Ketamine is a dissociative anesthetic medicine with psychedelic properties. In mental health applications, it is a treatment for trauma reprocessing, treatment resistant depression and anxiety, end of life and palliative care.

Ketamine works by reorganizing the activity in the brain – it breaks through inhibitory nets of neurotransmitters and turns on typically silent cells while quieting normally active ones. It targets the neurotransmitter glutamate by filling (i.e. blocking) the NMDA receptor, therefore preventing the NMDA receptor from being activated by glutamate. Ketamine activates the interaction between brain structures associated with cognitive processing of information (the frontal cortex) and structures involved in the processes of emotions, motivations, memory, and subconscious experiences and perceptions (limbic structures) (Eli Kolp et al). It creates neural plasticity which changes how brain regions respond to emotional stimuli and accompanies changes in behaviors. Ketamine increases delta activity and theta activity in the cerebral cortex.

Ketamine has been studied for its antidepressant properties, impact on mood disorders, Bipolar Disorder, reduction in suicidal ideation, treatment of PTSD, palliative and end of life care, eating disorders, anxiety, OCD.

Every ketamine journey is different - even for the same person journeying multiple times. What is consistent, though, is the experience of entering into a non ordinary state of consciousness (NOSC) where you will feel a lessening of normal defenses and normal perceptions.​​ The Default Mode Network (DNM), the way the brain normally fires, and the Medial Prefrontal Cortex, where we hold subjective experiences and our narrative self, will quiet down so that other parts of your brain activate. In their place, you may experience metacognitive or transpersonal awareness (i.e. feel like you have stepped outside of yourself so you are no longer preoccupied with yourself ), and feel a sense of impermanence, smallness, connectedness, oneness, empathy, compassion, warmth and love. You may experience an out of body sensation, dissolution of your ego and a loss of identity. You may experience transcendence in time and space. You may see visuals, you may feel music as movement in your body, you may revisit moments of your past. You may experience sensations of pleasure and you may experience sensations of discomfort. Some experiences may feel mystical and spiritual, some may not. You will likely experience dissociative effects and the experience may feel ineffable.

Ketamine assisted therapy is effective for different reasons. First, there is the biochemical element whereby glutamate receptors + neuroplasticity changes how brain regions respond to emotional stimuli and accompany changes in behavioral output (Keller).

Second, there is the experiential element of the journey itself where psychological insight from an altered state of consciousness – feeling freedom, perspective shifting, meeting symbols, radical acceptance and deeper connection – will bear an impact on the way you see and feel about things. The journey may be the first time you experience a shift in your life and self narrative, leaving a lasting impression on your perspective.

Third, there is the meaning we will make out of your experience, like reprocessing emotional trauma, crystallizing the benefits of the experience into your life. We will integrate the positive psychological changes and catalyze insights into applications for your life while we process what your journey means about reprocessing your past and crafting your future.

Absolutely; ketamine is federally legal (ie: legal in every of the 50 states). I only work with legal psychedelics. Ketamine is currently a Schedule III drug that was invented in 1962; put into use since 1964 (relied on heavily in the Vietnam War); approved by the FDA for use as a dissociative anesthetic with children, adults and the elderly in 1970; is currently applied under off-label use for mental health conditions; and was approved by the FDA in 2019 for treatment of depression under the brand name SpravatoⓇ. Ketamine can only be prescribed by a medical provider (a doctor or nurse practitioner) and as a Schedule III controlled substance it is subject to stringent prescribing procedures.

Ketamine has a very high safety profile, though there are several risks associated with using ketamine in an unsupervised and non prescribed manner. In the way I work, the biggest risk of ketamine is that the pleasure state it can induce may be something people seek to keep chasing and have an addictive quality in that manner. The molecular profile of ketamine, however, is not addictive in nature and does not have the same addictive properties as opioids.

I do not prescribe ketamine. I will refer you to a medical prescriber who does and will conduct a medical evaluation, dose determination and course of treatment plan. You and I will prepare for the treatment; we will be in person and I will guide you during the medicine sessions; and we will integrate or process your experience post medicine treatment. I will support every part of the process but I will not prescribe you ketamine.

Once you complete your medical evaluation, ketamine is prescribed as a sublingual lozenge and mailed to you (in a temperature controlled pack) by a compounding pharmacy. There are several routes of administration for ketamine (most commonly but not limited to: lozenge, intravenous, intramuscular shot, nasal spray) but I only work with sublingual lozenges.

Ketamine doses are determined by your medical provider and based on a few factors: your size (height and weight), your sensitivities and tolerances, your history of experience with psychedelic medicines, your symptom presentation, and how deeply you want to journey. It is possible to work with two types of dosing: psycholytic doses, (generally 15-75 mg dose) which are low doses where communication is possible and augmented by heightened emotional access; and psychedelic doses, which are higher doses (generally 75-400 mg dose) where consciousness is altered and mystical experiences occur. As dosage increases, consciousness itself diminishes and unconsciousness occurs.

Ketamine medicine sessions (“journeys”) are 3 hours long. We prepare for about 30 minutes, sit with the medicine for about 90-120 minutes and integrate for about 30 minutes. Ketamine absorption varies from person to person and according to dose and generally takes from 45-90 minutes. The half-life of ketamine is 1.2 hours.

We determine the number of recommended sessions for you based on what you are presenting with and how you respond to treatment. In a ketamine assisted therapy format, we generally offer between 2 and 8 medicine sessions paced out over a period of time that feels appropriate to your body, your needs and to your specific course of treatment. In other words, this isn’t as prescriptive in nature as some other models. We develop a treatment plan specific to you.

Preparation sessions are essential to the success of treatment. We will meet for 1-3 sessions before a medicine session during which I will complete a full assessment of your history and presenting symptoms and we will set treatment goals and intentions for your experience. I will explain the process and answer questions and we will discuss concerns preparing and priming your mindset for the best experience possible.

Integration is the processing of symbols, memories and feelings experienced during a psychedelic medicine session. During integration, we decode the experience, translate it into useful insights about your emotional landscape and make meaning out of the experience in order to crystalize the benefits of the experience and become behavior changes.

I only provide ketamine assisted therapy sessions in person. It is possible to prepare and integrate virtually, but all medicine sessions are conducted in person. So we will either meet in my office in Miami or New York City.

Loose, comfortable clothing is recommended as you will be laying down; people usually enjoy wearing socks and layers. You are invited to bring any meaningful objects (like photos or tokens) for an altar and a journal. I will provide eye shades, pillows and blankets, beverages and snacks.

Immediately after a ketamine medicine session, you may feel dreamy, woozy, nauseous or tired. You may also feel energized and excited. Most likely, you will feel hungry. You may experience a “psychedelic afterglow” where positive mood, feelings of increased confidence, relief, inner peace, motivation, empathy and energy benefits may be felt as soon as the same day or the next day, and last for days to weeks after. Often you will sleep very well the night of your treatment.

Operating a vehicle after a medicine treatment is strictly prohibited so we will discuss transportation arrangements during our preparation.

Physically, ketamine has a high safety profile and so long as you are cleared during your medical evaluation, there are no safety concerns.

Journeying into non ordinary states of consciousness can certainly feel scary at first. Preparation is central to feeling safe during these processes and I will make sure that you are well supported and cared for during your journey.