Ketamine creates new neurological pathways in the brain...

We generally begin ketamine treatment with the administration of sublingual lozenges of 50-100 mg. The lozenges dissolve slowly, and in order to receive the best results, we ask you to let the lozenges dissolve in your mouth for fifteen minutes. Ketamine will penetrate the oral mucosa (lining of your mouth) and is rapidly absorbed in this manner. This will assist us in accurately measuring your responsiveness to ketamine. After 20 minutes, you may choose to take an additional lozenge.

Your first session will be a "dose finding" session, as people respond differently to the medicine. We use lozenges containing 100 mg of ketamine each. Twenty minutes after your first dose, you may choose to take an additional dose to deepen and lengthen your session. Based on your experience, we'll collaborate to adjust the dosage as needed in following sessions.

Ketamine is a psychoactive drug classified as a dissociative anesthetic. It's used in a variety of medical situations because of its safety. Ketamine has been used off-label in sub-anesthetic doses to treat chronic pain, depression and other mental health issues for over 20 years. Ketamine is now used off-label in conjunction with psychotherapy to treat depression, anxiety, suicidality, and other psychological conditions.

1) Medical/Psychiatric Intake: After an initial consultation to determine whether KAP is likely to be a good fit for your treatment goals, you'll complete a medical intake with our physician, Dr. Jessica Yoos. Jess will determine whether there are any medical contraindications or areas of concern before prescribing your ketamine. This 60 to 90-minute session includes: an evaluation of your current concerns, needs, and goals; a medical history and physical exam (if possible); a review of your medical/psychiatric history; a review of current or past psychological/psychiatric history and treatment; and possibly the administration of brief psychological tests to assess your current level of functioning. Based on the findings in this session, our treating physician may also recommend additional diagnostic testing, including, but not limited to: blood and/or urine laboratory tests, EKGs, or other tests. 2) Preparation Sessions: Next, you'll work with one of our two therapists, Lisa Yeager, MSW, LICSW or Laurel Watjen, MA, LMHC, to prepare for your ketamine sessions. Over the course of several sessions, we'll get to know each other, explore your symptoms, clarify your goals, and create your treatment plan together. We'll discuss the variety of experiences you may have during the ketamine sessions and ways to navigate them. Our goal is for you to feel as prepared and comfortable as possible going into your first medicine session. 3) Medicine Sessions: You'll arrive at our downtown Bellingham clinic and we'll spend 15-30 minutes checking in, reviewing your intentions for the session, and getting you settled into our reclining chair or couch. You'll take your first ketamine lozenge and hold it in your mouth for 15 minutes, swishing the medicine so it absorbs through the skin, then swallowing it. Twenty minutes after taking your first dose, we'll offer you a second dose to deepen and prolong your experience. The effects will last approximately 90 minutes to two hours, after which we'll check in again and perhaps do some brief integration work before your ride takes you home. You should arrange to take the rest of the day off from work or other responsibilities or stressors. When possible, it's helpful to keep the following day gentle as well. Integration begins as the ketamine effects wear off, so having time for reflection and self-care will help you make the most of your experience. 4) Integration Sessions: 1-3 days after your medicine session, we'll meet for integration counseling. Your therapist will support you in reflecting on your experience, making meaning of it, and exploring how to integrate insights and shifts in patterning into your life for meaningful change. Depending on your experience and other factors, you may decide to do more than one integration session after a medicine session. ----- 5) Repeat Steps 3 and 4 according to your treatment plan. On average, our clients find symptom relief and feel "complete" after five to eight medicine sessions.

In general, ketamine has an extensive record of safety; however, the following conditions may be contraindicated for KAP and require further assessment by our clinical team prior to proceeding. Depending on the condition, if symptoms are well-managed, they may not preclude treatment. Pregnant or nursing (not eligible for KAP) Untreated/poorly managed hypertension or a history of heart disease Current or history of mania/hypomania, psychosis/hallucinations, or active substance abuse. Untreated/poorly managed hyperthyroidism History of significant bladder disease (cystitis, chronic UTIs) Ketamine is known to interact unfavorably with a very small number of medications. Your medication history will be closely assessed to determine your eligibility for KAP.

Certain medications need to be temporarily stopped. For specific questions please contact us directly and consult with your prescriber.

Common side effects may include a temporary increase in blood pressure and pulse rate, nausea, blurred vision, reduced balance/coordination. These generally resolve as the drug's effect wears off-- usually from two to four hours after administration.

Bellingham Ketamine Clinic was founded upon the principles of both excellence in care and accessibility. We offer a sliding scale in order to uphold our mission of making this unique form of therapy accessible to all who may benefit from it. We invite you to use our sliding scale pricing if you feel it will make a difference in your ability to access care. Sliding Scale Rates: · Medical/psychological intake (~60 minutes with physician): $275-350 · Preparation session (50-60 minutes with therapist): $125-200 · Lozenge Medicine session (2.5-3 hours with therapist): $350-550 · Integration session (50-60 minutes with therapist): $125-200 · Intramuscular Ketamine session (2-3 hours w/physician and therapist): $450-650 Your actual total cost will depend on your treatment plan and be dictated by how many services are provided. Other fees (e.g. late cancellation, after hours care, etc…) are described in your specific therapist’s Clinician Disclosure Statement. We do not require an application or personal financial information to access the sliding scale rates above. Instead, we ask you to decide in good faith on the amounts you are able to pay without undue hardship and let us know. If your circumstances change, we trust that you’ll adjust the amount accordingly and update us. See FAQ on Insurance

We accept payment via credit card, check, and cash.

KAP medicine sessions are not covered by insurance companies at this time. You may be able to seek health insurance payment/reimbursement for the intake, preparation and integration sessions. If your therapist/physician is contracted (In Network) with your insurance company they can submit claims on your behalf. If your therapist/physician is NOT contracted (Out of Network) with your insurance company, full payment is due at the beginning of the session and, upon request, they'll provide a Superbill which you may submit to your insurance provider. Reimbursement will depend on your coverage.

2023 Rates (per session) · Medical/psychological intake (~60 minutes with physician): $350 · Preparation session (50 - 60 minutes with therapist): $200 · Lozenge Medicine session (2.5 - 3 hours with therapist): $550 · Integration session (50 - 60 minutes with therapist): $200 · Intramuscular Ketamine session (2 - 3 hours w/physician and therapist): $650 A typical course of treatment will include: (1) Medical/psychological intake (3) Preparation sessions (5-8) Medicine sessions (5-8) Integration sessions (At least one after each medicine session) Your actual total cost will depend on your treatment plan and be dictated by how many services are provided. Other fees (e.g. late cancellation, after hours care, etc…) are described in your specific therapist’s Clinician Disclosure Statement.

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