Ketamine belongs to a group of medicines that work on N-methyl-D-aspartate (NMDA) receptors. Ketamine is understood to work on certain brain receptors and neurotransmitters that affect mood and emotional regulation, hence allowing for processing emotions, while experiencing a shift in state of consciousness. Ketamine therapy has been used to treat depression, post-traumatic stress disorder (PTSD), headaches, certain pain conditions and addiction disorders. 

Patients choosing IV infusion of ketamine undergo this with our pain anesthesiologists and the counselling guidance sessions are scheduled before and after the IV infusions. KAP may also be used before and after the IV infusion ketamine therapy.  

Patients choosing KAP will receive one to one psychotherapy at the same time they take the lozenges.  At changepain, we use Ketamine lozenges compounded by a specialized pharmacy.  On the day of the KAP session, the therapist provides the Ketamine Lozenge to the patient who will let it absorb slowly through the mucous members under the tongue or in the side of the mouth.  The dose per session is adjusted with careful supervision by specially qualified therapists experienced with this therapy. The dose typically ranges between 50mg to 300mg to optimize the experience with minimal side effects.    

• Anyone allergic to ketamine  
• Anyone with uncontrolled Hyperthyroidism  
• Anyone with Glaucoma  
• Anyone with abnormal heart tracing, requiring a pacemaker or AICD, or other certain heart conditions like cardiomyopathy or congestive heart failure  
• Anyone with heart medications would need to be reviewed in more detail   
• Anyone with uncontrolled seizures  
• Anyone with severe liver or kidney disease   

Screening

If you have been recommended KAP, before scheduling sessions, you will need to complete laboratory testing to ensure this treatment is safe for you, including liver function testing, ECG, bloodwork, and urine testing. The specialist will review these prior to the ordering of your medications.  

Possible Side Effects 

Overall, this treatment has very few risks. However, as with any procedure, there are some risks and possible side effects. The following are rare but possible.  

Mild-side effects include slight drowsiness, transient increase in blood pressure, or heart rate headache, light-headedness, nausea

Moderate side effects include marked sleepiness, nightmares, dizziness, confusion, anxiety restlessness, vomiting, dissociation or hallucination symptoms.   

Severe risks include Very Rare: Seizure and heart rhythm disturbances.  

Throughout the ketamine treatment, we pay careful attention and monitor for any misuse or abnormal cravings to prevent reliance or addiction to ketamine.  We monitor for any mood deterioration or suicidal thoughts that require additional assistance.  We aim for the least dose required to prevent side effects of long-term use such as bladder irritation, discomfort or liver dysfunction.  

Ketamine Assisted Psychotherapy involves four phases: Initial consult, preparatory phase, drug administration phase, and integration phase:  

1. Initial Therapeutic Assessment (60 min): The therapist conducts the initial assessment, establishes rapport, and discusses the individual’s treatment intentions and goals
2. Preparatory phase ( 60 min): The therapist prepares the patient for ketamine sessions, which take an additional visit. Once the client is prepared for the dosing session, they proceed to the next phase, the ketamine administration phase.
3. The Ketamine Administration phase (180 min) is when the patient takes ketamine and enters a non-ordinary state of consciousness, during which the client is supported by the skilled ketamine-assisted therapist so that they can explore their emotions, pain, experiences, and challenges. Ketamine-assisted psychotherapy helps individuals access deeper emotional material and may facilitate breakthroughs in therapy or the processing of past trauma.
4. Integration is the phase following the ketamine session. Integration is a crucial component of the therapeutic process. During integration, the therapist helps the client process and integrate their experience, make sense of the insights and experiences gained during the ketamine session, and provide guidance on how to implement the knowledge into everyday life for personal growth and healing.

Cancellation Policy

Please note that KAP group therapy requires a minimum of three clients to be scheduled. Once registration is completed and the therapist has begun planning the cohort, cancellation of KAP treatment is not permitted, as it would impact the entire cohort.

Ketamine Counselling is a counselling service specifically designed for those who are undergoing ketamine infusions at changepain for either chronic pain or depression or those who are prescribed at home ketamine.

Ketamine counselling will be focused on individuals needs and unique indication for ketamine therapy. Therapist and client will address various aspects of upcoming therapeutic ketamine infusions. Counsellor will assist client with emotional readiness, setting intentions, education about ketamine session, and coping strategies in relation to chronic pain or mental health.

While preparation for ketamine is important, integration is just as important. During the integration, counsellor assists client with integrating ketamine experience by exploring the insights, emotions, and memories that may have emerged during the ketamine session, helping the client make meaning of their experiences, and relate them to their therapeutic goals. Cognitive reframing or what we call meaning-making is the process in which the therapist helps client reframe and reinterpret their experiences in the context of their personal growth, healing, and intentions.

Counsellor assists client in integrating the insights gained during the ketamine sessions which may be conducted at the clinic or at home. Counsellor helps individual’s understanding of themselves and their life circumstances, while exploring intentions, goals, and behaviors that will contribute to longer lasting change and overall improved outcome.