Do you have treatment-resistant depression?

Ketamine has had profound effects on treatment-resistant depression. In a nutshell, ketamine enters the bloodstream, gets to the brain, and imitates glutamate, a neurotransmitter. By doing this, it strengthens the connections of neurons in the brain and increases neuroplasticity. To put it non-scientifically, ketamine helps to erase the depressive, ruminative patterns in your brain like one shakes and clears an etch-a-sketch.

Why is the depression qualified as “treatment-resistant”?

Often a psychiatrist will treat you with SSRIs before they will advise you to consider ketamine. More is known about the former and it’s been an established depression treatment for longer than ketamine.

Are you financially secure?

Ketamine isn’t covered by most insurance companies. A typical infusion at a clinic can set you back anywhere from $400 to $1200 with lozenges and sprays looking to be about the same price. But perhaps with your newfound tranquility, you won’t seem to mind human constructs like “money” as much.

Are you afraid of needles?

If so, you may want to consider the nasal sprays or lozenges instead.

Yes - Please complete contact form on site for more information.

PURE, in partnership with DPS, is a specialty clinic, providing only KAP services. If you are seeking a med management provider, you and your PURE provider can discuss a possible recommendation for other medication management providers in the area.

1409 Willow Street

Suite 201

Minneapolis, MN 55403

Free parking on Willow Street, and adjacent streets

Yes. We offer both in-person, and telehealth. You are welcome to choose which you prefer.

PURE is a specialty therapy clinic that focuses on providing KAP to patients, with coordination of services with outside providers, to ensure that there can be a team approach to your mental health needs. Integration, post KAP medicine session, can however, be longer-termed in duration, if needed, and agreed upon by yourself and your provider as a part of your course of treatment.

Traditional therapy is also offered at PURE, with or without KAP being part of your treatment plan.

A general course of treatment requires a minimum of a Psychological Diagnostic Assessment, one prep session, one medicine session, and one integration session, although this is not recommended, and is dependent on if you are familiar with altered states of consciousness. If this is your first psychedelic experience, preparation is required to help you understand the process and course of therapy, which is how KAP differs from ketamine infusions. If you are seeking acute symptoms relief, we recommend looking into ketamine infusion clinics.

Ketamine has been administered by intravenous (IV), intramuscular (IM), sublingual (SL), and intra-nasal routes. Often, it has been used after other treatment approaches have been unsuccessful. At PURE, the administration is through IM or SL, for those who cannot or wish not to receive injections in a medical setting, or if continued treatment plan includes SL KAP sessions, which will be discussed between yourself and your providers. You will remain awake and able to talk during the procedure, but your perception and mental state will likely be altered by the ketamine. You will return to a normal mental state as the immediate medication effects wear off.

Because of the dissociative effect of Ketamine, we require that you have transportation set up after your active Ketamine session. Once medically cleared, you will be allowed to leave the clinic with your arranged ride. Should you have any concerns when you are home, please call our office to discuss. 

1. Refrain from driving for at least four hours after you leave the office, or until anylingering effects have stopped. Ketamine has a long tail and it is possible to feel loopy,

unbalanced, and disoriented for a few hours after you leave the office.

2. Be gentle with yourself - You just went through a significant experience and your body,

mind, and spirit need to rest. Give yourself the rest of the day to be quiet and begin your

integration process (see notes below).

3. Listen to your body - Pay attention to cues for hunger and thirst. You fasted earlier today

and are likely somewhat dehydrated. Hydrate according to what your body needs and

eat foods that feel nourishing. Refrain from alcohol or other drug use (unless previously

discussed with therapist/doctor).

Music is an immensely important part of the experience and provides a framework for how the experience unfolds. Music is a vehicle to assist in the experience of medicine-psychotherapies. Often times music is equated to the ship that one rides on, through the oceanic experience provided by the medicine. Medicine-psychotherapies often have a degree of being ineffable; music assists in the narration of that experience that words cannot.

During the medicine session, your medical provider will administer the Ketamine, and then the therapist will be present in the room for the duration of the session. You will be provided a very comfortable chair that reclines, with pillows, blankets and other amenities to ensure optimal comfort. You will be provided with eyeshades and headphones with a music playlist designed specifically to help support your healing experience. The therapist will be available for whatever support is needed and bases their responses off of your individual needs. For example, if you have something you want to process, talk about or engage with, the therapist will be there to help. Or, if you prefer to listen to music the whole time, the therapist will support this as well. Beyond the basic measures taken to ensure your safety and that of the therapist, there’s no right or wrong way to do this. The therapist may offer you some recommendation/options based on their experience and knowledge and they will support you in determining what direction makes the most sense for you.

