How many sessions will I need?
There is no reliable way to predict how many sessions you will need, or how frequently. Some people will benefit from a series of sessions every 1-2 weeks; others will have a more durable experience. Some of this depends on the dose you receive, some will depend on the counseling you do. But just as some people take longer to make progress in counseling, some people are less responsive to ketamine and need more frequent dosing.
After a journey you will usually need a few days for the experience to settle in. After that we can consider scheduling another session. Or we can “play it by ear:” when you and your therapist think that another session is in order, contact me and we can schedule.
Ketamine at my therapist’s
Therapists who have specific training and experience with ketamine-assisted therapy may want to have you take ketamine in their office. This is generally done with dissolving oral troches. The target level is usually psycholytic: awake and in your surroundings, but with a very altered perception.
I am not prepared to prescribed lozenges for this purpose. I hope, in the future, to have space where your therapist can meet with you after I give a “psycholytic” dose.
Ketamine at home
Some companies are promoting home ketamine, essentially do-it-yourself. In my opinion this is highly dangerous without ongoing counseling and supervision. Likewise, some practitioners advocate micro dosing or daily dosing. In my opinion there is no legitimate role for this: it may seem like a good idea but the cumulative effect is really dangerous.
Ketamine will cause tachyphylaxis: Taking it regularly will cause it to become less effective. Basically, the brain gets used to it being there and adjusts its patterns (receptor numbers, sensitivity, etc.) to accommodate it: after a while the brain stops paying attention. This can be overcome by increasing the dose, then increasing the dose again, and again, until dangerously high doses are being used. Not a good idea
Ketamine can be addictive, and taking it regularly increases the likelihood of addiction.And ketamine withdrawal is a real thing.
Ketamine will alter judgment and manual response time. Driving, using power tools or knives, or making important decisions while ketamine is in the system or while having its after-effects is a really bad idea. Also, ketamine leaves you vulnerable and, in the wrong situation, vulnerable to abuse. There’s a reason ketamine is used as a date-rape drug.
If you are receiving ketamine from another source I will not consider treating you with ketamine.
Ketamine and tele-health
There are experienced, trained therapists doing tele-health with ketamine. At this time I’m not prepared to work with tele-health therapists.