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Ketamine Therapy

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Ketamine Therapy in NYC, Greenwich CT and Santa Monica California

Ketamine therapy has emerged as a breakthrough treatment for mental health conditions such as treatment-resistant depression, anxiety, and PTSD, and Principium Psychiatry stands out for providing superior care in this area. Principium’s approach to ketamine therapy is distinguished by expertise in the assessment of these psychiatric conditions; by experience in other forms of interventional psychiatry such as TMS, ECT, Botox, and VNS; by medical oversight and personalized care plans; and by a holistic, patient-centered philosophy that sets it apart from other providers.

At Principium Psychiatry, ketamine therapy is administered by highly trained psychiatrists and medical professionals with deep expertise in psychopharmacology. This ensures that each patient receives the right dosage and treatment method—whether intravenous (IV) or other routes, such as intranasal—tailored to their specific needs. Safety is a top priority, with patients closely monitored throughout the treatment process in a calming, medically supervised environment, ensuring both safety and comfort.

What makes ketamine therapy at Principium particularly effective is the integration of Ketamine-Assisted Psychotherapy (KAP). This innovative approach combines ketamine’s rapid effects on mood with therapeutic support, allowing patients to explore deeper emotional insights and process traumas that may be difficult to access in traditional therapy. By combining ketamine with psychotherapy, Principium offers a more comprehensive path to healing.

Moreover, Principium emphasizes personalized, long-term care, providing ongoing support through regular follow-ups and tailored maintenance plans. Their holistic approach, which integrates other therapeutic modalities like cognitive-behavioral therapy (CBT), group therapy, psychopharmacology, and other forms of interventional psychiatry (TMS, ECT, Botox, and VNS) ensures that ketamine is not a standalone treatment but part of a larger strategy for sustained mental wellness.

By combining cutting-edge science with compassionate, individualized care, Principium Psychiatry provides superior ketamine therapy that helps patients achieve meaningful, lasting improvements in their mental health.

There is a growing need for ketamine in the treatment of mental health conditions, particularly for individuals with treatment-resistant depression, anxiety, and PTSD. Traditional therapies, such as antidepressants and psychotherapy, often take weeks to show effects and are ineffective for a significant percentage of patients. Ketamine, however, has been shown to provide rapid relief from symptoms, often within hours, making it a crucial option for those who have not responded to conventional treatments.

Its unique mechanism of action, targeting glutamate receptors and promoting neuroplasticity, allows ketamine to offer benefits that other treatments cannot. As mental health crises escalate globally, ketamine therapy provides a much-needed, innovative solution for patients facing severe, debilitating conditions who require faster, more effective relief.

An estimated 7.3 million U.S., adults experienced as least one major depressive episode in 2017.

Principium Psychiatry offers ketamine therapy in a medically supervised, comfortable setting at its state-of-the-art clinics. Principium Psychiatry is located in:

Midtown Manhattan (near Grand Central), in New York City

Downtown Manhattan (near Wall Street and Tribeca) in New York City

Greenwich, Connecticut

Santa Monica (Los Angeles), California  

With locations designed to provide a calm and supportive environment, patients undergo ketamine therapy under the care of expert psychiatrists and medical professionals. Treatment is delivered through methods such as intravenous (IV) infusions or intranasally, tailored to the patient’s specific needs. Each session is carefully monitored for safety, and the clinic incorporates Ketamine-Assisted Psychotherapy (KAP) where appropriate to enhance therapeutic outcomes. Principium’s holistic, patient-centered approach ensures personalized, effective care for those seeking relief from mental health conditions.

What is Ketamine Therapy for Mental Health Conditions?

Ketamine infusion therapy is an innovative treatment used to address various mental health conditions, particularly treatment-resistant depression, anxiety, post-traumatic stress disorder (PTSD), and chronic pain conditions. Administered intravenously (IV) in controlled, medically supervised environments, this therapy involves delivering ketamine—a dissociative anesthetic—in precise dosages directly into the bloodstream.

