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Frequently Asked Questionnaires

  • Do I have to pick up Ketamine from the pharmacy?
    MINDEllipse sources its Ketamine from compounding pharmacies. Based on your prescription, your mental health provider will order your medication from the pharmacy and deliver it to your home
  • If I start Ketamine, can I stop taking my antidepressant?
    Though there are never guarantees, Ketamine works by healing your mental health conditions rather than just decreasing symptoms. There is a possibility that along with other life changes, such as positive coping mechanisms, proper nutrition, and adequate sleep, you may be able to discontinue your antidepressant. This is not a quick process; as stated, it is not guaranteed. This is a slow process that your provider may be able to help you with.
  • What are the effects of long-term ketamine use?
    A rare but known adverse effect of chronic ketamine use is ketamine-induced cystitis, a bladder pain syndrome characterized by ulceration of the bladder lining and chronic inflammation. This condition is typically found in people who abuse "street ketamine." Studies have demonstrated that specific concentrations of ketamine were toxic to the bladder wall cells, causing damage to the urinary barrier. Symptoms include pelvic pain, frequent urination, urgency, hematuria (blood in urine), nocturia (frequent urination during the night), and urinary incontinence. This condition is often reversible once the medicine is stopped. For individuals who develop this condition, complete ketamine cessation is recommended. Ketamine tolerance can also develop; while concerns arise over addiction, when used at low doses and with infrequent dosing models, as used in mental health, this is less likely to occur.
  • How likely is it that I will have a "bad trip" with Ketamine?
    Ketamine is a powerful dissociative drug that can cause profound changes in consciousness. Ketamine is known for producing intense hallucinations, so it's no surprise that many people are curious about the risks of having a "bad trip." However, the answer to this question is not so simple. Everyone reacts to medications differently, so it's impossible to say definitively how likely someone will have a bad experience with Ketamine. That said, certain factors can increase the risk of having a negative experience. For example, people who take Ketamine without knowing what it is or how it will affect them are more likely to have a bad trip. In addition, taking a high dose of the drug can increase the chances of having an unpleasant experience. Ultimately, it's important to remember that everyone reacts to medications differently, so it's impossible to say definitively how likely someone will have a bad trip on Ketamine. With the doses prescribed for mental health, the likelihood of having a "bad trip" is very low as long as you keep a positive mindset going into the experience and are in a comfortable session.
  • Does MINDEllipse offer psychotherapy with Ketamine?
    Though we do not offer psychotherapy, we offer guided coaching to make your ketamine experience more effective. If you would like a referral for a psychotherapist, let us know. We are glad to help!
  • I am on an SSRI. Can I still take my antidepressant while taking Ketamine?
    SSRIs (selective serotonin reuptake inhibitors) are a class of antidepressant medications that work by increasing levels of serotonin in the brain. Serotonin is a neurotransmitter that plays an essential role in mood and emotional regulation. Ketamine is a medication commonly used as an anesthetic, but it also has unique properties that make it effective in treating depression. When taken together, SSRIs and Ketamine can have synergistic effects, meaning they can provide more significant relief from depression than either medication taken alone. However, speaking with a provider before starting any new medication is crucial, as there may be risks or side effects associated with taking multiple medications for depression. With careful planning and supervision, however, SSRIs and Ketamine can effectively treat depression.
  • So, what is Ketamine?
    Ketamine is a powerful medication, FDA-approved initially as an anesthetic, but shown through several studies that in small doses, it can provide a significant improvement in depressive and anxiety symptoms. Ketamine is considered "off-label" for mental health reasons. Ketamine is 100% legal and has a mild side effect profile. Keep in mind, several prescriptions prescribed are not FDA-approved, which does not take away from the efficacy of the medication.
  • What substances and medicines should be avoided in clients using Ketamine?
