Intravenous (IV) Ketamine Therapy: Transformative Mental Health and Chronic Pain Treatment in Portland, Oregon

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

Is IV Ketamine therapy right for you?

Intravenous ketamine therapy has been shown in clinical studies to have a robust and rapid benefit for patients with some mental health disorders including treatment-resistant depression, generalized anxiety disorder, PTSD, chronic pain, and others.  Our clinic strives to provide evidence-informed individualized healthcare including IV ketamine therapy for patients seeking mental health support.

FAQ:

What should I expect during my IV ketamine treatment?
Intravenous ketamine is administered in our office over a period of 40-50 minutes.  The dose is determined at the time of treatment but can be titrated up or down based on your level of need and comfort.  Although ketamine is an anesthetic medication, the doses used for ketamine therapy sessions are too low to cause loss of consciousness.  During the treatment, patients can have changes in the way that they feel and perceive their bodies, also called dissociation and may have visual changes including colors, shapes, bright lights, etc.. Many people find these experiences relaxing, enlightening and pleasant.  Most patients leave the office about 30 minutes after their treatment and feel normal (maybe groggy or off balance).  There are no “flashbacks” associated with ketamine therapy. 

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 infusions 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.

If ketamine treatment works for me, how soon will I feel the benefit?

This varies from patient to patient.  Studies have shown that some patients feel better within hours of ketamine treatment, including those struggling with acute suicidal ideation.  Some patients will feel tired or groggy the day of treatment and much better the following day.  Some patients will need to complete 2-3 treatments before feeling better.  We recommend keeping track in a journal or on your phone of how much better you feel after each treatment. 

What happens after I complete my series of ketamine treatments?

We will be working with you throughout the course of your treatment to determine whether ketamine therapy is working well for you or if a different approach may be needed.  Most patients complete an initial series of ketamine therapy treatments and then choose to pursue maintenance treatments anywhere from every two weeks to every 2-3 months.

Can I eat or drink before my appointment?

We recommend avoiding food and drink for 4 hours before your ketamine session to help reduce/eliminate nausea. Sips of water are fine for up to 2 hours before your session.

Do I need to bring someone with me?

No, you are not required to have someone stay with you during your appointment.  However, we require patients to have a ride home, we recommend not driving or operating any heavy machinery for 12 hours after your session.

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 IV 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 | IV ketamine treatment sessions | 120-minutes
- $170 | Preparatory and follow-up integration sessions | 50-minutes

How many sessions will I need?
This depends on what method of treatment we discuss in the office that is going to provide you with the greatest benefit.  Our clinic provides oral ketamine-assisted therapy, intranasal microdosing of ketamine, intramuscular injections of ketamine and ketamine IV therapy.  Each of these methods has a unique timeline/protocol. 

The gold standard for IV ketamine infusions is 2-3x per week for two to three weeks or 6 infusions total with “booster” or maintenance doses every one to three months. 

Will I require treatments for the rest of my life?

No, many patients will complete a series of ketamine treatments and will achieve significant relief of their symptoms.  Some patients do require maintenance doses and some patients are able to heal with other types of continued support such as medications, talk therapy, stress management, etc…

Where will the treatments occur?

Our clinic provides comfortable, private clinic rooms for your ketamine therapy treatments.  We have providers available to work with you and/or check on you during and after your treatment session.

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.

Are ketamine infusions addictive?

No, ketamine infusions have not been seen to cause dependence.  However, there have been reports of ketamine being used at high doses recreationally (outside of a medical setting) causing a psychological (not physical) dependence.  This is discussed in detail during our medical intake 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 scale | 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.