Ketamine Treatment For Depression & Anxiety

A Fast-Acting, Proven Solution for Treatment-Resistant Depression and Anxiety.

Transformative Treatment Options for Depression and Anxiety at Pathwave Psychiatry

At Pathwave Psychiatry, we offer advanced Ketamine Treatment, a highly effective form of treatment for individuals battling treatment-resistant depression (TRD), anxiety disorders, and PTSD. Ketamine can be administered in various forms, including intramuscular injection, sublingual (oral), or as intranasal Spravato®, a FDA-approved option for TRD when combined with an oral antidepressant.

Our clinic focuses on three primary forms of ketamine administration:

  • Intranasal Spravato® (esketamine): A convenient, insurance-covered option, especially for patients with treatment-resistant depression.

  • Intramuscular Ketamine: A fast-acting method with deeper therapeutic effects, ideal for severe depression and PTSD.

  • Sublingual Ketamine (oral): A gentler, non-invasive option, allowing for a more gradual yet effective therapeutic response.

Backed by clinical research, ketamine treatments have shown rapid symptom relief in conditions that don’t respond to traditional therapies, including acute suicidal ideation and severe anxiety disorders. At Pathwave Psychiatry, we tailor each treatment plan to your unique needs, providing compassionate, personalized care to help you regain control of your mental health.

Key Benefits of Ketamine Treatment at Pathwave Psychiatry:

  • Spravato® (Intranasal Ketamine): Approved by the FDA, this treatment is often covered by insurance and provides a non-invasive alternative for those with treatment-resistant depression.

  • Rapid Relief: Unlike traditional antidepressants, which can take weeks to show effects, ketamine can reduce symptoms in as little as a few hours.

  • Diverse Treatment Options: We offer multiple ketamine administration methods to accommodate different patient needs and conditions.

Whether you’ve tried other treatments without success or are experiencing a mental health crisis, ketamine-assisted psychotherapy can offer fast and effective relief. Contact Pathwave Psychiatry today to learn more about how our customized ketamine treatment plans can support your journey to better mental health.

Why is Ketamine effective for Depression and Anxiety ?

Ketamine therapy helps the neuroplasticity process in the brain, enhancing the brain's ability to form new neural connections by stimulating the production of glutamate, a neurotransmitter that plays a crucial role in brain activity. Glutamate, in conjunction with GABA, influences electrical activity in the brain and is closely linked to mood regulation. Research indicates that abnormal glutamate levels are associated with depression and stress. By promoting healthy neural connections, ketamine treatment supports patients with mental health conditions as they engage in other forms of therapy.

The FDA's approval of esketamine has made ketamine treatment more accessible. Previously, patients could only receive ketamine through IV infusions, a method lacking FDA approval. Esketamine, available as a nasal spray, requires lower doses than traditional ketamine to achieve similar effects. This more patient-friendly form of ketamine allows individuals to receive therapy without the need for an IV infusion.

For optimal results, esketamine and other ketamine therapies should be integrated into a comprehensive treatment plan. The FDA currently recommends using SPRAVATO™ alongside an oral antidepressant. Your mental health provider may also suggest therapy, as ketamine's ability to foster new neural connections can be further strengthened through therapeutic interventions, helping to solidify these connections in a positive direction.

Conditions Treated with Ketamine

At Pathwave Psychiatry, we use Ketamine to treat several mental health conditions, particularly in cases where conventional treatments have not worked.

1. Treatment-Resistant Depression (TRD)

Ketamine treatment offers rapid relief for patients with treatment-resistant depression, where traditional medications and therapies have been ineffective. It works by altering brain chemistry, often producing results in hours instead of weeks.

2. Depression with Suicidal Ideation

For individuals with acute suicidal thoughts, Ketamine treatment can be a life-saving option. It has been shown to reduce suicidal ideation within 24 hours, offering immediate relief in crisis situations.

3. Post-Traumatic Stress Disorder (PTSD)

Ketamine is effective for PTSD, helping patients process traumatic memories in a safe, controlled environment. Ketamine reduces symptoms like hypervigilance and flashbacks, improving emotional resilience.

