One route of administration is via nasal spray with a medication called Spravato. Spravato is FDA approved and is meant to be used in conjunction with an oral antidepressant, though this stipulation was recently lifted. Spravato is not pure ketamine, but is a derivative. It is typically self-administered, but still requires a prescription and must be done with a licensed prescriber monitoring the journey. 

IM is a shot similar to a flu shot. The medication is typically very fast acting with this route. This is often the preferred method of administration because it is able to become immediately accessible to the circulatory system and optimizing bioavailability.

Also called troches or lozenges that are dissolvable tablets meant to be held in the mouth and not swallowed. This is typically a slower acting rate of absorption with less psychoactive effects. This is a great option for anyone that is needle shy or looking for a gentler approach and introduction to the medicine. 

This method is delivered directly into the vein. This is a very controlled and slower method of treatment, not typically seen for those trying to go deeper. Typically, IV is what is used during surgeries.

During a typical ketamine journey, you and your therapist will review your previously decided upon intention for this particular day. This is your healing journey and should you have something different that has shown up on that day, you are more than welcome to change your mind about the focus of the session!

Your medical prescriber will administer the medication in the previously agreed upon route and be available throughout the session for whatever medical needs may arise. Your therapist will also be present and available in whatever previously agreed upon manner you’d like them to be. Some clients turn inward and the therapist is present in the space with you to keep this space safe. Some clients process out loud and may need a comforting hand or safe touch.

There is no wrong way to show up on your journey. The idea behind psychedelics and dissociatives is to relax  your mind enough for your own inner healing abilities to show up. As this looks different for everybody and even different for the same individual on different days, you will have a protected container to show up however you need to in that moment to access these inner resources.

While ketamine can be used as a standalone treatment without therapy, there is a risk of dependence on the medication for symptom relief. Symptoms may ease for days up to weeks following treatment, but will typically require the patient to return for repeated administrations. Like many other medications used in the long-term, there are negative side effects associated with this more pharmaceutical approach to method of treatment. Long term effects include kidney and bladder toxicity, as well as ketamine tolerance and dependence. 

KAP is different from the typical pharmaceutical approach due to the necessary  psychotherapy component involved. This is beneficial for clients because the brain is more open to accepting change and creating new pathways that can more easily lead to healthier options vs treading down the same narrow paths depression and other mental health struggles take the client down. Those first 72 hours following a journey are crucial for therapy to take place because of the potential for positive brain changes . Oftentimes people have reported improvements after the first treatment where other medications can take weeks for clients to have results.  Therapy used in conjunction with the medication reduces the amount of sessions needed, allowing clients to remain symptom free and not face long-term physical side effects associated with extensive ketamine use.