Safe, effective therapy for treatment resistant depression and chronic anxiety in Plymouth, New Hampshire
What would gaining control of your stress response mean to you?
Can you imagine your life without clinical depression?
Many studies, including those conducted at Yale and the National Institute of Mental Health, have shown that low dose, intravenously administered ketamine can dramatically and rapidly improve symptoms associated with depression and many anxiety disorders. It does this by quelling the maladaptive fight-or-flight response of the amygdalae, giving your prefrontal cortex (the CEO of your thought processes), a chance to regain control of the emotional response. Imagine remaining calm and motivated long enough to:
Program your prefrontal cortex with new habits of mind.
Process trauma without re-traumatizing your neural networks.
Practice new psychologic patterns that you have already been working on by yourself, in community or in psychotherapy.
Comments from clients
“I now have a reference point outside of this despair, this thing I thought was myself is so obviously just, not. I know where to focus my efforts.”
“I know what my therapists and meditation teachers have been trying to teach me all of these years. I totally get it now, I don’t just know ABOUT it. Living beyond my ego doesn’t seem like an unachievable fantasy.”
“I woke up the next day, alive and motivated in a way I had not been in years…I can do this. I can transform.”
Rebecca Brachman’s Ted Talk about ketamine
Time Magazine Cover Story July 27, 2017
More recommended reading
1. Which diagnoses are treated with ketamine?
Chronic (treatment resistant) Depression, Post-Traumatic Stress Disorder (PTSD), Bipolar Depression, Obsessive Compulsive Disorder (OCD), Post-Partum Depression, and Chronic Anxiety are all appropriate diagnoses for outpatient ketamine therapy.
2. Do I need to be referred by a psychiatrist or other healthcare provider?
We prefer that you allow us to collaborate with your primary care provider, psychiatric care provider and/or therapist. However, as this service is not covered by insurance, no formal referral is required.
3. Will Ketamine Therapy help my treatment resistant depression?
Treatment resistant depression is chronic depression that does not respond to 2 or more medications with or without psychotherapy. Based on searches of major medical centers over the past fifteen years, and in our experience, up to 70% of all patients can expect significant, and fast, relief. Of course, we cannot predict any individual’s results. Our treatment is tailored in terms of frequency and dosage to each person, and we believe it offers your best chance of successful remission.
4. How many ketamine infusions will I receive?
That will depend on your response. Most patients receive a ‘loading series’ of six infusions. Continuation and maintenance plans are developed on a case-by-case basis.
5. What happens after my series of ketamine infusions?
Following the initial series of infusions, some patients choose, in consultation with their clinicians, to begin a maintenance program, returning for single infusions intermittently. The interval between maintenance infusions varies from patient to patient.
6. If ketamine therapy works for me how soon will I begin to feel better?
Some patients will begin to feel better within hours of the first infusion. Patients with thoughts of self-harm often notice those thoughts dissipating first. There can be a dramatic relief of dread and hopelessness. Other patients may not notice any mood improvement until the next day. Some patients will require a second (or even a third) infusion before feeling better.
7. Will I require ketamine infusions for the rest of my life?
No. Some patients seem to achieve long-term relief after a series of infusions.
8. How can I best prepare my mind and body for the ketamine experience?
In the days before your first treatment, practicing good sleep hygiene is the single best thing you can do for your body and mind. Decrease your caffeine intake, turn off your screens by 8 pm, read a book, drink enough water, eat a lower carb diet than usual.
Clarifying your intention is another vital part of preparation. Ask yourself: What am I trying to achieve? Why? What will I do if it works? What will I do if it doesn’t work? What am I struggling with now? Am I doing this for myself, or for someone else? Can I be open to this new experience? Am I really ready to let go of tightly held thoughts and patterns?
9. What should I expect during ketamine therapy?
Ketamine is administered over a period of 40 minutes. The dose is determined by your weight. The amount of ketamine administered is not enough to cause a loss of consciousness, so you will remain awake (in fact, some of our patients have walked to use bathroom during their infusion). During the infusion some patients experience odd perceptions—like seeing bright colors. Some report an “out of body” experience or entering a dream-like state. These side effects are considered non-ordinary experiences, and may be important for ketamine’s ultimate effectiveness. Most patients tolerate the experiences with no trouble, and many people find them pleasant. Once the infusion is complete, any side effects dissipate within 30 minutes. There are no delayed “flashbacks,” and patients generally leave the office within 30 minutes following the infusion feeling quite normal.
