that you will not benefit from this treatment option.  They are safe to combine; however, we may ask you to adjust your dosing schedule to ensure safety and preserve the highest efficacy of ketamine benefit for you.

• Lamotrigine (aka Lamictal). Patients should allow for at least 6 hours between taking lamotrigine and their ketamine treatment and should wait at least 6 hours after ketamine treatment to take their next dose.

• Gabapentin: This medication does NOT interfere with ketamine treatment and there is no medical need to adjust dosing. However, some patients report feeling more groggy/tired after ketamine treatment if they are using gabapentin concurrently.  We may recommend adjustment in dosage timing to reduce this possible effect.

In some cases, patients may wish to reduce or eliminate other medications during or after ketamine treatment.  We can assist you in discussing this possibility/process with your prescribing provider.

Are these sessions covered by insurance?
Ketamine IM sessions at Áureo are not covered by insurance. We are happy to provide a superbill for the medical intake appointment and post-treatment integration sessions that may provide full or partial reimbursement of expenses depending on your insurance plan.

We can offer a low-cost 0% APR payment plan, or take cash, Venmo, or credit card at the time of service.  We are also able to take HSA and FSA funds. 

What is the out-of-pocket cost for Ketamine Assisted Psychotherapy?
- $220 | Initial medical and psychiatric intake | 50-minutes
- $550 | Experiential ketamine therapy sessions | 3-hours
- $170 | Preparatory and follow-up integration sessions | 50-minutes

How many sessions will I need?
We recommend starting with a series of 1-2 treatments weekly for 4 weeks.  Each journey should be followed up with an integration appointment to help understand and implement the healing that is happening during the journeys. Some patients choose to start with one session and then determine if they need subsequent treatments after their first experience and discussing treatment planning with their provider.

What are the side effects of ketamine therapy?
Possible side effects of ketamine treatment include:

Tiredness: Patients do sometimes report feeling tired or groggy after treatment with ketamine. This usually subsides within a few hours and we often recommend that patients go to bed early on treatment days, most patients will feel completely normal by the next morning.

Nausea: Some patients experience nausea after a ketamine infusion, especially patients who are prone to motion sickness.  We can provide and administer additional anti-nausea medication before or after your ketamine treatment. 

Headache: Rarely, patients may feel a transient headache post treatment, we can advise you on support/relief for this as needed.

Seizure:  Very rarely, in patients who have a seizure disorder or are prone to seizures, may have a seizure associated with ketamine treatment.  Any history of seizure disorder should be discussed with your provider before initiating treatment with ketamine. 

There are no known long-term side effects of ketamine infusion therapy when administered by a properly trained clinician in a medical setting.

Do I need to have a psychiatrist to receive treatment?

We do not require a referral or prescription for ketamine treatment from a psychiatrist or other physician.  All patients are encouraged to engage in counseling/therapy treatment during and after ketamine treatment to support your mental health and integration process.

Do ketamine treatments cause bladder damage?

No, there is no link between therapeutic or medical ketamine treatment and bladder damage.  There have been reports of bladder damage caused by ketamine used recreationally (ketamine abuse) for years at 10 to 20 times the doses administered during ketamine treatments. 

Is there an age requirement for ketamine treatment?

There are no formal age limitations for IV or IM ketamine treatment.  Our clinic is unable to serve patients under the age of 18 at this time. 

What are ketamine group therapy sessions like?
We offer small in-person group ketamine experiential sessions once per month*. This provides a low-cost alternative to multiple in-office treatments and currently, a maximum of 6 patients per session are permitted. We require that each patient bring their own ketamine prescription to each session and patients will be monitored by the medical providers throughout the group session. A short post-session group share will be optional after each group.

- $180-$220 sliding sccale | Small group ketamine therapy | 3-hours
*If you would like to learn more about these small group sessions or discuss the sliding scale payment option, please reach out to the Áureo office via contactus@aureopdx.com.

Note: The medical providers at Áureo are not primary care providers and we encourage patients to have a support network of other trusted healthcare providers when engaging in psychedelic harm reduction/integration work or ketamine treatment. It is usually recommended for patients to have a primary care physician as well as a counselor or other licensed mental health provider to support patients during their healing process.