Ketamine Treatment for Depression, Anxiety, & PTSD in the Bay Area

Schedule Consultation
(833) 272-4111

Ketamine Treatment for Depression, Anxiety, & PTSD in the Bay Area

Schedule Consultation
(833) 272-4111

Overview

Treated
Conditions

FAQ

Locations

Overview

Treatment with Ketamine at Bay Psychiatric Associates

Ketamine and the related therapeutic Spravato® (intranasal esketamine) are exciting new advancements for the treatment of depression.  Ketamine is an “off-label” treatment that has been shown to be effective for the treatment of multiple mental health conditions. Spravato® is an FDA approved treatment for adults suffering from treatment-resistant depression or depression with suicidality.

Our providers are some of the first in the Bay Area to develop expertise in this modality. We are dedicated to providing effective, individualized treatment, including intravenous and intramuscular ketamine, as well as intranasal Spravato®. Contact us today to schedule a time to discuss treatment options.

Commonly Treated Conditions

  • Treatment Resistant Depression (TRD)
  • Major depressive disorder with acute suicidal ideation or behavior (MDSI)
  • Bipolar Depression*
  • Anxiety disorders including PTSD*

(*these conditions are not FDA-approved for treatment with Spravato®, and are therefore ineligible for usual coverage by insurance)

Ketamine Therapy For Substance Use Disorder

At Bay Psychiatric, we understand the complex challenges associated with substance abuse disorders. Our Ketamine Therapy for substance abuse disorder in our Berkeley location has emerged as a groundbreaking treatment for addiction, offering a range of unique advantages:

  • Rapid Relief: Ketamine can quickly reduce cravings and withdrawal symptoms, helping patients manage their addiction more effectively.
  • Neuroplasticity: Ketamine promotes the growth of new neural connections, aiding in the “reset” of the brain’s reward pathways that contribute to addiction.
  • Comprehensive Care: We offer a holistic treatment plan that includes psychological support, counseling, and aftercare to address both the physical and emotional aspects of substance abuse.

Addiction-Related Conditions

Bay Psychiatric has extensive experience in treating a range of substance abuse disorders, including:

Alcohol Use Disorder (AUD)

Study Reference: A study published in the American Journal of Psychiatry found that ketamine significantly reduced heavy drinking days in individuals with alcohol use disorder, offering hope to those struggling with alcohol addiction (Dakwar et al., 2019).

Opioid Use Disorder (OUD)

Study Reference: Research in Nature Communications demonstrated that ketamine can disrupt opioid addiction by modifying the brain’s reward system, reducing the urge for opioid use and minimizing withdrawal symptoms (Williams et al., 2018).

Cocaine Use Disorder

Study Reference: A trial published in Biological Psychiatry revealed that ketamine infusions reduced cravings and relapse rates in individuals struggling with cocaine addiction, providing an innovative approach to treatment (Dakwar et al., 2014).

The Process – How Ketamine Works to Alleviate Substance Abuse Disorders

Neuroplasticity

  • Enhanced Neural Connectivity: Ketamine enhances neuroplasticity, allowing the brain to form and reorganize neural connections that have been altered by addiction. This ability to “rewire” the brain is crucial in overcoming the cycle of addiction.
  • Scientific Evidence: A review in Frontiers in Neuroscience highlighted that ketamine’s promotion of neuroplasticity can lead to lasting changes in brain function, aiding in the recovery from substance abuse (Abdallah et al., 2015).

Glutamate Modulation

  • NMDA Receptor Antagonism: Ketamine works on the brain’s glutamate system, specifically by blocking NMDA (N-methyl-D-aspartate) receptors. This helps to restore balance in the brain’s neurotransmitter systems, reducing cravings and minimizing the withdrawal symptoms that drive addiction.
  • Scientific Evidence: Research published in the Journal of Psychopharmacology demonstrated that ketamine’s modulation of glutamate activity plays a critical role in its effectiveness in treating substance abuse disorders (Krystal et al., 2017).

Regulating the Default Mode Network (DMN)

  • Regulation: The Default Mode Network (DMN) is often hyperactive in individuals with substance abuse disorders, leading to obsessive thoughts and cravings for the addictive substance. Ketamine reduces this hyperactivity, thereby decreasing the compulsive behaviors that fuel addiction.
    Scientific Evidence: A study in NeuroImage demonstrated that ketamine reduces DMN activity, contributing to its success in treating addiction (Scheidegger et al., 2012).

