Head Well

Head Well

Integrative Psychiatry & Wellness

Head Well Integrative Psychiatry

Ketamine

Explore Ketamine Therapy in Eugene at Head Well Integrative Psychiatry & Wellness

If you’ve been having treatment for depression, but medication and talk therapy aren’t working, ketamine therapy might help. At Head Well in Eugene, Oregon, April Dvorak, PMHNP-BC, and her team offer ketamine, various types of medicine, therapy, and personalized treatment plans for mental health. Call to learn more or schedule an appointment. 

Discovering New Horizons in Mental Health Treatment

If traditional treatments for depression, such as medication and talk therapy, haven’t been effective for you, Head Well Integrative Psychiatry & Wellness offers an alternative: ketamine therapy. Led by April Dvorak, PMHNP-BC, our team specializes in this innovative treatment, which includes Spravato (esketamine) and other personalized mental health care strategies. We currently provide ketamine therapy exclusively by referral from other healthcare providers or for our existing patients.

Understanding Ketamine Therapy:

Ketamine, a medication initially used for anesthesia, has shown promise at sub-anesthetic doses for treating psychiatric conditions like depression, anxiety, PTSD, and OCD, particularly those resistant to standard treatments.

How Ketamine Works:

Ketamine operates through a unique mechanism, targeting the NMDA (N-methyl-D-aspartate) receptors in the brain, which are involved in mood regulation and thought processing. This action can lead to rapid antidepressant effects, significantly faster than those of traditional medications. The promotion of neuroplasticity, or the brain’s ability to form new neural connections, is another key benefit, offering the possibility of long-term improvement in mental health conditions when combined with appropriate therapeutic and behavioral interventions.

Types of Ketamine Therapy:

Esketamine (Spravato) is an intranasal version of specific configuration of the ketamine molecule that is administered as a nasal spray in medical settings. Clients must be observed for at least 2 hours following administration and cannot drive themselves home from treatments. Spravato received an FDA indication for treatment resistant depression in 2019, helping to establish the role of ketamine in managing psychiatric conditions.

Though FDA approved, insurance coverage can be limiting, as each insurer as specific criteria for approval (including specific requirements for past medication trials and failure of alternative treatments like psychotherapy).

Other formulations of ketamine (without FDA approval for the treatment of mental health conditions) include:

  • Injections (shots in the arm)
  • Infusions (IV)
  • Lozenges/Troches or Rapid Dissolve Tablet (sublingual)
  • Intranasal (racemic ketamine, not Spravato)

 

 

 

Ketamine Q&A

 

What types of Ketamine therapy do you provide?

Currently, we provide sublingual, intranasal and intramuscular (racemic) ketamine and Spravato treatments at our Eugene clinic. Though we help guide and process patients through treatments, we do not provide Ketamine Assisted Therapy at this time. Treatment is only provided at our Eugene location, not in Portland.

 

What can I expect from ketamine therapy?

 Given its distinct properties and the potential for side effects such as dissociation or elevated blood pressure, ketamine therapy is administered under close supervision in our clinic. It’s essential for patients to undergo a comprehensive assessment to determine if ketamine therapy is a suitable option for their specific condition

A treatment course is usually 6-8 total treatments every 5-10 days. We encourage patients to use this time to engage in meaningful lifestyle changes and require engagement in therapy outside of sessions during the treatment period. Maintenance treatments may be necessary for sustained improvement.

Usually, ketamine treatments last about 60 minutes. The dissociative experience starts between 5-15 minutes after administering the medication. We developed specific audio to support the ketamine experience. The audio starts with support and guided meditation recorded by a local breathwork practitioner to help you transition into the treatment experience, then the following tracks are designed to support your exploration and journey.

After the treatment, patients are encouraged to reflect and journal on the experience. Patients receiving Spravato must be observed for 2 hours after administration. For other ketamine treatments, patients are monitored for until the medication experience has ended, and the patient can safely leave. Patients be driven home from appointments with someone trusted who will remain with them. Patients cannot drive themselves home or take a Uber/Lyft.

A provider is on-site during the whole process, though not in the room with the person being treated. The provider is available if the patients needs anything or becomes confused or anxious.

We usually recommend six to eight treatments every five-to days. You may not experience significant benefit from your first or second treatment. Several treatments may be required, and some people may not respond. Depending on the person, the antidepressant effects of ketamine can wear off in hours, days, or a couple of weeks for those who only get a single treatment. A series of treatments may have longer-lasting effects*.

We encourage patients to use this time to engage in meaningful lifestyle changes and require engagement in therapy outside of sessions during the treatment period. Maintenance treatments may be necessary for sustained improvement.

 

How do I know if I am a good candidate for ketamine treatment?

At this time, we only provide ketamine treatment by referral from other practices or clinicians, or to our current patients. Ketamine is not recommended for all patients or conditions. Additionally, there are several medical and psychiatric contraindications for therapy including pregnancy, unstable high blood pressure or cardiac issues, and acute mania and/or psychosis. Patients must have a support person for transportation and access to our clinic in Eugene.

Before ketamine therapy begins, April and the team will perform an initial consultation and mental health evaluation. They work with you to design a treatment plan for your mental health needs and goals. There is no guarantee that Ketamine will be recommended as a part of your treatment plan.

 

How do I get started?

Ketamine therapy is only provided for current patients or those referred by other healthcare providers. We emphasize a collaborative approach, ensuring that each patient’s care is coordinated effectively.

For Current Patients: If you are currently under our care and interested in ketamine therapy, please reach out to discuss your options and potential next steps.

For New Patients: Those not currently under our care but interested in ketamine therapy should seek a referral from their primary care provider or mental health professional. Upon receiving a referral, we will schedule an initial consultation to evaluate your suitability for ketamine therapy and discuss the potential benefits and considerations.

A consultation is required to determine if ketamine therapy is indicated and to establish a treatment plan. Ketamine treatments are only provided at our Eugene clinic. We do not provide treatment in other parts of Oregon at this time.

 

How much does treatment cost and will my insurance cover it?

It’s important for patients to understand that ketamine therapy is typically not covered by health insurance plans, given its designation for conditions often considered beyond conventional treatment scopes. Spravato (esketamine) may be covered by your insurance if certain criteria are met (you can try contacting your insurance or our clinic can assist at the time of consultation).

Other types of ketamine therapy are generally considered non-covered services, and you would be responsible for payment. Our fees range from $400-550/session and additional fees may occur. We will review fees with you prior to initiating treatment.

Our clinic is committed to transparency regarding the costs associated with ketamine treatment, and we offer detailed information and support in navigating these financial considerations.

For more information on ketamine therapy, including the referral process and financial considerations, please contact our clinic. Our team is here to assist you through each step of the process, ensuring you have the support and information needed to make informed decisions about your mental health care.

 

*Results may vary from person to person.