Is psychedelic ketamine therapy right for me?

For persons facing a serious or deadly diagnosis can be scary, especially if a person feels anxiety about death itself or what might happen afterward. A handful of studies suggest that psychedelic therapy may ease this existential dread, as well as the anxiety and depression that accompany it. Psychedelic therapy may also ease symptoms of depression and anxiety in people not facing serious illnesses, and may help ease the effects of trauma. Psychedelic therapy may also help ease some symptoms of addiction. The mystical and psychedelic experiences a person has with psychedelic therapy, may shift a patient with body image, away from unhealthy thoughts, potentially easing symptoms of eating disorders.

Are you accepting new patients?

Yes, please inquire on contact page, about scheduling an appointment.

Will you prescribe me other medications?

PURE is a specialty clinic, providing only KAP services. If you are seeking a med management provider, you and your PURE provider can discuss a possible recommendation for other medication management providers in the area.

Where are you located? Where can I park?

4300 Baker Rd Suite 200 Hopkins MN 55343

Prosperwell Financial Building

Located on the 2nd Floor (waiting room upstairs)

Do you offer telehealth services?

Yes, many of our services are available with the convenience of telehealth technology.

Is it safe to attend sessions in the office with respect to COVID-19?

PURE is dedicated to protecting our patients. We choose to provide in-person therapy, due to the pandemic resulting in increased levels of the mental health concerns. We provide services are essential to many that are seeking help. If you have concerns about in-person sessions due to Covid, please speak to your providers to discuss a plan for your care.

Does PURE provide psychotherapy without psychedelics?

PURE is a specialty therapy clinic that focuses on providing KAP to patients, with coordination of services with outside providers, to ensure that there can be a team approach to your mental health needs. Integration, post KAP medicine session, can however, be longer-termed in duration, if needed, and agreed upon by yourself and your provider as a part of your course of treatment. Psychedelic informed psychotherapy is also available for those seeking to integrate psychedelic experiences, and further develop inner healing wisdom.

Do I have to commit to a series of sessions or can I just try it out?

A general course of treatment requires a minimum of one Psychological Diagnostic Assessment, one medical evaluation, one prep session, one ketamine exploration session, and one integration session, although this is dependent on if you are familiar with altered states of consciousness. If this is your first psychedelic experience, preparation and integration are required to help you understand the process and course of therapy, which is how KAP differs from ketamine infusions. If you are seeking acute symptoms relief, we recommend looking into ketamine infusion clinics.

How is Ketamine administered at the clinic?

At PURE, the administration is through intramuscular (IM) or sublingual (SL) only. SL is for those who cannot or wish not to receive injections in a medical setting, or if continued treatment plan includes SL KAP sessions, which will be discussed between yourself and your providers. You will remain awake and able to talk during the procedure, but your perception and mental state will likely be altered by the ketamine. You will return to a normal mental state as the immediate medication effects wear off. Ketamine can be administered by intravenous (IV), intramuscular (IM), sublingual (SL), and intra-nasal routes.

Can I drive after my medicine session?

Because of the dissociative effect of Ketamine, we require that you have transportation set up after your active ketamine exploration session. Once medically cleared, you will be allowed to leave the clinic with your arranged ride. Should you have any concerns when you are home, please call our office to discuss. 

What do I need to do after my medicine session?

1. Refrain from driving - for at least four hours after you leave the office, or until any lingering effects have stopped. Ketamine has a long tail and it is possible to feel loopy, unbalanced, and disoriented for a few hours after you leave the office.

2. Be gentle with yourself - You just went through a significant experience and your body, mind, and spirit need to rest. Give yourself the rest of the day to be quiet and begin your integration process (see notes below).

3. Listen to your body - Pay attention to cues for hunger and thirst. You fasted earlier today and are likely somewhat dehydrated. Hydrate according to what your body needs and eat foods that feel nourishing. Refrain from alcohol or other drug use (unless previously discussed with therapist/doctor).

How is music used in my treatment session?

Music is an immensely important part of the experience and provides a framework for how the experience unfolds. Music is a guide through your journey, to assist in the process of medicine-psychotherapies. There are often waves that we ride during our journey, and the music can safely carry you through the experience. Medicine-psychotherapies often have a degree of being ineffable; music assists in the guiding narration of your experience when words cannot.

What is the ketamine experience like?