Anti-Inflammatory Effects

  • Easing Depression and Anxiety: Many individuals struggling with substance abuse also suffer from co-occurring mental health conditions such as depression and anxiety. Ketamine is known for its rapid antidepressant effects, providing immediate relief that can stabilize emotions and create a stronger foundation for overcoming addiction.
  • Scientific Evidence: A study published in The Journal of Clinical Psychiatry found that ketamine infusions produce rapid and sustained antidepressant effects, making it a valuable option for individuals with dual diagnoses of addiction and mood disorders (Zarate et al., 2006).

Disrupting Maladaptive Thought Patterns

  • Breaking the Cycle: Ketamine can disrupt the negative thought patterns and compulsive behaviors associated with addiction. By inducing a more open and reflective state of mind, ketamine allows individuals to gain new perspectives on their behaviors and thought processes, which can lead to breakthroughs in treatment.
  • Scientific Evidence: Therapists have reported that ketamine-assisted therapy helps patients confront and process the underlying issues driving their addiction, leading to more successful treatment outcomes (Dore et al., 2019).

Get started with Ketamine treatment

  1. Call 833-272-4111 to complete screening and schedule a 60 minute consultation. You will be given a cost estimate based on your insurance.
  2. Meet with one of our psychiatrists for evaluation of mental health symptoms, co-occurring medical conditions, and discussion of treatment options.
  3. Schedule treatment sessions.

Cost

Many insurance plans will cover Spravato for treatment resistant depression and suicidal thinking. Many patients pay next to nothing for treatment sessions.

Ketamine is an “off-label” treatment, and therefore insurance only provides coverage for parts of the treatment sessions.

For intramuscular ketamine, a treatment is $550 without insurance, and with insurance patients often end up paying around $300.

For intravenous ketamine, a treatment is $825, and with insurance patients pay around $500 per treatment.

We work with insurance plans and some patients will pay only their standard copay when they receive ketamine. You will be given an estimate of the exact cost prior to starting treatment. We find that our willingness to work with insurance makes us one of the most cost-effective providers of ketamine in the bay area.

Ketamine / Esketamine FAQ

What is ketamine?

Ketamine is a drug that blocks pain — an anesthetic — that was first developed in the 1960s for use in surgeries. In 2000, researchers began studying the other effects of ketamine. They found that it was rapidly effective for the treatment of depression, even when other treatments had failed.

Treatment with ketamine has been recognized as one of the most significant developments in the treatment of depression in over 50 years. It has provided much-needed, fast-acting relief to those with chronic, treatment-resistant mental health conditions and suicidal thoughts. 

Spravato® is an FDA approved treatment used in conjunction with oral antidepressants for adults suffering from treatment-resistant depression (TRD) or major depression with suicidality (MDSI). People who have Major depressive disorder may have TRD if they have not sufficiently responded to at least two different antidepressants (taken at an adequate dose and duration).

As a result of studies in multiple, large multi-center, randomized placebo-controlled trials, Spravato® has a stronger evidence base overall. In contrast, Ketamine is an “off-label” treatment, and therefore insurance only provides coverage for parts of the outpatient visit. Because Spravato® is FDA approved for these indications and insurance will cover treatment, it is potentially more affordable. 

Though the precise mechanism is not fully understood, Ketamine is known to block NMDA receptors in the brain. This may help to create a more open state of mind and stimulate learning through the formation of new synapses. Research has shown that ketamine may be rapidly effective and can have long lasting effects, decreasing symptoms in as quickly as a few days or even hours. Therefore, most people require multiple treatments over a longer period of time to achieve durable improvement. 

All of our treatments are delivered in our offices.

Spravato® is delivered intranasally, and it is available in our San Francisco, San Mateo, Corte Madera, and Berkeley offices. These sessions are two hours in length.

Our group provides Ketamine treatment intravenously in our San Francisco office, and by intramuscular injection in our San Francisco, Berkeley, and Corte Madera offices. The intravenous treatment is given slowly over 40 minutes, while the intramuscular treatments are given all at once and last about 90 minutes. 

