Once a month, on the first Monday of the month at 6:00 pm, we organize an online information event for referring physicians and interested colleagues. You can find the dates here.

You are welcome to refer your patients to our therapy offer and mention our website. We will also be happy to send you brochures with further information about the therapy. We also organize regular information events for patients. The dates for these events can be found on our website under Info events.

You can obtain materials at info@augmentierte-psychotherapie.de

Continued use of long-term medication is possible during Augmented Psychotherapy and accordingly also during the sessions with ketamine. Under certain circumstances, a dose reduction can be attempted over the course of therapy.

We develop an individual treatment plan, which can also include the possibility of phasing out and discontinuing psychiatric medication. With Prof. Dr. med. Gerhard Gründer, university professor for psychiatry at the University of Heidelberg and head of the DGPPN department for psychopharmacology, the practice has a psychiatrist who specializes in the process of weaning off and discontinuing psychiatric medication as one of the practice’s psychiatrists at its disposal with his expertise. We are happy to work out an individual therapy plan for discontinuation with the use of augmented psychotherapy and relapse prophylactic therapy.

A combination with outpatient psychotherapy can be carried out if Augmented Psychotherapy can thereby be meaningfully embedded in the longer-term therapy process. Thus, by working with altered states of consciousness, Augmented Psychotherapy can deepen long-term positive therapy processes and add a new dynamic to psychotherapy.  Also, the direct antidepressant effect of ketamine can be very beneficial for long-term therapeutic work, as it allows psychotherapy with less symptom burden. We see the combination of Augmented Psychotherapy as a specific short-term therapy over about 9 weeks in combination with outpatient longer-term treatment as highly useful. Here we strive for a transparent and constructive exchange between the treatment providers in the interest of the patients. In most cases, a pause of the outpatient psychotherapy for the duration of the augmented psychotherapy is appropriate.

Ketamine is an anesthetic and painkiller that has been in use for over 50 years. It is not covered by the Narcotics Act. There is a broad range of studies on the use of ketamine in mental illnesses, especially in the treatment of treatment-resistant depression. The esketamine-containing nasal spray Spravato® is currently the only product approved as an add-on for treatment-resistant depression. It is currently still very expensive and is not covered by all health insurers. We use ketamine i.v. via perfusor under anesthesiological supervision. This allows a patient-specific dosage to be administered and the treatment can be discontinued at any time. Ketamine i.v. is used here as an “off-label” drug, which is explicitly explained. In contrast to conventional psychopharmacotherapy, ketamine is only used in a few targeted individual doses as part of the therapy; there is no substitution treatment with continuous intake, as is the case with antidepressants, for example.

Ketamine has been used for over 50 years. It has few side effects and is safe to use. For example, there are no changes in respiratory drive. There is a low dependence potential, which mainly affects people with existing substance use disorders. This risk is explicitly clarified in the preliminary discussions.

As with any psychotherapy, augmented psychotherapy can lead to a brief intensification of symptoms before an improvement occurs. This is exactly why it is important to us that our patients feel well cared for through close-meshed support. If ketamine is not tolerated, therapy can be continued with altered states of consciousness through non-pharmacological methods. If further help is needed at the end of our therapy, there is the option of extension in integrative psychotherapy. Likewise, we help in arranging further outpatient treatment if it does not already exist. In the case of a relapse, a shortened therapy protocol for interval treatment is conceivable.

Patients may also have intense challenging experiences during substance use sessions. Through therapeutic support and assistance with integration, the greatest insights can often be gained from challenging experiences. However, in order to find the optimal ketamine dose for our patients and to keep the risk of feeling overwhelmed as low as possible, an individual dose determination takes place at the beginning of each therapy. Furthermore, it is possible to discontinue ketamine administration at any point in the therapy if this should be medically or therapeutically necessary.

Augmented Psychotherapy is an intensive short-term psychotherapy over approximately 9 weeks. Of these, 5 weeks in the middle form the core, in which a 2-hour session with ketamine administration and an integration psychotherapy session on the following day take place. Thus, patients usually receive 5-6 sessions of ketamine administration. If patients need more or less therapy units, our concept can be flexibly adapted to individual needs.

We understand the use of ketamine as an addition (augmentation) to a well-founded psychotherapy. In augmented psychotherapy, the use of medication thus differs significantly from the classic psychopharmacological approach, which focuses more on the neurobiological antidepressant effect. We see the therapeutic potential of ketamine not only in its direct antidepressant effect but also, among other things, in its mind-altering effect. These altered states of consciousness often make it possible to take a different perspective on oneself and the environment. Working with unconscious content and recognizing and breaking old patterns is possible more often. This can enormously enrich and intensify a psychotherapeutic process. In our practice, ketamine is administered intravenously via a syringe pump (perfusor). The administration of ketamine is always monitored by anesthesiologists. Continuous ECG and oxygen saturation monitoring is performed. With the help of the syringe pump, the anesthesiologists can find the optimal dosage of ketamine for therapeutically valuable altered states of consciousness.

The altered states of consciousness that occur during ketamine administration are desired and encouraged in Augmented Psychotherapy. In other applications of ketamine, these perceptions are considered mere side effects. We conceive of altered states of consciousness as an authoritative therapeutic tool. In the context of these altered states of consciousness, there is a temporary marked change in perception, feelings and thoughts. Under certain circumstances this change of consciousness can be very intense. That is why we embed it in a specifically developed psychotherapy.

Other physical side effects include a moderate increase in blood pressure and an increase in heart rate. Nausea, vomiting and blurred vision may also occur. Allergic reactions are very rare. All patients are informed in more detail about possible risks and side effects during medical information sessions.

Contraindications: We cannot offer Augmented Psychotherapy with ketamine treatment to patients who have the following medical contraindications to therapy:

• Structural heart disease (including heart failure)
• Labile, difficult to control or untreated hypertension
• Unstable angina pectoris
• Myocardial infarction and/or stroke in the past 12 months
• Increased intracranial pressure
• Untreated or inadequately treated hyperthyroidism
• Glaucoma
• Liver cirrhosis, severe liver dysfunction

If patients* are still interested in therapy with us, they are welcome to contact us and we can review the possibility of Augmented Psychotherapy with non-pharmacological methods.