Booster:
A booster is an optional additional partial-dose of Ketamine administered after an initial dose to prolong the effects during a dosing session. The prescriber will discuss the differences in dosing options, and will provide individualized instructions during the KAP consultation at Journey Clinical.
Clinical Scales:
Clinical scales are used by our medical team to help tailor the plan of care individually to meet your specific needs. The clinical scales surveys will be reassessed throughout your KAP treatment and can be documented in the patient portal prior to consultations.
Dosing Session:
A dosing session is when ketamine is self-administered by you as the client in a therapeutic environment. This session lasts about 3 hours, with the ketamine effects typically lasting 45 minutes. You will take your vitals before taking ketamine and again at the end of the session.
Full-dissociative dose:
A full-dissociative dose of ketamine is the dose determined based on weight that allows for a sense of separation between one's and body.
Half-dissociative dose:
Once the full-dissociative dose is calculated for you, that dose is split in half to create two half-dissociative doses. This amount of ketamine is a lower dose that may still produce a dissociative state, and can be titrated according to your individual response to treatment and goals. At Journey Clinical, we encourage starting slow while determining how your body and mind reacts to ketamine. Having half-dissociative dose tablets and booster tablets allows for more flexibility in dosing options to tailor the experience best to your needs. Please refer here for additional information on dosing options for your first session and the sessions afterwards.
In-Person KAP:
In-Person KAP is conducted at your therapist's office. The therapist will act as your chaperone during the dosing session, and you should pre-arrange to have safe transportation home from the appointment. After taking ketamine, you cannot drive or operate machinery for at least 12 hours. You will still need to obtain your vitals before and after the treatment, and can read them to your therapist while in-session. Your therapist will have comfort measures in place for you.
Integration Session:
An integration session is a therapy session between a patient and their member psychotherapist after a ketamine dosing session to process and integrate the insights and experiences gained during and after the dosing session. They may sometimes happen immediately after your dosing session. Integration sessions are scheduled directly with your therapist and must occur between dosing sessions.
KAP:
Ketamine-assisted psychotherapy (KAP) is a treatment modality that combines the use of ketamine, a dissociative anesthetic, with psychotherapy to treat a range of mental health conditions. All medical activities, including patient eligibility, ketamine prescriptions and clinical follow-ups, are done by Journey Clinical’s in-house medical team of psychiatrists and psychiatric nurse practitioners. Journey Clinical also matches eligible patients with a KAP-trained, licensed psychotherapist in your area for preparation, dosing journey and integration sessions.
Ketamine:
Ketamine is a safe, legal medication prescribed off-label to treat a variety of mental health diagnoses, including depression, anxiety and PTSD. It has rapidly acting antidepressant and mood-enhancing effects, which can begin to take effect within hours after treatment, and lasting for several weeks after. It works by blocking the brain’s NMDA receptors and by stimulating AMPA receptors, which may help form new synaptic connections and boost mood-regulating neural circuits. Ketamine has also been shown to enhance neuroplasticity for lasting symptom improvement.
Self-Guided KAP:
Self-guided KAP therapy is similar to remote KAP, however the member therapist is not actively present during the dosing session. This modality is scheduled in advance, and still includes preparation before the appointment as well as integration work afterwards with your therapuetic alliance. Your Journey Clinical therapist will need to be able to check in with you before AND after the session via text or phone. You will have a pre-arranged chaperone who is fully present with you for acute monitoring. The chaperone must visually check-in with you every 15 minutes and should be someone you trust and are comfortable with. They can assist you with comfort measures and escalate any concerns as needed. You will still need to record your vitals before and after treatment, and can relay them to your therapist before and after during their check-ins. Your therapist and prescriber will work collaboratively to determine your eligibility for this modality. Please follow your individualized instructions, including whether your KAP session will be in-person, remote, or self-guided.
RDT:
Rapidly Dissolving Tablet (RDT) is the form of Ketamine that Journey Clinical prescribes for KAP dosing sessions. Ketamine absorption varies greatly depending on the membrane it’s in contact with, and the cost of Ketamine can vary depending on its form. With other routes, there’s the risk of changes in absorption and duration of effects. At Journey Clinical, we prescribe rapidly dissolving tablets (RDTs) and use a swish and spit method, which will be discussed with your prescriber during your initial appointment. This is very cost-effective and minimizes the chance of unwanted effects including nausea or vomiting, while allowing patients to have a consistent experience of knowing when the effects of the medication will dissipate. You may feel the effects of Ketamine within 15 minutes of taking a RDT, and the effects typically last about 45 minutes.
Remote KAP:
Remote KAP is conducted with the Journey Clinical member therapist being fully present throughout the dosing session with the patient on a Zoom call. The therapist will act as the chaperone and stays on the call throughout the entire session. You will still need to obtain your vitals before and after treatment, and can read them to your therapist while in session on the video call. You will still complete preparation work before the dosing session, and integration work between sessions with your therapist.