10. Are there other side effects I should be concerned about?
Our patients rarely experience nausea following an infusion. If this occurs, there is medication that will help. More rarely, a patient may experience a transient headache. Patients can expect to be tired following the infusion. Very, very rarely, patients already at risk for seizure have reportedly experienced one. Seizure disorder is a contraindication to ketamine treatment in our office.
11. I am bipolar, will ketamine make me manic or hypomanic?
Neither mania nor hypomania has been reported following ketamine therapy.
12. What medical conditions or psychiatric conditions could keep me from receiving ketamine?
Uncontrolled hypertension, seizure disorder, schizophrenia, schizoaffective disorder, acute psychosis, or active substance use disorder.
13. Are ketamine infusions addictive?
14. Do I need to bring someone with me?
You will need a driver. You do not need to have someone bring you or accompany you during the infusion, but we request that you have someone bring you home. We advise you not to drive a car until the following morning.
15. Can I eat or drink before my appointment?
You cannot eat for the 4 hours prior to your scheduled appointment. You may have clear liquids up until 2 hours before your appointment.
16. Will my current psychiatric medications interfere with ketamine treatment?
Anti-depressant medications (SSRIs, MAOIs, and tricyclics) do not interfere with ketamine, and there is no need to stop them. Ketamine infusions can even provide relief during the time it takes antidepressant medications to begin working.
If you are taking beta-blockers (e.g., Inderal, propranolol) for panic disorder, we recommend you hold for 24 hours prior and the day of the infusion. If you are taking these for hypertension, do not hold.
Naltrexone should be held for 48 hours prior and including the day of the infusion.
Benzodiazepines should be held for 12 hours prior and including the day of infusion.
Important: You should not decrease or stop taking any other prescribed medication without first consulting your prescribing clinician.
17. Will my insurance company pay for ketamine therapy?
Because ketamine therapy for mood and anxiety disorders is recent and still viewed as experimental, insurance companies do not provide reimbursement.
18. I am afraid of needles, what should I do about that?
We can discuss mindfulness practices that can ease your anxiety and make IV insertion more comfortable.
19. What should I bring?
We ask that you download and fill out our new patient registration forms and bring them with you to your appointment. A link to our forms can be found on our home page.
Consider bringing your own music listening device. We can also play peaceful music of your choice.
20. Do you offer concierge services?
New Hampshire has many wonderful communities in which to recreate. We can suggest activities, amenities and hotels, but ultimately we encourage you to utilize the internet as it is a wonderful resource for developing your New Hampshire itinerary. We do plan to develop relationships with hospitality service providers in the future. New Hampshire was the chosen home of many of America's greatest philosophers. Consider this: in New Hampshire you can hike the same mountains and stroll the same paths as Emerson, Thoreau, Melville, William James and Norbert Wiener.
21. Why does Neuragain require payment up front?
At Altum, love is the bottom line. Advance payment is a commitment to yourself and to us that we will be in the same space together at the designated time. Paying in advance is honest and efficient. When payment is not received in advance, the likelihood of not arriving at the designated time dramatically increases. When one person skips a scheduled appointment, that time has been taken from others including other clients and our clinicians. Additionally, we are not interested in engaging with debt collection companies to recoup owed monies after the fact, because that sounds awful. When evidence for shorter protocols is produced, Neuragain will offer packages of fewer than 6 infusions, which we understand would be more cost effective.
Altum Psychiatric Services provides convenient, comfortable, safe, outpatient, state-of-the-art ketamine infusion services in our Plymouth, NH office.
Protocols for the use of ketamine for acute suicidality are in the process of validation in studies around the globe, but we are not there yet.
Suicidality is an emergency.
If you feel you are in a crisis, stop now and call the National Suicide Prevention Lifeline at 1-800-273-8255. No matter what you are dealing with, they want to help you. You will be connected to a skilled, trained counselor at a crisis center in your area, anytime 24/7.
The Crisis Text Line is an alternative, text CONNECT to 741741. You are their priority.
If you are in a medical emergency or suicidal crisis and you cannot connect with those numbers, please call 911.