Unlike traditional antidepressants, which can take weeks or months to show results, ketamine has a rapid effect on mood and mental health, often providing noticeable relief within hours or days of the first infusion. Ketamine works by targeting the brain’s glutamate system, particularly NMDA receptors, which are involved in promoting neuroplasticity—the brain’s ability to form new neural connections. This mechanism helps “reset” certain pathways in the brain, which may contribute to alleviating symptoms of depression, anxiety, and PTSD. 

Ketamine infusion therapy is particularly beneficial for patients who have not responded well to traditional treatments like antidepressants or psychotherapy. During each session, patients are monitored closely by medical professionals to ensure safety and efficacy, as ketamine can cause temporary dissociative effects. Multiple infusions over several weeks are typically recommended for optimal results, with some patients also receiving maintenance infusions to sustain their improvement. This therapy offers a promising alternative for individuals seeking fast-acting relief from debilitating mental health conditions. 

Ketamine taken intranasally is FDA approved as Spravato. While IV ketamine as an anesthetic holds U.S. Food and Drug Administration (FDA) approval, it is considered an off-label treatment when used for depression and other mental health disorders. Psychiatrists and physicians have permission to prescribe off-label medications at their discretion based on available evidence and the potential benefits to the patient. 

Principium Psychiatry offers superior ketamine therapy through its psychiatry led program. Principium Psychiatry has expertise in the diagnosis and treatment of mental health conditions using a range of interventions including ketamine, transcranial stimulation (TMS), electroconvulsive therapy (ECT), botox, and vagal nerve stimulation (VNS).

Ketamine therapy offers significant benefits for individuals struggling with mental health conditions, particularly those who have not found relief through traditional treatments like antidepressants, mood stabilizers, or psychotherapy. People with treatment-resistant depression—a condition where standard medications have proven ineffective—can experience rapid relief from symptoms with ketamine therapy, often within hours or days.

Additionally, individuals suffering from anxiety disorders, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD) may also benefit from ketamine therapy, especially when their conditions have not responded to other treatments. Ketamine’s unique mechanism, targeting the brain’s glutamate system to promote neuroplasticity, helps address these conditions in ways that traditional therapies cannot.

People who experience chronic suicidal thoughts can also benefit from ketamine therapy. The rapid-acting nature of ketamine can provide immediate symptom relief, making it particularly valuable for those in acute mental health crises.

Furthermore, individuals with certain chronic pain conditions that have a psychological component, such as fibromyalgia, may find ketamine therapy beneficial as it addresses both physical and emotional pain.

In summary, ketamine therapy is a valuable option for people with treatment-resistant mental health conditions, offering hope and faster relief for those who have not found success with conventional treatments.

The experienced and caring team and Principium Psychiatry will provide a thorough evaluation and help determine whether ketamine is right for you. You will then receive an individualized treatment plan. Your treatment plan may also include combining ketamine with any of our other treatments, such as psychotherapy, integration therapy, group therapy, psychopharmacology, TMS, ECT, VNS or Botox.

When you come to Principium Psychiatry for ketamine therapy in NYC, we’ll do everything we can to make you feel comfortable and relaxed at every appointment. In most cases, we’ll provide six ketamine infusions, given 2-3 times per week over 2-3 weeks. Depending on your unique needs, you may receive additional infusions after this initial treatment period.

At a typical ketamine therapy appointment, you’ll have both a registered nurse and a psychiatrist or psychiatric nurse practitioner in your private room with you the whole time. Once the IV is inserted, treatment usually takes around an hour. You’ll stay awake during treatment, and you’ll have the option to listen to music or chat with the supervising staff. Our unique ketamine protocol was developed by our medical director Dr. Cohen.

Some patients start to experience relief from symptoms soon after the first treatment, although you may have several treatments before you notice a substantial effect.

Insurance typically does not cover ketamine infusion therapy. However, we will provide a detailed invoice you can give to your insurance company to receive reimbursement for aspects of treatment that are covered, such as IV placement and saline solution.

In addition to IV, there are ketamine nasal sprays available for patients in NYC. Although IV infusions are the gold standard of ketamine therapy given the large clinical trials proving their efficacy, Intranasal ketamine is now available in an FDA approved formulation, Spravato. Only specially licensed clinics are able to provide Spravato therapy. At Principium, we are proud to offer Spravato treatment to our patients. Please visit our Spravato page to learn more about this exciting form of ketamine therapy.