4. Anxiety Disorders

Ketamine can treat generalized anxiety, social anxiety, and panic disorders. By targeting brain circuits involved in fear and stress responses, ketamine helps patients experience relief from overwhelming anxiety.

5. Obsessive-Compulsive Disorder (OCD)

Although still being researched, Ketamine treatment shows potential for reducing the severity of OCD symptoms by disrupting the repetitive thought patterns that characterize the condition.

Ketamine Treatment at Pathwave Psychiatry: Understanding Your Treatment Options

At Pathwave Psychiatry, we offer three different methods for ketamine administration as part of our treatment services: Intranasal (Spravato), Intramuscular, and Oral (Sublingual). Each of these methods has its own unique benefits and considerations, allowing us to tailor the treatment to best suit your needs and preferences.

1. Intranasal Ketamine (Spravato)

Spravato, an FDA-approved nasal spray, is specifically designed to treat treatment-resistant depression. This option is often the preferred method for patients who need a non-invasive and insurance-covered treatment. The nasal spray delivers a lower dose of esketamine, a derivative of ketamine, which is absorbed through the nasal mucosa and acts rapidly to alleviate depressive symptoms.

  • How it Works: Spravato sessions are conducted in-office under supervision to monitor your response to the medication. Spravato must be administered in a clinical setting due to its potent effects and the need for monitoring post-treatment. After administration, you will be observed for around 2 hours to ensure safety and stability.

  • Insurance Coverage: One of the major benefits of intranasal ketamine with Spravato is that it is covered by most insurance plans, making it an accessible option for many patients. For those concerned about the costs of ketamine therapy, this may be the most financially viable option.

  • Ideal For: Patients with treatment-resistant depression who are looking for an insurance-covered, non-invasive option with moderate dissociative effects.

  • Side Effects: Common side effects include dizziness, nausea, elevated blood pressure, and dissociation. However, these are closely monitored, and patients are required to stay in-office after treatment to ensure safety.

2. Intramuscular Ketamine (IM)

For those seeking a more intense, fast-acting form of Ketamine treatment, intramuscular (IM) ketamine is a powerful alternative. This method involves an injection of ketamine directly into the muscle, leading to a more rapid and pronounced therapeutic effect than other methods.

  • How it Works: The ketamine is injected into the muscle, usually in the thigh or upper arm. The effects of intramuscular ketamine are often felt within 5 to 10 minutes, making it a fast-acting option. You will enter a deeply relaxed, dissociative state that allows for therapeutic breakthroughs, especially when paired with psychotherapy.

  • Insurance Coverage: IM ketamine is not covered by insurance, so patients must consider the out-of-pocket costs. Despite this, many patients find it worth the expense due to the faster onset of therapeutic effects and deeper dissociative states that can enhance psychotherapy.

  • Ideal For: Those with severe depression, PTSD, anxiety, or chronic pain who need quick relief or have not found success with more conservative methods of ketamine administration. This method is also suitable for patients looking for a shorter treatment duration.

  • Side Effects: Some patients may experience nausea, dizziness, or transient increases in blood pressure. Dissociation may be stronger with IM administration, and the effects generally last about 45 minutes to an hour.

3. Oral (Sublingual) Ketamine

The oral (sublingual) method is another effective option for Ketamine treatment at Pathwave Psychiatry. Sublingual ketamine involves dissolving a ketamine lozenge under the tongue, which then absorbs into the bloodstream through the mouth’s mucous membranes. This method allows for a more gradual onset compared to intranasal or intramuscular administration but can still be highly effective for certain conditions.

  • How it Works: The lozenge is placed under the tongue and takes about 10 to 15 minutes to dissolve, with effects appearing in 15 to 20 minutes. The dissociative effects are usually milder compared to intramuscular administration, but still significant enough to facilitate deep therapeutic work. This method is particularly suitable for those who prefer a less invasive option without the need for injections.

  • Insurance Coverage: Like intramuscular ketamine, the oral (sublingual) method is not covered by insurance, and patients should be prepared for out-of-pocket costs. However, it can be a more affordable option than some other treatments and provides a less invasive alternative.

  • Ideal For: Patients with moderate depression, anxiety, or PTSD who are looking for a gentler dissociative experience or are uncomfortable with needles or more invasive procedures.

