Ketamine is a commonly used medication in our hospitals across Canada for anesthesia, and it has anxiolytic, antidepressant, and psychedelic effects. Its dissociative properties allow you to be disconnected from the typical way you think about and experience your life, which helps you gain new insights into your inner world. Things that were hard or intolerable to understand, feel, or remember become more accessible or clear, making it easier to process and resolve them. Ketamine, when used alongside therapy, has been shown to be effective in the treatment of anxiety disorders, post-traumatic stress disorder, treatment-resistant depression and substance use disorder.

Ketamine used in this therapeutic setting is experienced differently from person to person. Some people have deep psychedelic experiences, and some people feel their experience of ketamine is mild. Please note that regardless of how you are cognitively registering the experience of ketamine, the medicine and your inner wisdom are working together to move toward healing.

At Upstream, a physician, nurse practitioner and/or nurse will be available to care for you throughout the entire session alongside your therapist to help you prepare and integrate your experiences. Our priority is that you are safe, and you feel supported leading up to, during, and coming out of the session.

Your KAT appointment will be 3 hours long. Current research and our experience is showing maximum benefits are recorded by patients when partaking in 3 consecutive KAT sessions. We highly recommend booking three KAT dates when you submit your application, but can make bookings for a single session available if you so choose.

Ketamine will be administered to you sublingually for your first session; subsequent sessions may continue with sublingual or intramuscular administration.

i. Sublingual
This will be in the form of lozenges which you will “swish” in your mouth for 15-20 min.

ii. Intramuscular
Ketamine will be administered through intramuscular injection. You will have a private room with a comfortable area for your experience but you are asked to bring blankets and a pillow from home to help you feel at ease and comfortable as much as possible. Individuals unable to lay down or needing to sit in a chair will be supported to do so.

Currently, our services are offered to people experiencing anxiety, depression, post-traumatic stress disorder and/or substance use disorder. Your care provider may also refer you to us if they believe you may benefit from this treatment even though you do not have a formal diagnosis at this time. Our medical team will be able to consult you on what treatments are available to you.

We want you to be as supported as possible while trying this approach to treatment. This means, we require you to have a therapist as well as a support person who will be available to you following your ketamine sessions.

Though it’s not expected, if you experience a increase in suicidality over the course of the treatment, we will expect you to inform your physician, your therapist, and ask you to contact the crisis line at any point if you are in crisis by phoning 1-800-784-2433 or by chat through www.crisiscentrechat.ca

Exclusion criteria includes allergic reaction to ketamine, presence of psychotic symptoms, severe liver disease, and kidney disease. Ketamine may increase your heart rate and blood pressure during the session. For this reason, if you have uncontrolled hypertension or cardiovascular disease, it is essential you speak to the physician on our medical team on how best to manage your condition before starting this treatment. Please note that your blood pressure will be monitored throughout the session to ensure your wellbeing. Certain medications may interact with ketamine so it is imperative that you inform the medical team of all medications you are currently using.

Although using ketamine therapeutically has the potential for positive outcomes, there are also some potential risks. You may experience a temporary elevated heart rate or blood pressure. The most common side-effect is mild nausea/vomiting; we will have anti nausea medication available to you before the start of the session if needed. Ketamine impacts each person differently, which means some people may experience more psychedelic features of the medication than others. It is possible that while using Ketamine therapeutically, a person will encounter challenging psychological material, including difficult or previously unexplored memories or emotions. It is important to let your therapist or our medical team know during a session if you need some support. Even though the session typically itself lasts 1-2 hours, you may still experience some effects of the ketamine so we ask you not to operate any heavy machinery including an automobile until the following day.

Please reach out to us at medicalupstream@gmail.com and our team will be happy to assist you.