Oral Ketamine Assisted Therapy at Home

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

Is at home Ketamine therapy right for you?

Ketamine can sometimes be safely used at home for patients to treat chronic anxiety, depression, PTSD, chronic pain and some other health concerns.  The company Mindbloom has shown efficacy providing oral ketamine treatments for patients in the comfort of their own home.  At Portland Psychedelic Medicine, we strive to make this model of at-home ketamine treatment even more safe and effective by providing improved medical monitoring and a deeper understanding of the needs of our local community here in Portland.

FAQ:

How does at-home ketamine treatment work?
In most cases, we ask patients to schedule their initial medical intake appointment in-person with us so that we are able to get accurate vital signs and a blood pressure reading before prescribing ketamine.  We will typically prescribe enough oral ketamine (either in a syrup or lozenge) to complete 4 journeys at home.  We will follow-up with you with integration after each session to help fine-tune your dosing, troubleshoot any problems/questions, and refill medication as needed based on your treatment plan.

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 appointment is 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.

Is at-home ketamine treatment safe?

Ketamine has a strong safety profile and is being used by thousands of patients safely from home.  There are important safety guidelines that we follow to help ensure the safe use of this medicine at home.  We do recommend always having someone present for patients during these sessions to check-in and provide support if necessary.

What dosage will I be able to use at home?

One of our trained medical providers will help assess and determine the appropriate starting dose for your tolerance and treatment goals.  We can offer very low “sub-psychedelic” dosing as well as a full dose for a psychedelic experience. 

Will ketamine at home help with my treatment-resistant depression?

Clinical trials have shown that ketamine treatment 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 as needed.

Can I eat or drink before my at-home ketamine session?

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 have someone with me?

Yes, we do ask that you have someone within earshot of you while you are journeying at-home. We also ask that you do not drive, operate heavy machinery, or make any big decisions 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 treatments though our clinic 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 the initial 6-session at-home ketamine series?
The total cost for the 6-session at-home ketamine treatment package is $1500. This total includes a 30-minute initial ketamine-focused medical intake, one medical provider 30-minute follow-up after your first 3 journeys, 50-minutes of support with each journey from our integration specialists, and access to weekly group integration sessions.

This does not include the cost of the medication which is typically $40-60 for the total number of rapid dissolve tablets that will be drop-shipped to your home. You will also need to purchase a wrist blood pressure monitoring device, we will provide a specific recommendation at the time of your initial medical intake.

How many sessions will I need?
We typically start with 6 at-home treatments and will continue therapy on an individual basis after we’ve determined the efficacy and long-term goals for your treatment. There is an initial medical provider consultation, a journey that is supported by one of our integration specialists, and a medical follow-up after your first 3 journeys. At the end of treatment, you have the option to schedule another medical evaluation follow-up appointment and continue. We offer a variety of supportive measures for the integration process as well.

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…

What are the side effects of ketamine treatment?
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.

Is ketamine addictive?

Ketamine can be used as a drug of abuse and 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 ketamine treatment.  Our clinic is unable to serve patients under the age of 18 at this time. 

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.