  • Side Effects: While oral ketamine typically results in fewer dissociative side effects, some patients may still experience mild nausea, dizziness, or feelings of detachment. The effects are milder than intramuscular administration but still potent enough for effective therapy.

Comparison Table of Ketamine Treatment Methods

ketamine treatment method chart

What to Expect During Your Ketamine Treatment Sessions

At Pathwave Psychiatry, we are committed to providing a comfortable and supportive environment throughout your treatment journey. Here’s what you can expect before, during, and after each session:

1. Initial Consultation and Assessment

Your treatment journey begins with a thorough initial consultation. During this session, your mental health provider will:

  • Review your medical history and assess your current mental health condition.

  • Discuss your suitability for ketamine therapy and determine the most appropriate administration method (intranasal, intramuscular, or oral).

  • Set therapeutic goals and expectations for the treatment. This preparation is crucial to ensuring the best possible outcome.

2. Preparation for Your Ketamine Session

Before your ketamine session, you will attend a preparation meeting with Dr. Yaqubi. This session helps you get comfortable with the process and sets the stage for the treatment. In this meeting:

  • You’ll work with your Dr. Yaqubi to set intentions for the session, such as what you hope to explore emotionally or mentally.

  • Dr. Yaqubi will answer any questions you may have about the treatment and ensure you feel prepared for the experience.

3. Administration of Ketamine

On the day of your ketamine session, your mental health provider will administer the ketamine through one of the following methods:

  • Intranasal (Spravato): This is a nasal spray form of esketamine, administered in a comfortable, relaxed environment. You will be observed in-office for about two hours after administration to monitor for side effects and ensure safety.

  • Intramuscular Injection: Ketamine is injected into the muscle, typically in your thigh or upper arm. This method leads to rapid onset of dissociative effects, typically within 5 to 10 minutes.

  • Oral (Sublingual): A ketamine lozenge is placed under your tongue and dissolves over about 10-15 minutes. Effects begin gradually, usually within 15-20 minutes.

During this time, you may feel relaxed, dissociated, or detached from your surroundings. This dissociative state allows you to explore thoughts, emotions, and memories with less emotional resistance, making it an ideal time for psychotherapy.

4. During the Session

While under the effects of ketamine, you will be sitting on a recliner in our quiet soothing treatment room for about two hours. We will check your vital signs prior, during and after your treatment. Ketamine treatment can help you to :

  • Focus on key emotional issues or processing trauma that you might not typically access in conventional treatment.

  • Experience deeper insights or perspectives on your mental health challenges.

5. Follow-Up and Continuing Care

Your mental health provider will monitor your progress through follow-up appointments, adjusting your treatment plan as necessary. Your psychiatrist will work with you to :

  • Process and make sense of any experiences, thoughts, or feelings that emerged during the ketamine session.

  • Incorporate new insights into your ongoing therapy and everyday life, helping to solidify positive changes in mood and behavior.

Depending on your condition, you may receive multiple Ketamine treatment sessions over the course of several weeks or months, to help maintain your mental health improvements.

What do we offer at PathWave Psychiatry ?

Some insurance plans cover Spravato (nasal spray ketamine) for treatment-resistant depression and suicidal ideation. We work with insurance providers, allowing some patients to pay only their standard copay for ketamine treatment.

In addition to Spravato, we offer intramuscular and sublingual ketamine treatments. Since ketamine is an "off-label" treatment, insurance typically does not covers these treatment sessions. For sublingual(oral) and intramuscular ketamine, the cost would be from $350 to $550 per session.

Before beginning treatment, you'll receive an estimate of the exact cost. 

FAQ for Ketamine Treatment

  • Spravato® is a form of ketamine, specifically esketamine, which differs from traditional ketamine in its formulation and administration. While ketamine can be administered through intravenous infusion, Intra muscular or sublingual, Spravato® is administered as a nasal spray. Spravato® is FDA-approved for treatment-resistant depression, whereas ketamine is often used "off-label" for a broader range of conditions.

  • Ketamine and Spravato® are administered using different methods, tailored to their formulations and clinical applications : Ketamine can be administered through Intravenous (IV) Infusion, Intramuscular (IM) Injection or via Sublingual, and Spravato® (Esketamine) is a Intranasal Spray.