1-Please bring any questions you have to your assessment visits. We will ask you about medications you’re taking and any past mental health and medical diagnoses you have received. We may request additional information as needed.

2-If you have an ongoing therapist, psychiatrist or medical provider, it is helpful for us to be able to coordinate with your providers. Sometimes it’s helpful to ask your existing providers to complete a Release of Information so that we can communicate. Otherwise you can complete an ROI with us at the time of your intake.

No. We do however, recommend that you have engaged in psychotherapy in the past, as this treatment can feel intense for someone who is not as aware of aspects of their mental health concerns/symptoms, that may need to be assessed and treatment goals may be recommended to have been met, prior to engaging in KAP.

PURE therapy accepts credit, cash or check for services rendered. We also accept most major insurances for preparation and integration sessions.

PURE works with Advanced Care, for financing solutions for medical procedures and treatments.

https://advancecarecard.com/for-patients/

Assessment & Psychotherapy services can possibly be billed to your insurance, in the future when PURE begins to accept insurance. Please check with your insurance carrier if you have any questions regarding coverage, copays, or deductibles to determine what your actual out-of-pocket expense will total. Ketamine sessions are not covered by insurance and are paid out of pocket. You are welcome to use an HAS or FLA card to pay for your KAP session, and if needed, your statement can be used as an EOB for your insurance carrier.

The cost per Ketamine Medicine Session is listed below:  

• Individual Ketamine Medicine Session: 

            -Initial IM Session: $800.00 out-of-pocket per session

            -Additional IM Sessions: $600.00 out-of-pocket per session

            -Initial SL Session: $700.00 out-of-pocket per session

            -Additional SL Session: $500.00 out-of-pocket per session

• Couples Ketamine Medicine Session: 

            -Initial Session: $800.00 out-of-pocket per session

            -Additional Sessions: $600.00 out-of-pocket per session

• Group Ketamine Medicine Session: 

            -Initial Session: $600.00 out-of-pocket per session

            -Additional Sessions: $500.00 out-of-pocket per session

Ketamine-assisted psychotherapy (KAP) is a mental health treatment method that involves using ketamine’s trance-inducing and pain-relieving properties to help individuals work through various mental and emotional challenges.

The most common effects are nausea & vomiting, increased salivation, increased blood pressure and heart rate. Vital signs will be checked before your encounter and during if there are signs of physical distress. It is normal for patients that work through their trauma to have moments of distress that do not pose a physical danger to themselves. The therapist will aid in your journey and guide you through those difficult moments. For nausea, you may be offered anti-nausea medication before your session. You can minimize this risk by eating a light meal that day and not eating 4 hours prior to therapy.
 
Visual, tactile, and auditory processing are affected by Ketamine. Your sense of time and space may be altered, causing difficulty with balance and coordination. Other adverse side effects may include blurred and uncomfortable vision, slurred speech, mental confusion, excitability, diminished ability to see things that are present, diminished ability to hear or to feel objects accurately (including one’s own body), agitation, anxiety, and Synesthesia (a mingling of the senses).  

There have been reports of some decrease in immune function in patients receiving surgical doses of ketamine, however the outpatient use of Ketamine is very different from inpatient use, as the doses are significantly lower. 
 
In terms of psychological risk, Ketamine has been shown to worsen certain psychotic symptoms in people who suffer from Schizophrenia or other serious Mental Disorders. It may also worsen
underlying psychological problems in people with severe Personality Disorders. There is also a small risk that use if Ketamine may induce a manic episode. Finally, it is a risk that the use of Ketamine may not alleviate your desired psychological symptoms. 

Ketamine therapy should not be used in patients with the following contraindications:

·      Active substance abuse

·      Psychosis

·      Active suicidal ideation/ plans

·      History of increased intracranial pressure

·      Pregnancy or breastfeeding mother

·      Uncontrolled high blood pressure

·      Untreated hyperthyroidism

·      Prior hypersensitivity or negative reaction to ketamine

·      Heart Attack or Stroke in the past 3 months

·      History of allergic reaction to ketamine

Ketamine is an essential medical and veterinary drug used for anaesthesia and pain relief under a wide range of circumstances. Ketamine is much less likely than other anaesthetics to depress the heart and respiration, so it is the anaesthetic agent of choice in low income countries and in environmental/conflict disasters where there are few trained medical personnel, anaesthetic machines or consistent sources of electricity. In the western world ketamine is the most commonly used veterinary anaesthetic, particularly in horses and the more unusual species. In developed countries ketamine is less commonly used for routine anaesthesia in people as it may cause hallucinations during recovery; more conventional anaesthetics are preferred where trained anaesthetists and appropriate equipment are readily available to monitor the patient and support respiration.