During the Ketamine exploration session, your medical provider will administer the Ketamine, and the therapist will be present for the duration of the session. You will be provided a very comfortable chair that reclines, with pillows, blankets and other amenities to ensure optimal comfort. You will be provided with eyeshades (Mindfolds) and headphones, with a music playlist designed specifically to help support your healing experience. The therapist will be available for whatever support is needed and bases their responses off of your individual needs. For example, if you have something you want to process, talk about or engage with, the therapist will be there to help. Or, if you prefer to listen to music the whole time, the therapist will support this as well. Beyond the basic measures taken to ensure your safety and that of the therapist, there’s no right or wrong way to do this. The therapist may offer you some recommendation/options based on their experience and knowledge and they will support you in determining what direction makes the most sense for you.

How do I prepare for my ketamine treatment?

1-Please bring any questions you have to your assessment visits. We will ask you about medications you’re taking and any past mental health and medical diagnoses you have received. We may request additional information as needed.

2-If you have an ongoing therapist, psychiatrist or medical provider, it is helpful for us to be able to coordinate with your providers. Sometimes it’s helpful to ask your existing providers to complete a Release of Information (ROI) so that we can communicate. Otherwise you can complete an ROI with us at the time of your intake.

Do I need a referral for psychedelic therapy?

No. We do however, recommend that you have engaged in psychotherapy in the past, as this treatment can feel intense for someone who is not as aware of aspects of their mental health concerns/symptoms, that may need to be assessed and treatment goals may be recommended to have been met, prior to engaging in KAP.

What methods of payment does PURE accept?

PURE therapy accepts credit, cash or check for services rendered. We currently accept insurances of:

HEALTH PARTNERS

MEDICA (MN Preferred & Select Care)

MN MEDICIAD (Medical Assistance-MA)

United (OptumHealth Behavioral Health)

We also accept private pay, and have sliding fee scale options for those who need financial assistance for services. We also have credit options available through Advanced Care Card.

How much does Ketamine Assisted Psychotherapy (KAP) cost?

PURE accepts private pay for services, and offers a sliding fee scale that is income based, for those in need of financial assistance for services. Ketamine exploration sessions are not covered by sliding fee scales, nor by insurance plans, and are always an out of pocket expense. You are welcome to use an HSA or FLA card to pay for your ketamine exploration session, and if needed, your statement can be used as an EOB for your insurance carrier. The cost per Ketamine Exploration Session is listed in the service fees section at the bottom of the page. There is additional cost per psychotherapy session, and potentially also for your medical evaluation. Please reach out if you have questions regarding pay structure at PURE. Prices listed above are for the active KAP medicine session only.

What Is ketamine?

Ketamine is a dissociative anesthetic. At sub-anesthetic doses, the experiences resemble classic psychedelic medicine. It can be administered through intravenous infusions (IV), intramuscular injections (IM), sub-lingual lozenges (SL), or a nasal spray called Esketamine/Spravato. Esketamine is approved by the FDA for the treatment of treatment-resistant depression. The others are used “off label.” Other off label uses include: PTSD, anxiety, OCD, and bipolar disorder.

What is KAP?

Ketamine-assisted psychotherapy (KAP) is a clinical mental health treatment that includes using ketamine alongside psychotherapy, to help individuals work through various mental and emotional challenges.

How does Ketamine work?

Psychedelics cause significant changes to one’s perceptions, sense of self and experience of reality. Psychedelics may offer a “break” by helping one to access non-ordinary states of consciousness, which can help give them an opportunity to reflect more deeply on their struggles and sense of purpose and place in the world. Uncovering our values, meaning, and sense of self may help us to find freedom from the patterns we feel trapped in.
 
In terms of the pharmacology, most typical psychedelics impact the 5HT2A receptors in the brain, although atypical ones like Ketamine impact other systems. Researchers have recently discovered a network of activities in our brain that’s referred to as the “default mode network”. This is the idea that we tend to engage in patterns of behavior and can feel stuck in a certain story of who we are, and what our life means. Challenging life experiences can distort our thinking; we can often feel insecure, unsafe, and want to remove ourselves from daily life.
 
Having a “break” from our normal ways of being, in combination with therapy can help to identify alternative narratives to our life. We believe the stories we tell ourselves about our lives can lead to deeper meaningful interactions or keep us stuck in patterns that are destructive.  Creating a new narrative requires an interruption to unhelpful stories we tell ourselves; psychedelic psychotherapy aims to help promote such a break.

What are the risks of ketamine?