    Below is a list of medications and substances that should be avoided in clients who are being treated with ketamine: · Theophylline or Aminophylline; Can lower the seizure threshold. · Benzodiazepines (Klonopin, Ativan, Xanax, Valium, Librium), opioid analgesics, or other CNS depressants; Can cause profound sedation, respiratory depression, coma, or death; they can also interfere with the mental health benefits of ketamine. · Lamotrigine (Lamictal); May block the clinical efficacy of ketamine. · Monoamine Oxidase Inhibitors (MAOIs) (Nardil, Phenylzine, Emsam, Marplan, Parnate, tranylcypromine); Can cause blood pressure problems or heavy sedation. · Sleeping aids and sedatives, such as Ambien, Benadryl, Remeron, Lunesta, or Sonata. Since several other medications may interact with Ketamine, the MINDEllipse team will thoroughly review your medications before your prescriptions are authorized. We also recommend to our clients to refrain from the following substances during treatment as they can interfere with the benefits of ketamine, and some can lead to dangerous interactions: · Alcohol · Marijuana · All illegal substances, such as cocaine, heroin, etc. MINDEllipse clients will have an agreement with all clients stating that they will not use the above substances during ketamine treatment days. We do not recommend mixing ketamine with other medications, including using ketamine with psilocybin, MDMA, Kambo, LSD, DMT, ayahuasca, mescaline, ibogaine, etc. Combining medicines has an increased risk of adverse events, notably hypertension, and is not recommended unless the combination is studied in a clinical trial. Further, if an individual is on a benzodiazepine, we ask them to taper off under the care of their prescriber or to at least hold the dose on treatment days. Rapidly tapering off benzodiazepines is NOT recommended and can result in severe withdrawal and potential death.
  • Should I stop my other medications while taking Ketamine?
    The great thing about Ketamine is that it is safe, and most individuals can continue other medications. Of course, there are some exceptions. If you are on a stimulant (Adderall, Vyvanse, Ritalin, etc.), you should avoid it on the day of ketamine administration (for macrodoses). Stimulants can potentially increase your blood pressure, and a side effect of Ketamine is increased blood pressure, so it should be avoided for safety reasons. Benzodiazepines, such as Xanax and Clonazepam, should be paused on the day of Ketamine administration for safety reasons. Benzodiazepines can also decrease the effectiveness of Ketamine. In general, the higher doses of benzodiazepine that individuals take, the less effective Ketamine can reduce depression and anxiety symptoms.
  • How much time should I take between ketamine treatments?
    When it comes to oral ketamine treatments, there is no one-size-fits-all answer. The time you should take between treatments will depend on several factors, including your age, health, and the severity of your condition. Most experts recommend taking one dose of ketamine weekly for the first six treatments. This allows the body to metabolize the Ketamine fully and can help to reduce the risk of side effects. If you are unsure how often you should take Ketamine, it is best to speak to your healthcare provider. They will be able to advise you on the best course of action based on your individual needs.
  • How can Ketamine improve my mental health?
    Several studies show that Ketamine can significantly reduce depressive and anxiety symptoms. At low doses, Ketamine produces a dissociative effect (an out-of-body experience). During this dissociative process, individuals can obtain more clarity on their life, purpose, and perspective and gain a connection with themselves. The dissociation associated with Ketamine is the healing process.
  • Isn't Ketamine an anesthetic and used as a tranquilizer for animals? How is this safe?
    Ketamine was initially FDA-approved as an anesthetic used for humans in the 1970s. Though it is classified as an anesthetic, Ketamine is not an animal tranquilizer. Dosing for mental health is a lot less than anesthetic doses.
  • What type of ketamine does MINDEllipse prescribe?
    MINDEllipse uses a specialized sublingual formulation of ketamine that rapidly dissolves under the tongue or in between the gums and cheek. Our protocol was developed with client safety and the medicine’s efficacy as top priorities. We provide clients with client-specific dosing based on their weight and body mass index. We chose to work with sublingual ketamine as it is not only safe but the use of sublingual ketamine also allows people to tap into challenging states of mind with decreased fear. Further, it allows clients to integrate healing after the acute phase of the medication starts to wear off. We find that the peak experience of ketamine usually lasts approximately 25-60 minutes and the medicine becomes much less intense after this initial wave. Please note that everyone metabolizes ketamine at a different rate, and while most clients do not have prolonged experiences with the medicine, it is possible. Planning the first medicine session with ample time is recommended, ideally at the end of the day when possible.
