• Ketamine is a legal, safe, and effective medicine used to treat a variety of mental health conditions, including depression, anxiety, and Post-traumatic Stress Disorder (PTSD). Ketamine has rapidly acting antidepressant and mood-enhancing effects, which can begin to take effect within 1-2 hours after treatment. It works by blocking the brain’s NMDA receptors, as well as by stimulating AMPA receptors, which are thought to help form new synaptic connections and boost neural circuits that regulate stress and mood. Ketamine has also been shown to enhance overall neuroplasticity for lasting symptom improvement.
• Ketamine can be administered in a variety of ways. In our work with Journey Clinical we only use the sublingual lozenge form, which is a small tablet dissolved under the tongue.

The effects of ketamine, which most patients find pleasant, last for approximately 45 minutes. These effects can make you feel “far from” your body, and facilitate shifts in perception that can often feel expansive in nature. Your motor and verbal abilities will be reduced, so you will be lying down in a comfortable position during the experience. Once these effects subside, we will spend the remainder of our session giving you space and time to process and discuss your experience. While it may feel hard to articulate what happened during the experience, patients nevertheless feel like the insights gained are clear. Studies have shown that the benefits to mood and neurological growth can last for weeks after the ketamine experience.

1. Initial consultation with Journey Clinical:
   1. You schedule an initial evaluation with a clinician from the Journey Clinical medical team via Zoom. They will go over your medical and psychiatric history with you, provide education on the treatment, and determine if you are eligible for KAP.
   2. If Journey Clinical’s medical team determines that you are eligible for KAP, they will develop a personalized ketamine prescription and outcome a monitoring plan for you.
   3. Journey Clinical’s medical staff will write a ketamine prescription for you, and a small amount of oral ketamine will be sent to your home (enough for the first two KAP sessions). You will be taught to take your vitals and self-administer the ketamine lozenges in advance of our KAP sessions.
2. Preparation sessions with IPG:
   1. Once you receive your ketamine lozenges we will schedule time together for our KAP preparation, dosing, and integration sessions. Your preparation session(s) will be scheduled just like regular therapy sessions prior to the KAP dosing session. The goal of the preparation session(s) is to align on the process and set intentions for our KAP sessions together.
3. KAP Dosing Session:
   1. A typical ketamine dosing session lasts between 1-2 hours and can take place either in person at an IPG office, or remotely via telehealth.
   2. During a dosing session, you will self-administer your ketamine lozenge either in our office or in your home. You will be in a comfortable, reclining position, wearing an eye mask, and listening to calming music. Although a KAP dosing session may be largely an internal experience, I will be present with you the entire time to hold space and provide support as needed.
4. Integration Sessions:
   1. After our KAP dosing session, we will meet for multiple integration therapy sessions to review the memories, thoughts, and insights that arose during your dosing session, and to prepare for the next dosing session.
5. Follow-up Consultations with Journey Clinical:
   1. After our first KAP session, Journey Clinical’s medical team will schedule regular follow-ups with you to monitor outcomes and prescribe ketamine lozenge refills, as appropriate. The frequency of follow-ups depends on your unique treatment plan, at a minimum of once per quarter.

Both the medical and psychotherapy aspects of KAP may be eligible for insurance coverage, depending on your plan. Here is a breakdown of the costs:

• IPG Psychotherapy Costs:
  • Consultation and preparation sessions prior to dosing, and integration sessions afterward: our normal per-session rate
  • 4-hour ketamine dosing session: 3 hours at the same rate, and if your insurance does not cover the first 3 hours then the 4th hour is free
• Medical Costs
  • Medical intake: $250 (one-time fee)
  • Follow-up medical consult sessions (if needed): $150
  • Ketamine lozenges: $75 for 4-6 lozenges (not covered by insurance)