Ketamine is a potent pain killer and is particularly useful for children undergoing agonizing procedures such as treatment of burns. It is now also an important treatment for chronic pain.

New therapeutic uses for ketamine have more recently been identified, including treatment of depression and refractory status epilepticus. A single low dose of ketamine can rapidly lift depression, although the effect does not last long-term. It is thought to work by causing new connections (synapses) to be made in the brain. This is a promising lead for the development of new treatments because conventional antidepressants take some time to work. Self-treating using ketamine puts the user at risk of the harmful effects of ketamine, and it has not yet been established through large-scale trials that the benefits outweigh the risks.

A typical ketamine dosing session lasts between 2-3 hours and takes place in-person, in clinic. During a dosing session, patients administer/are administered prescribed ketamine. The patient will be in a comfortable, reclining position wearing a Mindfold eye mask and listening to calming music with headphones.

1- Powerful Antidepressant Effects – Strong evidence shows that KAP is highly effective at treating various forms of depression including Treatment Resistant Depression (tried two or more medications without success). Data indicates that approximately 70% of clients have a positive response to the treatment, which is higher than most existing treatment approaches.

2- Increased Openness – Clients often notice feeling much more open after KAP. This can manifest as openness to new experiences, new opportunities, or new ways of participating in their relationships.

3- Enhanced Cognitive Flexibility – Clients report that they feel much more flexible in their views, perspectives, and approaches to their lives. Whereas mental health problems like anxiety and depression involve a lot of rigid, inflexible thinking, KAP can help reduce such rigidity and replace it with a more flexible way of viewing oneself and others.

4- Increased Connection with Self and Others – KAP can help clients feel a deeper sense of connection with themselves, other relationships they have, or even the broader universe as a whole. This can lead to better, more vibrant interactions as well as an openness to a relational connection that brings healthy, healing elements to one’s life.

5- Effective Trauma Processing – Clients find that they are able to process trauma while undergoing KAP experiences actively. Ketamine can help bring a profound experience of viewing trauma through a unique lens, navigating associated emotions, and releasing traumatic material from the brain and body. Trauma processing happens best when ketamine is combined with therapeutic support to help clients unpack, process, and heal from the trauma they’ve been carrying.

6- Deep Emotional Reset/Cleanse – KAP helps facilitate productive emotional processing, which can feel like an emotional “cleansing” or “reset switch” of sorts. Clients often find that they experience more balance in their emotions, leading to increased feelings of peace and emotional regulation.

7- Opportunities for Spiritual Growth – Some individuals report having mystical experiences while under the effects of ketamine including feeling connected to something universal or larger than themselves. Clients can have many spiritual or existential layers to their KAP experience, and there are opportunities for deeper spiritual connection and exploration when these are viewed with a curious openness

8- Sustainable Change – KAP can often lead to more sustainable changes over time than many conventional treatment approaches. Clients sometimes find that they view themselves, others, and the world around them in a much healthier way after undergoing KAP. These new insights are frequently helpful in preserving and furthering positive changes.

It is normal to feel mental fogginess and dizziness after the Ketamine session. The medicine will last in your system for another 10-12 hours, but you should not have any significant impairments four hours after discharge. Do not drive or operate any motor vehicles or machinery for four hours after your Ketamine session, or until you do not feel fogginess, dizziness, or imbalance, whichever is longer. Your journey can be a powerful experience and can bring up varying emotional states. We expect deep rooted memories and feelings to surface afterwards. Please contact your therapist if you are having difficulty processing these emotions yourself. We typically schedule a brief follow up session the day following your Ketamine session and continue with the integration process for as long as you and your therapist see fit.  

It is important to note that ketamine infusion and ketamine infusion clinics differ greatly from ketamine-assisted psychotherapy, in the set, setting, administration, support, structure and integration. The more knowledge and understanding you have regarding available treatment options, the more informed and empowered you will be when deciding which treatment options are best suited for your wellness goals.