  • How am I going to feel when I take Ketamine?
    Many people who receive ketamine treatments report feeling a sense of detachment from their surroundings. You may feel like you are floating or dreaming. Some people report feeling all-encompassing euphoria or feelings of profound calm. Others say they feel a sense of lightness or joy. There is usually minimal, if any, pain felt during the ketamine treatment itself. Most people report that the effects of Ketamine are short-lived and wear off within a few hours. While the specific impact of Ketamine may vary from person to person, many people find the experience relaxing and even therapeutic.
  • Why is therapy recommended with ketamine?
    Ketamine is routinely given in sterile clinical settings for various mental health indications. Oftentimes there is no therapy provided with this service, and clients are left trying to make sense of the experience and navigate challenging experiences on their own. This lack of supportive therapy during ketamine treatment shortchanges clients as they are less likely to integrate the experience into their everyday lives.
  • How long will the benefits of ketamine last for me?
    The duration of benefits is variable and depends a lot on why the client sought out ketamine, to begin with. Many clients will return for further courses of treatment, especially those with long-standing mental health conditions and/or people who are resistant to other treatments. For some, the clinical benefits of ketamine can last months or even years. Others find that the clinical benefits fade after a few months and may require "booster" treatments with ketamine. These booster treatments are often prescribed as a dose every 2 weeks or monthly.
  • Is ketamine FDA-approved?
    Ketamine, trade name Ketalar, is a schedule III-controlled substance that is FDA-approved for general anesthesia in intravenous or intramuscular formulations. Ketamine is a racemic mixture, made up of two molecules that are mirror images of one another, R-ketamine and S-ketamine. Ketamine does not have FDA-approval for any psychiatric illness. S-ketamine, derived from ketamine, called esketamine, trade name Spravato, was approved in 2019 in nasal spray form, and is FDA-approved for treatment resistant depression in adults with major depressive disorder with acute suicidal ideation or behavior, in conjunction with an oral antidepressant. Most ketamine being used for the treatment of mental illness is being prescribed legally by healthcare professionals “off-label.” MINDEllipse uses sublingual ketamine, which is considered “off-label.”
  • How do I prepare for my first ketamine session?
    Once you've decided to go ahead with the treatment, be sure not to consume food at least 4 hours before the session and no fluids at least 2 hours before the administration. You should also wear comfortable clothing and avoid wearing anything constrictive, like tight jeans or belts. Ketamine can produce powerful dissociative effects, so it's essential to be open-minded and prepared for anything. Trusting your provider and following their instructions will help ensure that you have a positive experience. With these tips, you can have a safe and successful ketamine session.
  • Why isn't ketamine FDA-approved for depression and anxiety?
    Before the FDA can approve a drug, clinical data and other information must be sent to the FDA to prove it is safe and effective. While "safe" does not mean there are no side effects, it indicates that the drug's benefit outweighs any potential risks. This allows healthcare providers to prescribe a particular medication for different uses than initially intended, an act termed "off-label" use. Off-label prescribing is quite common in the US – about one in five prescriptions are off-label. Ketamine has been used for over 50 years as an anesthetic, but despite growing evidence of its effectiveness in treating depression, anxiety, PTSD, OCD, and chronic pain, it remains off-label. As its patent has expired, making Ketamine a generic drug, companies have no economic incentive to invest in costly clinical trials to receive FDA approval. This means many people suffering from mental or physical health issues related to these conditions may benefit from ketamine therapy without proper oversight or regulation.
  • How do I take the Ketamine that was prescribed?
    Sublingual Ketamine is administered under your tongue. It is recommended to keep it under your tongue for at least 30 minutes to allow adequate absorption into the bloodstream.
  • Is at-home ketamine treatment considered safe?