If you have any questions or concerns about the infusion therapy process, we would be happy to discuss them with you.

For many patients with treatment-resistant depression, the benefits of ketamine therapy are numerous. Ketamine therapy for depression is typically fast-acting, effective and safe. The dose of ketamine required is much lower than when used for anesthetic purposes, and it can quiet suicidal thoughts and help you start feeling better quickly.

Compared to antidepressant medications, ketamine comes with few side effects. Ketamine can affect blood pressure and heart rate, which is why we monitor these metrics during treatment. Long-term risks in those who abuse ketamine at high doses include urinary symptoms, substance use disorders and cognitive impairment. As a result, the American Psychiatric Association has advised doctors to consider the advantages and risks for individual patients based on available data.

At Principium Psychiatry, our team members will work with you to understand your medical history and identify potential risks before recommending ketamine therapy.

KETAMINE FAQs

In recent years, there has been a surge of information on the uses of ketamine for the treatment of depression. Ketamine is an anesthetic which has been on the market since the 1960s. Ketamine was introduced into clinical practice as an anesthetic that reliably brought about sedation for surgical purposes with little effect on respiration or the circulatory system. The name “ketamine” derives from two of the molecules found in ketamine’s molecular structure: a ketone and an amine.

It was first suggested in 2000 that ketamine may have antidepressant effects in humans. The suggestion was based on animal studies of depression showing that a neurotransmitter called glutamate was dysfunctional in depression. Other studies showed that NMDA, a drug that binds to glutamate receptors, relieved depression in humans. This led to the “glutamate hypothesis” about the origins of depression. Ketamine was known to bind to glutamate receptors.

A number of clinical trials support the use of ketamine for depression. These randomized, controlled clinical trials, have compared Ketamine to a placebo. Studies have shown that even one infusion of Ketamine is superior to placebo and achieves clinically meaningful reductions in depression rating scores. Other studies have shown that serial treatments with Ketamine (i.e. more than one infusion) can increase the response rate to the treatment. On the basis of this evidence, the American Psychiatric Association released a consensus statement on the use of Ketamine to treat depression: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2605202

Ketamine treatment for depression is an off-label treatment. This means that although Ketamine is an FDA approved drug for anesthesia, and has passed the FDA’s rigorous safety testing process for this purpose, the FDA has not approved the use of ketamine for depression. Physicians, however, are authorized to prescribe a medicine to treat other conditions based on clinical judgment and professional evidence.

The website of the FDA (https://www.fda.gov/ForPatients/Other/OffLabel/default.htm) explains off-label medication use:

“From the FDA perspective, once the FDA approves a drug, healthcare providers generally may prescribe the drug for an unapproved use when they judge that it is medically appropriate for their patient. You may be asking yourself why your healthcare provider would want to prescribe a drug to treat a disease or medical condition that the drug is not approved for.  One reason is that there might not be an approved drug to treat your disease or medical condition.  Another is that you may have tried all approved treatments without seeing any benefits.  In situations like these, you and your healthcare provider may talk about using an approved drug for an unapproved use to treat your disease or medical condition.”

Of note, Ketamine is given in smaller doses for the treatment of depression than are typically used in anesthesia.

The nasal spray medication used in SPRAVATO™ is covered by every major insurance provider in-network through Principium. However, Ketamine is an off-label treatment. Therefore, the appointment for SPRAVATO™ is not covered in-network while the medicine SPRAVATO™ used in the appointment is covered. Conventional Ketamine IV injections are not covered by insurance. Please call our office to learn more.

Studies show that approximately 3 out of 4 patients will have a positive response to ketamine treatment for depression.

Simply call our office at 212-335-0236. Alternatively, you can book an appointment online at ZocDoc: https://www.zocdoc.com/doctor/ziv-cohen-md-40226. You do not need a referral from a psychiatrist, since Principium Psychiatry is psychiatrist led by our medical director, Ziv Cohen, MD, a Fellow of the American Psychiatric Association. Dr. Cohen will do a comprehensive assessment and provide you with a diagnosis and recommendations, including whether you are appropriate for Ketamine treatment.

