We offer KAT for the following conditions: • Depression • Anxiety • PTSD • Bipolar 1 and 2 (non manic phase) We do not currently offer KAT for the following conditions • OCD • Bipolar 1 (manic phase) • Psychotic disorders • Personality disorders If your condition is not listed, please feel free to contact our office for a consult. Our mission is accessible treatment, and we want to help!

Ketamine is safe When administered according to best practice protocols, ketamine is extremely safe. Ketamine has been around since the 60s and is on the WHO's list of essential medicines. There are hundreds of medical journal articles testifying to its safey and efficacy. It is hard to find any medicine with a safety track record and safety profile (for adults and children) like ketamine. Ketamine is not only phsyically safe, but safe psychologically. Known as the "forgiving psychedelic", there is no record of any pyschological damage caused by ketamine when administered in a controlled, therapeutic enviroment. Ketamine is legal Ketamine is a legally prescribed medication. All Perspective Wellness clients undergo a complete psych-med intake and screening process with our Nurse Practitioner (APNP) to ensure treatment is safe and appropriate.

“Psychedelic“ is a word that carries a lot of cultural baggage. Psychedelic comes from the Latin words for “mind manifesting “. Most of the classic psychedelics such as LSD, Peyote, Psilocybin, and Ayahuasca (DMT) work through common pathways in the brain which involve the serotonin receptors, (i.e. 5HT-2A), Ketamine works through the glutamate system. Leaders in the field agree that the use of ketamine in the doses used for KAT is truly “mind manifesting”, though certain characteristics of the experience, the signature, are different. Ketamine provides a more introspective experience, hence the term "emotional psychedelic". We use eye shades and music to enhance the introspective nature of the experience.

Ketamine is a schedule III drug. Drugs in this class tend to have “very minimal potential for addiction”. However abusive and addictive behaviors with relation to the ketamine experience occur. The most common pattern is that there is a desire or preference to be in the ketamine state of awareness as opposed to our day-to-day reality. In KAT, access to the medication is strictly controlled. We monitor for behaviors that might indicate the emergence of dependence and actively guard against it.

Ketamine works on the brain's glutamate system, as does alcohol and nitrous oxide (laughing gas). Many people report the initial feelings of ketamine feel like a few glasses of wine or dental nitrous oxide. Another first thing clients notice is the "music becomes alive" and deeply felt. We use only low to moderate doses. Also, because we use rapidly dissolving tablets, the onset is very gentle. At the doses we use, clients maintain a "sense of agency", which is especially important for clients with trauma histories.

Generally speaking, there are very few rule outs for treament. Hard Rule Outs • Schizophrenia: Immediate Family History Of • Pregnancy or Planned Pregnancy • Current Psychosis or Active Mania • Uncontrolled Hypertension • History of Ketamine or Anesthesia Reaction with or without Malignant Hypothermia • Acute Intoxication or Alterned Mental Status • Taking MAOIs • Mental Impairment • Needs Substance Abuse Treatment First Soft Rule Outs (may accept for treatment upon consultation with other client providers) • Current Alcohol Dependance • Postpartum or Breast Feeding • History of Cardiac Rhythm Disturbance • History of Cardiac and/or Circulatory problems • History of Respiratory problems • History of Seizures • Liver conditions (Cirrhosis, etc) • Hyperthyroid • Renal Failure and Dialysis • Current Subtance Abuse Treatment

Because of its chemical properties ketamine is easy to administer using a number of different routes. In research settings it’s usually administered with an IV. We believe use of IVs medicalizes the process and interferes with the set and setting clients are trying to establish. Several of our clients have visited IV clinics and prefer KAT. At Perspective, we use primarliy sublingual ketamine in the form of rapidly dissolving tablet (RDT) lozenges, especially for new clients. The RDTs are absorbed by the submucosal membranes of the mouth. Clients sit up in the treatment chair, dissolve the medicine in their mouth, and do the "psychedelic swish" for 10-15 minutes. The medicine is spit out into a cup, the chair reclined, and the journey begins. The RDT experience has a wonderful experience curve, building slowly and steadily to peak experience of 15-30 minutes, and then gently curving back to a peaceful and gentle slow return. This slow return to ordinary consciousness is knows as the "long tail" and is an incredibly therapeautic part of the experience. We also administer ketamine by Intramuscular (IM) injection. This is an option for clients that have tried the RDT experience. If you have questions about IM, let us know.

Our treatment philosophy is to use the least medication possible to achieve maximally beneficial outcomes. KAT is a new field, and we are constantly learning. Typically, clients start with three fully prepped and integrated KAT sessions over 90-180 days. After each KAT session we assess together how you are responding to treatment. That said, we've had many clients have remarkable, durable responses after a single session. After the first three treatments, clients tend to shift into a "maintenance" phase of between one to three treatments per year. Treatments become part of their mental health and wellness regime, with each treatment providing an opportunity to catalyze deeper growth and resilience.

Ketamine "plays nice" with most medical and psychiatric medications. The are a few exceptions which require a "day of" hold, like benzodiazepines, ADHD medications, or mood stabilizers like lamotrigine, which blunt the effect of ketamine. Every Perspective client receives a full and complete medical intake and screening, which includes an analyis of your current medications.

Emotional and physical safety is our #1 concern. We currently only provide actual KAT sessions in our clinic. Preparation and integration sessions with faciliating guides are done via telehealth.