Cody and Sierra were my guides for this journey and I could not have chosen a better team to support meAndrew
They take their time to create a peaceful and calm environment and then remain there with you every step of the way through words, touch, or with additional medication/treatment if neededAndrew
What is the recommended treatment course?
DEPRESSION, BIPOLAR, PTSD, AND OTHER MOOD DISORDERS To determine if this treatment option is suitable for you, we will discuss your situation over the phone or by email. Once we’ve decided to move forward with the treatment, you will come to our Truckee location to meet our interdisciplinary team— Clinical Psychologist, Dr. Amy Vail, and Physician Assitant, Cody Sims. The initial consultation fee is 325 dollars. Be prepared to follow strict Covid-19 Protocols, which we will discuss beforehand. If you choose to progress into the program to treat depression, anxiety, and/or PTSD, we strongly recommend that during a 5-session treatment course, you participate in THREE additional therapy sessions with Dr. Vail. These allow our team to identify and address the reasons you came to the center. Many insurance providers will cover part or all of Dr. Vail’s fees. The five-session Ketamine treatment with the additional psychological support from Dr. Vail costs 2750 dollars. We offer 1-hour Ketamine sessions for 425 dollars or a five-session option for 2000 dollars. It’s recommended that clients complete five infusions over a 3-4 week period, followed by booster infusions as needed. These will differ, depending on the patient’s condition and response to the initial treatment program. On average, patients require one infusion every 2-4 weeks, but some go months without needing one. We offer discounts on maintenance infusions for those that go through our program. Please note: Currently, due to Covid-19, we’re requesting every patient bring his/her noise-canceling headphones to use during treatments. We offer 14-month interest-free financing through Advance Care Card.
Will health insurance cover the cost of my infusion?
Most health insurance providers do not yet cover this treatment. We encourage all patients to call their health insurance company and petition for this potentially life-changing therapy to be covered ASAP. The initial evaluation and psychological evaluation session with Dr. Amy Vail and the two follow up therapy sessions are potentially reimbursable from your insurance company. Most health insurance plans include coverage for psychotherapy. We can provide more information at your request. We offer 14 months of interest-free financing through Advance Care Card.
Do I require a referral?
No. Referrals from other health care providers are not required. However, if you are under the care of other health care providers, we request to have your medical records sent to us, and/ or bring any type of documentation that you have from your primary care, pain specialist, psychiatrist, or mental health care provider concerning your diagnosis and past treatment, including a full and accurate list of medications and allergies. We recommended and prefer that you make your physician aware, and hopefully, they are supportive of your plans to start ketamine infusions. We can help facilitate obtaining medical records after you have filled out a medical information release form that allows us to communicate with other health care providers on your team.
What should I bring?
We recommended that you bring one family member or trusted friend to help you understand if ketamine is right for you. Please do not bring pets or children to any appointments. Cell phone use for phone calls during your infusion is not permitted—please expect to be out of contact for the duration of your infusion. We recommend you wear comfortable, loose-fitting clothing. Most patients prefer to listen to music during their infusions. Due to Covid-19, we ask you to bring your personal portable electronic devices and headphones to your sessions. Free WIFI is available.
Should I discontinue any of my medications?
No. You should continue to take all your medications as scheduled, including your medications for pain and depression. You may find a decreased need for these medications after your infusion. However, if you decide to discontinue or make changes with your medications, you should always work closely with your doctor to slowly and safely wean off any medication.
Should I eat or drink prior to my treatment?
Some people experience nausea as a side effect of Ketamine therapy. Please do not have anything to eat four hours before your infusion appointment or have anything to drink two hours before your appointment. Water is available during your ketamine infusion, and we offer beverages and snacks that you may enjoy after your treatment.
Are there serious contraindications to Ketamine therapy?
Any uncontrolled hypertension, severe heart disease, evidence of drug abuse (cocaine, amphetamines or opiates), schizophrenia or psychotic disorder, or manic symptoms during your physical or psychological exam will prohibit you from receiving ketamine.
Am I able to drive myself home after my infusion?
No. Your wellbeing and safety are extremely important to us. Ketamine can impair your coordination, attention, and decision-making capacity. We require you to have someone to drive you home BEFORE starting the infusion. We also ask that you refrain from operating heavy machinery, avoid strenuous activities, or make any important decisions for at least 12 hours post-treatment.
How do you monitor treatment progress?
During your ketamine therapy, our integrated medical and psychological team is available to discuss your experience and support you psychologically. Additional psychological support and psychotherapy are available through our clinic, for those who want ongoing psychotherapy/integration. We are exploring the use of an app-based symptom monitoring service as well to help you decide when you might need booster sessions.
How does ketamine work?
Ketamine is a known antagonist of the NMDA receptor and is also known to interact with several other receptors. The mechanism for its antidepressant or analgesic effects is poorly understood.
Do you treat patients with Spravato (esketamine)?
We can certainly provide Spravato, but we do not advocate this expensive therapy when a cheaper alternative exists: standard ketamine delivered intranasally or by other routes. A consultation with a physician can help determine the ketamine treatment option that is best for you.
How do I know it worked/what should I expect?
It is possible to notice effects as soon as 40 min after the infusion, most typically starting 2-4 hours after the treatment, and sometimes it can take up to 24 hours to notice a difference. Further improvements are often seen over the course of treatment.
How long will the results last?
A single infusion typically lasts anywhere from a couple of days up to 1-2 weeks. A series of 6 infusions may last anywhere from weeks to months, and often a single booster infusion when effects are wearing off can restore response. For those who have not had longstanding chronic problems with depression, the results may last much longer.
Is there potential for addiction?
Clinical experience has found that in the low doses used in medical settings combined with a lack of access at home and infrequent dosing significantly decreases the potential for addiction.
Do I continue with my current psychiatrist, therapist, or primary care physician?
Yes. In some cases, patients may choose to see one of our doctors or health care providers doctors in his/her private practice. But in most cases, people will continue with either their primary psychiatrist or primary care doctor. If you do not have a primary care provider or psychotherapist, our integrated health care team can be available to help connect you with these doctors. If you are considering Ketamine treatment, we highly encourage you to work with a therapist. If you need help finding one, we will facilitate that process.
What are the success rates?
Approximately 70% of patients respond positively to ketamine infusions.
Is it more expensive than taking an oral medication?
An infusion of ketamine is more expensive than a typical doctor’s visit and medication copay. However, considering the financial toll of depression and the symptoms of depression affecting work, social functioning, and ongoing medication costs, ketamine is often worth the expense. Partner ketamine’s efficacy with the lack of relief many experience from traditional anti-depressants, and it becomes a clear value for some.
What are the risks?
How do I maximize the benefits?
Ketamine works better when patients also engage in other activities that support their health, such as healthy eating, exercise, and socializing. Sometimes other standard therapies such as SSRI/SNRI medications can be added to a wellness plan to support a person’s mental health and wellbeing. Ketamine often facilitates motivation to pursue other life-affirming activities. Talk therapy is considered an ideal way to capitalize on the unique transformative experience that exists before and after ketamine sessions.