The most common effects are nausea & vomiting, increased salivation, increased blood pressure and heart rate. Vital signs will be checked before your encounter and during if there are signs of physical distress. It is normal for patients that work through their trauma to have moments of distress that do not pose a physical danger to themselves. The therapist will aid in your journey and guide you through those difficult moments. For nausea, you may be offered anti-nausea medication before your session. You can minimize this risk by eating a light meal that day and not eating 4 hours prior to therapy.
 
Visual, tactile, and auditory processing are affected by Ketamine. Your sense of time and space may be altered, causing difficulty with balance and coordination. Other adverse side effects may include blurred and uncomfortable vision, slurred speech, mental confusion, excitability, diminished ability to see things that are present, diminished ability to hear or to feel objects accurately (including one’s own body), agitation, anxiety, and Synesthesia (a mingling of the senses). There have been reports of some decrease in immune function in patients receiving surgical doses of ketamine, however the outpatient use of Ketamine is very different from inpatient use, as the doses are significantly lower. 
 
In terms of psychological risk, Ketamine has been shown to worsen certain psychotic symptoms in people who suffer from Schizophrenia or other serious Mental Disorders. It may also worsen underlying psychological problems in people with severe Personality Disorders. There is also a small risk that use if Ketamine may induce a manic episode. Finally, it is a risk that the use of Ketamine may not alleviate your desired psychological symptoms. 

Are there any medical conditions that would prevent me from receiving treatment?

Ketamine therapy should not be used in patients with the following contraindications:

·      Active substance abuse

·      Psychosis

·      Active suicidal ideation/ plans

·      History of increased intracranial pressure

·      Pregnancy or breastfeeding mother

·      Uncontrolled high blood pressure

·      Untreated hyperthyroidism

·      Prior hypersensitivity or negative reaction to ketamine

·      Heart Attack or Stroke in the past 3 months

·      History of allergic reaction to ketamine

What is the difference in dosage between ketamine therapy and anesthesia?

Ketamine is a highly versatile drug and can be administered orally, via injection, or intravenously. When administered via injection the dose is 6-10 times higher for anesthesia and 2-6 times higher for short procedures.

What does “off-label” mean?

“Off-Label” use of a medication is using an FDA-Approved medication in a manner not approved by the FDA. The process for receiving FDA indication for use is extensive and costly. This generally means medications will not get additional FDA indications after they can be made generic. Medications are commonly used off label when there is not an approved drug for a condition, there are reasons you would not choose to use an approved drug for a specific condition, or you have tried approved treatments without seeing significant benefits.

Is ketamine addictive?

Whilst many people use ketamine on occasion without feeling cravings, some people get addicted to ketamine use and may use it daily. People can struggle and fail to be able to stop using ketamine. Tolerance builds up, so users need much more ketamine to get the effects they like. Signs of tolerance should be considered an early warning sign of addiction and harmful use.

What can Ketamine be used to treat?

Ketamine is an essential medical and veterinary drug used for anaesthesia and pain relief under a wide range of circumstances. Ketamine is much less likely than other anaesthetics to depress the heart and respiration, so it is the anaesthetic agent of choice in low income countries and in environmental/conflict disasters where there are few trained medical personnel, anaesthetic machines or consistent sources of electricity. In the western world ketamine is the most commonly used veterinary anaesthetic, particularly in horses and the more unusual species. In developed countries ketamine is less commonly used for routine anaesthesia in people as it may cause hallucinations during recovery; more conventional anaesthetics are preferred where trained anaesthetists and appropriate equipment are readily available to monitor the patient and support respiration.

Ketamine is a potent pain killer and is particularly useful for children undergoing agonizing procedures such as treatment of burns. It is now also an important treatment for chronic pain.

New therapeutic uses for ketamine have more recently been identified, including treatment of depression and refractory status epilepticus. A single low dose of ketamine can rapidly lift depression, although the effect does not last long-term. It is thought to work by causing new connections (synapses) to be made in the brain. This is a promising lead for the development of new treatments because conventional antidepressants take some time to work. Self-treating using ketamine puts the user at risk of the harmful effects of ketamine, and it has not yet been established through large-scale trials that the benefits outweigh the risks.

What does a ketamine exploration session look like?

A typical ketamine exploration session lasts between 2-3 hours and takes place in-person, in clinic. During a dosing session, patients administer/are administered prescribed ketamine. The patient will be in a comfortable, reclining position wearing a Mindfold eye mask and listening to calming music with headphones.

What are the benefits of KAP?

- Powerful Antidepressant Effects

- Increased Openness

- Enhanced Cognitive Flexibility

- Increased Connection with Self and Others

- Effective Trauma Processing

- Deep Emotional Reset/Cleanse

- Opportunities for Spiritual Growth

- Sustainable Change

What are the side effects?