Traditional therapy uses multiple interventions in the course of therapeutic treatment, where KAP uses not only traditional forms of therapy, but it adds the component of medicine, for an integrated psychotherapy and psychiatric experience. It can be helpful for persons who have engaged in traditional therapy, and find they feel “stuck”, and are ready for a perspective shift and a different approach to healing.

This is one of the more frequently asked questions regarding psychedelics, and absolutely understandable. In a therapy setting, we like to differentiate between "bad trips" and "challenging trips". It's our belief that "bad trips" can be avoided, with attention to set and setting and through trusting relationships with your therapist. For some people, the ketamine therapy experience can still be challenging.... but, it's often the challenging experiences that are most rewarding. For many people, psychedelics in therapy can help them to confront and deal with things that they've struggled to address in the past. This is similar to "regular" therapy, in that it too can also be challenging at times.

The set and setting, play a tremendous role in the overall experience. Set is the mindset of the individual and setting is where the experience takes place. PURE puts a lot of intention into helping with both of these- to prepare you for having the right mindset and in providing an optimal environment for your experience. Set and setting are the absolutely most important things we can control or influence, and generally the cause of "bad trips", when not properly cared for. 

When used recreationally, without proper attention to set and setting, psychedelic experiences may be scary or unsafe- because you're senses and perceptions are so heightened and "different" with psychedelics, "normal" environments can be very overwhelming (ie. at a party, in a public space, with someone you don't know well or have had conflict with, in a space with bad lighting, outside noises, or anything that is unclean or disorganized, etc.). At PURE, we design the setting to help facilitate a "letting go", which is very difficult to do in settings where you do not feel safe enough. We can also provide additional preparation sessions for anyone that has fears about it- this allows you to develop your confidence and form a trusting bond with your therapist. It is normal to have worries about this experience, and we welcome you to reach out to us and discuss any concerns that you may have.

Currently Ketamine is the only legal psychedelic available outside of research settings, in the state of Minnesota. As more psychedelic medicines are made available for clinic use, PURE will incorporate them into their practice.

 MDMA-assisted psychotherapy, which is demonstrating promising results for PTSD is likely to be approved by the FDA in 2024 for clinic use.

 Psilocybin- assisted psychotherapy is also being studied and expected to be available in 3-5 years for clinic use. The psychedelic therapy process that PURE currently uses with Ketamine, is the same general structure that PURE will use with future psychedelics.

Psychedelics were primarily used in the clinical setting before they were co-opted by the counterculture revolution of the 1960s. By 1951, over 100 articles on LSD had been published in medical journals. The drug was capable of inducing a new level of self-awareness that had enormous therapeutic potential compared to other modalities of the day. Studies on LSD and alcoholism reported that between 40 and 45% of patients given the drug had not experienced a relapse after a year. Bill Wilson, co-founder of Alcoholics Anonymous, believed LSD could be used to cure alcoholics and credited the drug with helping his own recovery from depression.

Psilocybin (mushrooms) and LSD psychotherapy peaked in the late 1950s and early 1960s, and was widely considered to be “the next big thing” in psychiatry. Between the years of 1950 and 1965, some 40,000 patients had been prescribed one form of LSD therapy or another under the trade-name Delysid. Research into the potential therapeutic effects of LSD and other hallucinogens had produced over 1,000 scientific papers and six international conferences.

Preliminary findings were very positive and warranted further study, but the research abruptly stopped. It came to a halt not for safety or efficacy issues, but primarily for political reasons. The Nixon administration heavily restricted further research despite some politicians and researchers speaking out against the government’s actions. Nixon and his fight against anti-war protestors eventually led to the Controlled Substances Act of 1970 as a tool to jail and imprison dissidents of the Vietnam War.

Another psychedelic medication, MDMA, was patented by Merck in 1914 and has a long history of use in relationship therapy. It gained notoriety in the 1980s as the illicit drug “ecstasy”, but it was originally known as “empathy”. Therapists found that it had the extraordinary ability to make their patients more willing to communicate and participate in the psychotherapy process. It also eliminated the typical fear response in patients with histories of trauma. Anecdotally, psychotherapists reported that it greatly accelerated therapy, which made it an important adjunct not an alternative to traditional therapy. Unfortunately, underground use in clubs and bars became more widespread prompting the DEA to investigate by the early 1980s.

There were no links to deaths or violent crimes, but under the banner of the War on Drugs it was placed in the Schedule 1 category under the Controlled Substances Act despite its history of therapeutic use. The DEA acted against the recommendation of the administrative law judge who presided over the scheduling hearings, while also disregarding opposition from the medical profession and researchers.