  • The number of sessions required for ketamine or Spravato® treatment can vary based on individual response, the severity of symptoms, and treatment goals. Here’s a general overview:

    1-Initial Phase: Patients usually start with 2 sessions per week for the first 4 weeks. This intensive phase is designed to rapidly stabilize the patient.

    2-Maintenance Phase: After the initial phase, the frequency may be reduced to once a week or every other week, depending on the patient’s response and clinical judgment.

    Treatments often require ongoing evaluation to adjust the frequency and duration of sessions based on the patient's improvement and any side effects experienced. Regular follow-up appointments are crucial to monitor progress and make necessary adjustments.

  • Each treatment session typically lasts around two hours, depending on the type of treatment and individual response. The session usually includes an initial administration period followed by a monitored observation period of about two hours to ensure safety and to monitor for side effects. The total duration of the visit may vary slightly based on the patient's response and clinic protocols.

  • Some insurance plans may cover Spravato (nasal spray ketamine) for treatment-resistant depression and suicidal ideation. We collaborate with insurance providers, so some patients may only need to pay their usual copay for Spravato treatments.

    Alongside Spravato, we provide intramuscular and sublingual ketamine treatments. However, because ketamine is used “off-label” for these treatments, insurance generally does not cover them. The cost for sublingual (oral) and intramuscular ketamine sessions typically ranges from $350 to $550 per session.

  • Yes, there are several contraindications for using Ketamine or Spravato®. These treatments may not be suitable for individuals with certain medical or psychiatric conditions. Some contraindications include:

    1. Uncontrolled high blood pressure: Both Ketamine and Spravato® can elevate blood pressure, so they are not recommended for patients with uncontrolled hypertension.

    2. History of aneurysms or vascular conditions: Due to the potential increase in blood pressure, individuals with a history of aneurysms or other vascular issues may be at higher risk.

    3. Severe liver disease: High doses or long-term use of Ketamine may affect liver function, so caution is advised for patients with severe liver conditions.

    4. Substance abuse history: Ketamine is a controlled substance, so individuals with a history of substance abuse or dependency may not be ideal candidates.

    5. Certain psychiatric disorders: Patients with a history of psychosis, including schizophrenia, may not be suitable for Ketamine or Spravato® as these treatments could exacerbate symptoms.

    6. Pregnancy or breastfeeding: There is limited research on the safety of Ketamine and Spravato® during pregnancy or breastfeeding, so they are generally not recommended in these cases.

    Before starting treatment, a thorough evaluation by a healthcare professional is necessary to determine if either option is appropriate.

  • No, it is not safe to drive home immediately after a Ketamine or Spravato® treatment. Both treatments can cause side effects such as drowsiness, dizziness, or dissociation, which can impair your ability to drive safely. After treatment, it’s recommended that patients arrange for transportation or have someone else drive them home.

  • When undergoing treatment with Ketamine or Spravato®, potential side effects may vary depending on the individual, dosage, and method of administration. Common side effects include:

    1. Dissociation: A temporary feeling of detachment from reality, often described as feeling spaced out or disconnected from surroundings.

    2. Nausea and vomiting: Some individuals may experience gastrointestinal discomfort during or after treatment.

    3. Increased blood pressure: Both Ketamine and Spravato® can cause a temporary rise in blood pressure, particularly during the treatment session.

    4. Drowsiness or sedation: Many patients feel sleepy or fatigued after treatment and may need time to rest before resuming normal activities.

    5. Dizziness or lightheadedness: A common side effect that can persist for a few hours after treatment.

    6. Headaches: Some patients report mild to moderate headaches following treatment sessions.

    7. Anxiety or agitation: In some cases, patients may feel anxious or restless, especially during the dissociative effects of the medication.

    8. Nasal discomfort (with Spravato®): Spravato® is administered as a nasal spray, which may cause temporary irritation, discomfort, or a runny nose.

    These side effects are generally short-lived and resolve after the treatment session. However, a we will closely monitor for any significant or persistent adverse reactions. It’s important to discuss your full medical history with your provider to minimize risks and ensure the safest treatment approach.