KETAMINE

Ketamine is currently the only FDA-approved legal psychedelic medication. Research has shown that using ketamine under supported supervision may have profound therapeutic capabilities for mental health and chronic pain.

Dr. Michelle Weiner’s team is trained in Pain Reprocessing Therapy (PRT) and Mindfulness-Oriented Recovery Enhancement, which help get to the root cause of one’s suffering using a bio-psycho-social model to heal the whole person.

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Pain Reprocessing Therapy

PRT is a system of techniques rooted in neuroscience to reduce or eliminate chronic pain, based on the premise that physical problems in the body do not cause most forms of chronic pain but instead learned neural pathways in the brain and the misfiring of pain circuits.

Mindfulness-Oriented Recovery Enhancement

Mindfulness-Oriented Recovery Enhancement is an integrative therapy for Pain, Stress, and Addiction that unites Mindfulness (self-control), Reappraisal (psychological flexibility), and Savoring (reward and meaning) to increase resilience and restore sensitivity to natural pleasures while decreasing suffering.

Ketamine Assisted Psychotherapy

Treatment Options & Pricing

  • $1900 for 4 ketamine IV infusions + 3 coaching sessions with integration coach

  • $3100 for 6 ketamine IV infusions + 7 coaching sessions with integration coach

  • $1,500 for 4 intramuscular ketamine sessions + 3 coaching sessions with integration coach

  • $2,500 for 6 intramuscular ketamine sessions + 7 coaching sessions with integration coach

  • $3400 for 6 ketamine infusions + 4 coaching sessions.

    Indicated for chronic pain such as fibromyalgia, neuropathic pain, and complex regional pain syndrome

In-Network Insurances Accepted

First consultation covered by insurance
(all others accepted Out-of-Network)

TREATMENT PROTOCOL

INITIAL CONSULTATION
Includes screening for eligibility, diagnosis assessment (chronic pain vs mental health conditions), and preparation including preferred route of ketamine administration: intramuscular or intravenous or oral microdose during therapy.

PATIENT & THERAPIST MEET
Patient meets with therapist/coach to establish a therapeutic alliance and goal setting including teaching self-regulation tools, cognitive/ behavioral and lifestyle skills. If a patient has their own therapist or coach, we are open to case coordination with our team.

KETAMINE SESSIONS
First ketamine session occurs, with meditation/breathwork before and brief integration discussion after to help process the experience. Most require 4-6 ketamine sessions total, to steer the neuroplastic changes in the brain. Objective measures help guide the overall treatment plan (phq9, BPI).

Maintenance ketamine sessions may be warranted after the initial 4-6 sessions.

Ketamine FAQs

  • Ketamine therapy can relieve various types of depression, suicidal thinking, post-traumatic stress disorder (PTSD), anxiety, obsessive-compulsive disorder (OCD), other mood disorders, and chronic pain conditions.

  • Ketamine is an FDA approved dissociative anesthetic developed in 1962 used for general anesthesia in surgery for children and adults. It is remarkably safe as it doesn’t affect respiration. Yale University discovered that a subanesthetic dose of Ketamine can be used to treat depression, anxiety, PTSD, chronic pain such as fibromyalgia and even addiction. Ketamine is very unique as it works on the neurotransmitter glutamate as its mechanism differs from antidepressants which work on the serotonergic pathways.

  • The effects of a single infusion typically last up to two weeks. After a series of six sessions based on evidenced based research, most remain symptom free for months. We also offer the option of booster sessions which can be given monthly or a few times per year as needed. The idea with Ketamine is that you’re building up new neural pathways in your brain to offset the trauma or pain. Ketamine can help you depattern and adapt and be less affected by triggers allowing you to create a healthier pathway down a new ski slope instead of assuming your usual ride.

  • Using ketamine in a medical setting through IM injection, IV infusion or oral route with guidance and psychotherapy are the best options. We rarely prescribe ketamine for at-home or daily use to avoid addiction, minimizing repetitive use. The idea is that a series of sessions using ketamine may have long lasting effects so that we can decrease pharmaceutical use and addiction and feel well. We also do not prescribe the intranasal Esketamine route.

  • Ketamine is extremely safe, that is why they use it on children for surgery. Some report nausea, so we give you an anti-nausea medication before your treatment and recommend no eating for 4 hours before. Your blood pressure, which is monitored may elevate temporarily during the treatment but resumes to baseline following. You will need a ride home from the treatment.

  • We recommend you continue your medication. We do not recommend taking stimulants or benzodiazepines that morning. We have noticed that healing through ketamine assisted psychotherapy allows us to taper off pain medications as well as antidepressants and anti anxiety medications. You can continue seeing your psychiatrist while doing ketamine treatments.

  • Dr Weiner will see you for an initial evaluation through insurance to establish a plan including the route of administration and help prepare you for the first session. We charge $300 for an intramuscular ketamine treatment, and $500 for an IV infusions with the protocol being to receive 3-6 treatments.

  • Unfortunately, it is not covered by insurance. We hope this insurance coverage changes in the future. We want Ketamine to be an option for those suffering and unfortunately most who try ketamine have already tried and failed other medications.

