KETAMINE-ASSISTED PSYCHOTHERAPY

● Ketamine is a legal, safe, and effective medicine used to treat a variety of mental health conditions, including depression, anxiety, and PTSD. Ketamine has rapidly-acting antidepressant and mood-enhancing effects, which can begin to take effect within 1-2 hrs. after treatment and last for up to 2 weeks. 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, including IV infusion, intramuscular injection, via nasal spray and using sublingual lozenges. In my work with Journey Clinical we only use the sublingual lozenge form.

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’ll be lying down in a comfortable position during the experience. Once these effects subsided, we’ll spend the remainder of our appointment giving you space to process and discuss your experience. While it may feel hard to articulate what happened during the experience, patients feel like the insights gained are none-the-less clear. Studies have shown that the benefits to mood and neurological growth can last up to two weeks after the Ketamine experience.

1. Initial consultation with Center for New Growth (CNG) ● You schedule an initial evaluation with a clinician from the CNG 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. ● If CNG’s medical team determines that you are eligible for KAP, they will develop a personalized Ketamine prescription and outcome monitoring plan for you. ● CNG’s medical staff will write a ketamine prescription for you. You will be taught to take your vitals and self-administer the ketamine lozenges by CNG’s medical team in advance of our KAP sessions. 2. Preparation sessions: ● Once you receive your ketamine lozenges, we will schedule time together for our KAP preparation, dosing, and integration sessions. Preparation session(s) will be scheduled just like regular therapy sessions prior to the KAP dosing session. The goal of a preparation session(s) is to align on the process and set intentions for our KAP sessions together. 3. KAP Dosing Session: ● A typical ketamine dosing session lasts 3 hours and can take place either in-person at my office, or remotely via telehealth. ● During a dosing session, you will self-administer your ketamine lozenge either in my 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: ● After our KAP dosing session, we will meet for multiple integration therapy sessions to review the memories, thoughts & insights that arose during your dosing session, and to prepare for the next dosing session. 5. Follow-up consultations with CNG: ● After our first KAP session, CNG’s medical team schedules 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.

Ketamine-Assisted Psychotherapy is an affordable, accessible modality. Although the medical intake and follow ups are not covered by insurance, they are eligible for out-of-network reimbursement. Ketamine-Assisted Psychotherapy: ■ My typical hourly rate is $275 an hour, intake sessions are $300. Dosing sessions will be booked for up to 3-hours ($900). Insurance does not cover these dosing sessions, but insurance can be used for the preparation and integration sessions if you so choose - you would submit the superbill (a receipt) to your insurance company for possible reimbursement. Center for New Growth Medical Costs (CNG) ■ First-time patients ● Initial medical consultation with CNG: $250-375 ● Cost of medication: varies ■ Ongoing treatment ● Follow-up medical consultation with CNG $135

If you would like to explore the possibility of working with me on KAP, please e-mail me at drloi@drloi.com to discuss eligibility and next steps. Or give me a call at 707-962-4106.

Please see: https://humboldtcenterfornewgrowth.com/ Helpful Resources: 1. Paradigms of Ketamine Treatment by Raquel Bennett, Psy.D. for MAPS https://maps.org/news/bulletin/paradigms-of-ketamine-treatment-spring-2019/? 2. Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy-research study by Jennifer Dore et al, 2018 https://www.tandfonline.com/doi/full/10.1080/02791072.2019.1587556? 3. 3. Ketamine for Depression and Mood Disorders by Erica Zelfand, ND for Townsend Letter https://www.townsendletter.com/article/438-ketamine-for-depression-and-mood-di sorders/? 4. Ketamine-Facilitated Psychotherapy for Trauma, Anxiety, and Depression by goop https://goop.com/wellness/health/ketamine-facilitated-psychotherapy/? 5. Ketamine Assisted Psychotherapy with Jonathan Sabbagh of Journey Clinical- Psychology Talk Podcast https://www.spreaker.com/user/11347814/ketamine-assited-psychotherapy-with-jo na?