    When it comes to mental health, there is no one-size-fits-all solution. What works for one person may not work for another, and what works at one point may not be effective later. This is why it's so important to have various treatment options available. Ketamine is one option showing promise as a treatment for depression, anxiety, and other mental health conditions. Unlike many other psychiatric medications, which can take weeks or even months to take effect, Ketamine begins working almost immediately. This makes it an appealing option for people struggling to find relief. However, because Ketamine is still a relatively new treatment, there is not a lot of research on its long-term safety. The evidence suggests that at-home ketamine treatment is safe when administered by a trained professional.
  • Does ketamine work for everyone?
    Some individuals do not respond to ketamine, even at higher doses. Additionally, some individuals with rigid personality structures, including those with severe OCD or personality disorders and possibly those with profound PTSD, may not be able to go into a trance-like state and may find it challenging to maintain the benefits of the treatment experience if they find any relief with the experience at all. Additionally, some data suggest that the elderly are less likely to benefit from ketamine. We do not yet know enough about who won’t benefit, and we recommend attempting this treatment if no contraindications exist, as the medicine is incredibly safe and well-tolerated.
  • Who would not be a candidate for ketamine therapy?
    Ketamine therapy is not for everyone. Individuals with certain medical conditions or taking certain medications may not be candidates for treatment. In addition, Ketamine should not be used by pregnant or breastfeeding women or people who are intoxicated or have a history of substance abuse. Psychosis, mania, and active suicidality are some contraindications with ketamine therapy. Some people may also be more susceptible to the side effects of Ketamine, such as hallucinations or dissociation. As a result, it is crucial to discuss all your medication conditions with your provider before starting ketamine therapy. Only a qualified medical professional can determine whether Ketamine is right for you.
  • Are there any side effects I should worry about with Ketamine?
    Unfortunately, with any medication, there are risks for side effects. The positive thing is that the side effect profile associated with Ketamine is relatively low. Some side effects from ketamine may include: · Headache · Blurry vision · Nausea · Vomiting · Anxiety · Diminished ability to see/hear/feel · Dry mouth · Lip tingling and/or heaviness · Elevated blood pressure · Elevated heart rate · Elevated intraocular or intracranial pressure · Excitability · Loss of appetite · Confusion · Nystagmus (rapid eye movements) · Restlessness · Slurred speech · Synesthesia (overlapping of the senses, for example seeing sounds) · Dissociation (feeling out of body) · Dizziness · Tinnitus (ringing in the ears) · Hypoesthesia (partial or total lack of sensation in a body part) · Lethargy (fatigue) · Sedation (somnolence) · Vertigo (room spinning) · Feeling drunk · Rarely a client may experience a feeling of paralysis
  • How will I feel right after the Ketamine session? How about the next day?
    The effects of Ketamine can vary depending on the individual, but most people report feeling relaxed and dream-like after a session. Some people may also experience visual or auditory hallucinations. The effects usually last for around an hour, although some people may feel the effects for up to four hours. The day after a ketamine session, most people feel normal, although some may experience mild headaches or fatigue. Overall, Ketamine is considered to be safe and well-tolerated by most people. Although some risks are associated with ketamine use, such as dissociation and impaired motor function, these are typically only experienced at high doses. With proper medical supervision, the risks of Ketamine are minimal.
  • What are psychedelic medications?
    Psychedelic drugs are used to produce changes in perception, mood, and cognitive processes for therapeutic purposes. Studies indicate that such substances may positively influence mental health by relaxing the mind and ego, breaking self-defeating cycles, and offering a new perspective. When integrated into a comprehensive wellness plan, perspectives can aid in rewiring the brain, allowing for transformation.
  • When will I be able to resume normal activities after treatment?
    Soon after your ketamine dose, you will likely feel more relaxed. You may experience some dizziness and nausea, but these effects usually wear off within a few hours. Most people can return to their normal activities the next day. However, it is important to avoid strenuous activities for 8 hours after treatment or a night of sleep. This gives your body time to recover from the ketamine treatment fully. Some people may feel tired or have trouble concentrating for a day or two after treatment. If you experience these effects, it is best to rest and take it easy until they subside. Overall, most people quickly adjust to the mild side effects of Ketamine and can return to their everyday lives within a few days.
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