  • Ketamine is an NMDA receptor antagonist and an AMPA receptor stimulator. AMPA stimulation is necessary for increasing brain derived neurotrophic factor (BDNF) which in turn stimulates the formation of new receptors and synapses. This process is critical for making connections between neurons and is often severely compromised among those suffering from PTSD, depression, and mood disorders.

  • Ketamine can provide a catalyst for change, lifting depression and minimizing pain and allowing people to more easily engage in other activities that will protect against relapse. People wake up and realize how much time was lost to their illness, how much money was spent, how many relationships ruined, how many opportunities missed. We encourage regular exercise and movement, healthy eating, socialization, behavioral activation, work/life balance, addressing activities or relationships that clash with personal values and setting better boundaries.

Can Ketamine Help with Your Sex Drive?

Dr. Michelle Weiner, featured in Giddy

For some people, ketamine treatments can help with the symptoms of depression and improve libido. Depression carries with it many symptoms, including decreased libido and erectile dysfunction (ED), and ketamine therapy is becoming an increasingly popular treatment for depression. Ketamine helps patients break out of these harmful patterns by providing new perspectives through generating new neuronal pathways within the brain.

READ MORE

Ketamine-Assisted Therapy Treatment of Comorbid Depression & Chronic Pain: A Pilot Study of Two Different Approaches

Daniella Batievsky, Michelle Weiner, Shari B. Kaplan, Michael Edward Thase, Domenick Nicholas Maglione, Denise Christina Vidot

(University of Pennsylvania, Spine and Wellness Centers of America, Cannectd Wellness, Perelman School of Medicine, US Dept of Veterans Affairs, Univerisity of Miami)

Principal findings support ketamine-assisted therapy’s efficacy for the treatment of depression and chronic pain comorbidity and indicate its potential use for anxiety and trauma-informed indications. Results suggest that the psychedelic approach may be superior to the psycholytic approach, which implies that larger doses and intramuscular routes may be optimal.

VIEW THE POSTER PRESENTATION HERE

RESEARCH

RESEARCH

Dr. Weiner’s Keynote Presentation at Wonderland Conference, Miami (December 2023)


Dr. Weiner had the pleasure of participating in multiple panels this last Wonderland conference, with one highlight being her keynote: Chronic Pain & Ketamine Assisted Therapy. In this presentation, she reviewed everything from how pain works to how ketamine works in the brain to create a “window of opportunity” to reduce pain, and how the biopsychosocial approach and therapeutic alliance are keys to successful pain management.

DOWNLOAD THE PDF HERE

From MMJ to Special K: How Federal Cannabis Patients Use Ketamine to Escape pain

Dr. Michelle Weiner discusses how, at high doses ketamine, produces anesthesia; at lower doses, it relieves pain and causes hallucinations - and how patients are utilizing it to alleviate pain.

READ

Cognitive Behavior Therapy May Sustain Antidepressant Effects of IV Ketamine in Treatment-Resistant Depression

Psychotherapy and integration with ketamine will enhance the outcome.

READ

The Effects of Therapy-Guided IM Ketamine Treatment on Chronic Pain & Depressive Symptoms for Individuals with Fibromyalgia or Other Chronic Pain Syndromes and Comorbid Depression

READ

Assessment of Initial Depressive State and Pain Relief With Ketamine in Patients with Chronic Refractory Pain

Oral ketamine for 6 weeks showed an alleviation of depressive symptoms in chronic pain, and ketamine improved both depression and pain.

READ

Time to Relapse After a Single Administration of Intravenous Ketamine Augmentation in Unipolar Treatment-resistant Depression

Of the 60 randomized participants who received a single ketamine (0.1, 0.5, or 1.0 mg/kg) infusion, 19 (34%) met criteria for remission and 27 (48%) for response, on day 3 post-infusion.

READ

Cognitive Behavior Therapy May Sustain Antidepressant Effects of IV Ketamine in Treatment-Resistant Depression

CBT may sustain the antidepressant effects of ketamine in TRD. Well-powered randomized controlled trials are warranted to further investigate this treatment combination.

READ

Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists

READ

A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder

This randomized controlled trial provides the first evidence of efficacy of repeated ketamine infusions in reducing symptom severity in individuals with chronic PTSD.

READ

Ketamine’s antidepressive effects tied to opioid system in brain (Stanford Medicine)

Ketamine’s antidepressive effects require activation of opioid receptors in the brain, a new Stanford study shows. The surprising finding may alter how new antidepressants are developed and administered in order to mitigate the risk of opioid dependence.

READ

Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices

Aa view of KAP’scurrent status combining data from three different related centers, with attendant outcomes with correlations.

READ

"The psychedelic effects may occasion mystical experiences, a sense of awe, and changes in the way intrapsychic conducts and possible solutions to them are perceived. Ego defenses are altered and with the expertise of a skilled psychotherapist the experience may yielded insights and improvement in maladaptive patterns of behavior."

Raquel Bennett
Ethical Guidelines for Ketamine Clinicians