Mental fogginess and dizziness are common after the ketamine exploration session. The ketamine will last in your system for another 10-12 hours, but you should not have any significant impairments four hours after your session. Do not drive or operate any motor vehicles or machinery for a minimum of four hours post KAP medicine session, or until you do not feel fogginess, dizziness, or imbalance, whichever is longer. Your journey can be a powerful experience and can bring up varying emotional states. We expect deep rooted memories and feelings to surface afterwards. Please contact your therapist if you are having difficulty processing these emotions yourself. We typically schedule a brief follow up session the week following your Ketamine session, and a brief check-in the following day. You then continue with the integration process for as long as you and your therapist see fit.  

How KAP is different from a “Ketamine Clinic”

It is important to note that ketamine infusion and ketamine infusion clinics differ greatly from ketamine-assisted psychotherapy, in the set, setting, administration, support, structure and integration. The more knowledge and understanding you have regarding available treatment options, the more informed and empowered you will be when deciding which treatment options are best suited for your wellness path.

How is KAP Different Than Traditional Therapy?

Traditional therapy uses multiple interventions in the course of therapeutic treatment, where KAP uses not only traditional forms of therapy, but it adds the component of medicine, for an integrated psychotherapy and psychiatric experience. It can be helpful for persons who have engaged in traditional therapy, and find they feel “stuck”, and are ready for a perspective shift and a different approach to healing.

What if I have a bad “trip”?

In a clinical setting, we like to discuss the difference between bad trips and challenging trips. Bad trips can be avoided, with appropriate and safe, set and setting, and through a trusting relationship with your providers. For some people, ketamine therapy can be challenging but, it's often the challenging experiences that are most rewarding. Psychedelics in conjunction with therapy can help people to move through, confront, and deal with things that they've struggled to address in the past.

Set and setting, play a tremendous role in the overall experience. Set is the mindset of the individual and setting is where the experience takes place. PURE puts a lot of intention into helping with both of these- to prepare you for having the right mindset and in providing an optimal environment for your experience. Set and setting are absolutely the most important things we can control or influence, and is generally the cause of "bad trips", when not properly cared for. 

At PURE, we design the setting to help facilitate letting go, and leaning into the experience, which is very difficult to do in settings where you do not feel safe enough. We can also provide additional preparation sessions for anyone that has fears about it which can help you to develop your confidence and form a trusting bond with your providers. It is normal to have worries about this experience, and we welcome you to reach out to us and discuss any concerns that you may have, and encourage you to discuss these concerns with your providers.

Are other psychedelics legal too?

Currently ketamine is the only legal psychedelic available outside of research settings, in the state of Minnesota. Other states have taken steps toward decriminalization of plant medicines, and we are hopeful that Minnesota will soon follow this direction so these medicines are more accessible to assist in the current mental health crisis. As more psychedelic medicines are made available for clinic use, PURE will incorporate them into their practice.

MDMA-assisted psychotherapy, which is demonstrating promising results for PTSD is likely to be approved by the FDA in 2024 for clinic use.

Psilocybin- assisted psychotherapy is also being studied and expected to be available in 3-5 years for clinic use. The psychedelic therapy process that PURE currently uses with Ketamine, is the same general structure that PURE will use with future psychedelics.

What is the history of psychedelic medicine?

Psychedelic plants and fungi have been used in indigenous medicinal traditions for millennia. Modern psychedelic research began when Albert Hofmann first synthesized lysergic acid diethylamide (LSD-25) in 1938. Five years later, became the first person to ingest LSD. Hofmann was unaware of the significance of his actions, and the effects they would set in motion. After a burgeoning period of scientific and cultural exploration in the1950s and '60s, psychedelic research was slowed to a near halt. Throughout the 1970s and '80s governmental interventions severely hampered global psychedelic research, despite evidence of the limited medical risks and therapeutic potential of psychedelics. After decades of persistent education and advocacy, rigorous research employing psychedelics as tools of discovery and healing are abundant today. Studies are taking place in research institutions and in private practice sites supported by non-profit and for-profit organizations, as well as individual investigators. This research includes clinical trials with MDMA-assisted therapy for the treatment of PTSD, alcoholism, and social anxiety, and psilocybin clinical studies for depression and addiction, as well as the ability of psychedelics to catalyze spiritual or mystical experiences and inspire creativity, and into the neuroscientific understanding the effects of psychedelic substances on our nervous system.