Ketamine is given in small doses for the treatment of depression. As such, a typical side effect is mild sedation. Some patients complain of mild nausea, which is easily treated with anti-anxiety medication. Some patients have mild elevations or reductions in blood pressure. Dr. Cohen will discuss with you side effects in detail during your consultation.

The typical treatment course involves 6 infusions, which are given 2 to 3 times per week (for a period of 2-3 weeks). In some cases, further infusions are given during the initial course.

At Principium Psychiatry, we offer Ketamine infusions in our private, comfortably appointed offices in our midtown and downtown locations in the heart of New York City.

During the infusion, a multidisciplinary team will be present, including a registered nurse and a psychiatrist or psychiatric nurse practitioner. Your blood pressure, heart rate, and blood oxygen levels will be measured continuously during the infusion. The team will be closely monitoring you. You will be free to engage in conversation, close your eyes and relax, or listen to calming music. You will not fall asleep during the treatment.

Ketamine is rapidly metabolized. Within ten to fifteen minutes after the infusion you will feel substantially more alert. Patients generally report that a full recovery to normal activities takes about 1 hour. There is some individual variation in responses to ketamine.

After you finish your initial course of 6 or more infusions, you and the treatment team will make a plan for follow-up care. Some patients will return for further infusions on an as needed basis (typically several months or more after the initial course), while other patients with particularly severe symptoms will be placed on a regular maintenance treatment schedule (typically monthly infusions).

Yes, Ketamine is safe to administer with most medications.

No, administered at small doses in a medical setting, there is no evidence that Ketamine is addictive. In contrast, those who abuse ketamine recreationally do so at very high doses to induce psycho-active affects.

Yes, clinical experience supports that Ketamine can be effective for patients with treatment resistant depression, including those who have already tried ECT and TMS without benefit.

In general, ketamine is safe for patients with a variety of health conditions. If there is a concern about your cardiovascular health, we may refer you for a check-up to make sure you are able to receive ketamine treatments.

While still in preliminary studies, there has been scientific evidence showing that IV infusions of ketamine can be effective in treating generalized anxiety disorder and social anxiety disorder. Our team at Principium Psychiatry has treated many patients who, in addition to having depression, also have varying degrees of anxiety. Throughout their infusion protocols, we have found that not only do their depressive symptoms improve, but so does their anxiety.

Some patients ask, “Why does it have to be IV? I don’t like needles!”

IV is the best route for your brain to receive ketamine because of something called bioavailability. In addition, it is also more effective, more precise, and safer for you.

Receiving a medication intravenously is the only way to have 100% bioavailability. Let’s take a look at the different bioavailability percentages based on what route you receive ketamine:

Intravenous: 100%
Intranasal: 25-50%
Sublingual (under the tongue): 30%
Orally (by mouth): 16-24%

When we give ketamine intravenously, we know exactly where your entire dose is going: straight to your brain. The same cannot be said for other forms of ketamine.

IV ketamine is by far the safest and most effective approach in using ketamine to treat depression. You are in a comfortable setting with healthcare providers with you the whole time, the potential for side effects is low, and you are certain that the dose you receive is the dose that is going to your brain, maximizing the benefits of this cutting-edge treatment.

Why Choose Principium Psychiatry for Ketamine Therapy in NYC?

Our multidisciplinary team includes experienced psychiatrists, psychologists, nurses and psychiatric nurse practitioners who come to us from a range of respected institutions, including Cornell University, Columbia University, Binghamton University and Yale University. All of our team members work hard to make patients feel welcome and heard.

We’re committed to finding effective treatment options for every patient, no matter how mild, severe or treatment-resistant their symptoms may be. Our comfortable and convenient locations at Grand Central Station, Wall Street, Greenwich Connecticut and Santa Monica, CA see patients between 9 a.m. and 8 p.m. Monday-Friday, and on weekends by special appointment.

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Getting treatment is the best way to move forward from depression and find relief from symptoms. Even if you’ve tried other treatments in the past, ketamine therapy can offer help. If you’re ready to take the next step toward feeling better, please view our availability online or call 212-335-0236 to schedule an appointment with Principium Psychiatry today.

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