Based on the best evidence available, we begin both Ketamine and Spravato® treatment with an induction course, which consists of multiple treatments given over a short period of time. This allows us to maximize symptom improvement and the amount of time the benefits last. For Spravato®, the induction course consists of eight treatments total, given twice per week over four weeks. For Ketamine, the induction course consists of six treatments total, given twice per week over three weeks.

As many as half of our patients may continue to experience benefits from treatment for a year after this induction course, and many patients will require maintenance treatment to sustain the benefits.

For Spravato®, maintenance treatment is given once every one to two weeks.

Ketamine maintenance treatment is typically given once every 4 to 6 weeks, though most patients receive more frequent infusions at first before reducing the frequency of treatment. 

Spravato® is an FDA approved treatment, and many insurances will cover this for TRD and MDSI. However, it is not covered by insurance for treatment of Bipolar depression, anxiety disorders, or Major depressive disorder without suicidality that has not been demonstrated to be treatment-resistant.

Ketamine is an “off-label” treatment, and therefore insurance only provides coverage for parts of the outpatient visit, leaving a higher out-of-pocket cost. Our treatment team will work with you and your insurance to determine what coverage is available. 

We provide a comfortable, safe setting for receiving treatment. Before each treatment, you meet with a psychiatrist for brief evaluation of symptoms and side effects. Each treatment room includes a comfortable lounging chair and warm relaxed lighting, and eye shades are provided for comfort.

We offer curated music and headphones to patients to help guide their experience. During treatment, people generally describe a sensation of feeling light and/or floating in the clouds. It is common to experience a sense of being disconnected from your body and surroundings, in a dream-like state, and to visualize pleasant scenery. 

The intravenous Ketamine treatment is given slowly over 40 minutes. The effects wear off quickly after the infusion is completed, and most patients are recovered within about 30 minutes. From arrival at our clinic to the time you leave, most can expect to be with us for about 90 minutes. For Spravato®, the FDA requires 2 hours of monitoring after the medication is delivered. There are no exceptions to this. 

The treatment experience with Ketamine is highly suggestible. We encourage patients to ground themselves and let go of stressors in order to be more open to the experience during treatment. Additionally, being in psychotherapy is helpful for reflecting on the experiences and insights that occur during treatment.

Journaling after treatment (through audio recording or writing) is also often helpful.

We advise patients to abstain from using alcohol or other substances during the course of treatment, which may impede the beneficial effects of treatment.  

Ketamine and Spravato® commonly cause significant increases in blood pressure. This is very safe in most people, but not with certain conditions. Treatment with Ketamine or Spravato® is contraindicated in people with aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial, or peripheral arterial vessels), history of intracerebral hemorrhage, arteriovenous malformations, or hypersensitivity to ketamine or esketamine.

People with high blood pressure and/or cardiac disease will need to have these conditions well managed before receiving treatment. Additionally, people who are pregnant or attempting to become pregnant should not receive Ketamine or Spravato® because they are believed to cause birth defects. 

Though most patients feel fairly alert and awake shortly after receiving the treatment, it takes time for the medication to fully wear off. Since the medication can impair attention, motor skills, and reaction time, you must not drive or operate heavy machinery until 24 hours after treatment. 

Ketamine and Spravato® are safe and generally very well tolerated. Side effects from Ketamine and Spravato® tend to be transient and occur mainly during the treatment session itself. Aside from the dissociative experience that is expected, other transient side effects include increases in blood pressure, sedation, nausea (which can be pre-treated with anti-nausea medication), motion sickness (which eye shades help prevent), dizziness, and headache.

In rare cases treatment can cause liver injury, and liver function tests are collected prior to beginning treatment so that can safely be monitored. Ketamine and Spravato® are potential substances of abuse, so there is concern that some individuals may develop cravings for Ketamine and seek it outside the treatment setting. Therefore, we provide treatment only in the clinic setting to reduce this risk.

Though they do not appear to be established risks with treatment with Ketamine or Spravato® for depression, there are uncertain long-term adverse effects on cognition and the lower urinary tract.

We continue to monitor developments of adverse effects over time and advise our patients about risks as new evidence becomes available.