FREQUENTLY ASKED QUESTIONS
Questions about our therapy
About ketamine-augmented psychotherapy
Case reports have described the development of an addiction in people who are also dependent on other substances. In Augmented Psychotherapy, ketamine is used only in low doses and only a few times. Developing a dependence at that rate is highly unlikely. Additionally, altered states of consciousness can be used therapeutically to treat substance abuse disorders (Johnson et al. 2014).
The altered states of consciousness which occur during ketamine administration are considered desirable and will be molded and processed with you in Augmented Psychotherapy. In other applications of ketamine, these perceptual changes are viewed purely as side effects. We understand altered states of consciousness as important instruments of therapy. During these altered states, distinct changes in perception, feelings, and thoughts can occur. Under some circumstances, these changes in consciousness can be very intense. This is why we embed them in a psychotherapy specifically developed for working with them.
Further physical side effects include moderate increases in blood pressure, as well as increases in heart rate. Nausea, vomiting, and blurry vision may also occur. Allergic reactions are very rare. In pre-treatment medical discussions, all patients will be thoroughly informed about possible risks and side effects.
Ketamine is approved as an established anaesthetic and pain medication and is prescription-only. It is not regulated by the German Narcotics Act (Betäubungsmittelgesetz). It may only be administered by physicians. For treatment in our practice, the so-called “off-label-use” is applied: a medical doctor is allowed to use a drug outside of the specific approval framework if there is an indication or medical justification for it. This justification exists in Augmented Psychotherapy with ketamine.
As with every psychotherapy, at the beginning of Augmented Psychotherapy symptoms can briefly intensify before improvements appear. This is precisely why it is important to us that you feel well taken care of through our continuous support. If you should need more help from us after the end of the therapy program, further psychotherapeutic treatment is possible. We also work closely with a network of therapists and institutions in the health care sector, and together at the end of therapy we can decide how things should continue for you.
A complete session usually lasts 2 hours. 60 minutes of this is the substance administration, with your therapist supporting you the entire time. Afterwards, you have time to process the experience and can engage yourself creatively in the integration room. Following this, you can discuss the experience further with our medical personnel if needed.
It is possible that you may have intense and sometimes challenging experiences during the substance sessions. Through our therapeutic support and assistance during the experience and integration, often challenging experiences can in fact be transformed into the greatest positive changes. However, in order to find the optimal dose for you and keep the risk of feeling overwhelmed as small as possible, each therapy begins with finding an individualized dose. Furthermore, ketamine administration can be terminated at any time if this is medically or therapeutically necessary.
Our concept includes 25-35 therapy sessions over the course of 9 weeks. Of these, 5 weeks in the middle make up the heart of the therapy, with each week including a 2-hour ketamine session and an integration session the next day. As a general rule, this means that you will have 5 substance sessions with ketamine administration.
Indications & Contraindications
Ketamine administration is only one method of evoking altered states of consciousness. If this is not possible for medical reasons, we offer methods without the use of medication, such as stroboscopic light or special breathing techniques. Intensive changes in consciousness are also possible with non-pharmacological methods and can be therapeutically useful.
Augmented Psychotherapy with ketamine is a therapy for treatment of psychological disorders. We do not offer treatment without an existing indication for it. You are welcome to attend one of our information sessions to learn more about Augmented Psychotherapy.
The use of ketamine in mental illness is the subject of current research. Most results are available for the treatment of depression (Memon et al. 2020). Augmented psychotherapy with ketamine additionally utilizes the effect of altered states of consciousness, which is considered one of ketamine’s antidepressant mechanisms of action (Luckenbaugh et al. 2014). With a thorough preliminary psychiatric and physical examination and in psychotherapeutic discussions, we will make sure that therapy with ketamine and altered states of consciousness is appropriate for you. The following are conditions for which augmented psychotherapy with ketamine may be appropriate.
- Depression
- Treatment-resistant depression: after unsuccessful therapy attempts
- Depressive symptoms due to pain
- Depressive symptoms in palliative care
- Depressive symptoms with bipolar disorder (manic-depressive disorder) without frequent manic episodes
- Obsessive-compulsive disorders: Intensified therapy
- Obsessive-compulsive disorders with depressive symptoms
- Anxiety disorders: Intensified therapy
- Anxiety disorders with depressive symptoms
- Persistent psychological symptoms in the context of severe stress (e.g. death of relatives, separations, job loss, serious illness)
For some mental illnesses, there are still too few or negative study results, or therapy with ketamine and altered states of consciousness is inadvisable from a psychotherapeutic point of view. This particularly concerns illnesses for which the possibility of the treatment making symptoms worse cannot be ruled out. These illnesses are listed below. You will be psychiatrically evaluated before starting treatment to minimize any potential mental health risks to you.
- Psychotic illnesses
- Severe personality disorders
- Severe substance dependence (esp. stimulants and among others, ketamine abuse)
- Severe bipolar disorder (manic-depressive disorder) with regular manic phases
- Severe eating disorders
- Severe dementia and organic brain disorders
Contraindications: Unfortunately, we cannot offer Augmented Psychotherapy treatment with ketamine if you have any of the following medical contraindications. Please consider this before booking an initial examination.
- Severe heart disease/distinctly high blood pressure
- Heart attack or stroke within the past 12 months
- Severe functional disorder of the liver
- Elevated intracranial or intraocular pressure
- Pregnancy
If you are nevertheless interested in therapy with us, you are welcome to contact us and we can assess the possibility of Augmented Psychotherapy with non-pharmacological methods.
Current treatment
Together we will create an individual treatment plan, which can also include the possibility of tapering and stopping medications. In our concept of Augmented Psychotherapy, there is a post-treatment session after six months. This is the typical period in which depressive symptoms can return after one stops taking antidepressants (recurrence of depression). We will gladly work with you to use Augmented Psychotherapy with ketamine as a way to protect against such recurrence after stopping antidepressants.
You can also come to use if you are in a stable phase without depressive symptoms, or with only mild symptoms, and want to stop taking antidepressants because of their side effects. We will work with you on a plan for quitting, in which Augmented Psychotherapy can help protect you from regressing back into a depressive episode (relapse prevention).
A combination with your outpatient psychotherapy can be done. For therapeutic reasons, we strongly recommend discussing the procedures of Augmented Psychotherapy with your psychotherapist. Because Augmented Psychotherapy is conceptualized as an intensive short-term therapy, we recommend pausing your outpatient psychotherapy for the duration of the treatment and resuming it afterwards. We are happy to work with you on an individual treatment plan and we can get in touch with your therapist if you would like us to do so.
Reimbursement
Logistics & Travel
About the OVID Clinic Berlin
INFO EVENTS
You have more questions?
During our 60-minute group info event, a physician or therapist from our team will introduce you to our treatment. You will gain insights into our practice and our treatment concept. We are happy to answer your individual questions. Due to the COVID-19 pandemic, info events currently take place via digital (video) call.