Ketamine therapy is becoming popular for various mental health conditions, including depression, anxiety, and PTSD. Both at-home and in-person treatments are becoming more widely available. At Nushama, we treat our members exclusively in person at our center under medical supervision, but this may not be for everyone. What do you need to know before choosing the right treatment for you? Here, we will explore some of the key differences between these two models of ketamine-assisted therapy.
For safety purposes, nothing beats a medical setting with trained doctors, clinicians, and nurses on hand. This ensures the participant is monitored closely throughout the process, including clinical administration, proper dosing, and the ability to stop the treatment altogether if needed. Ending a ketamine journey is as easy as stopping its IV drip—the source of its delivery. If the person experiences severe side effects such as nausea or elevations in blood pressure, medical professionals are present to provide immediate support.
Some people may prefer receiving treatment at home, especially if they live far away from the nearest ketamine center. At-home ketamine is usually not medically supervised, which can be dangerous, particularly for those unfamiliar with the medication or its side effects. Without medical supervision, there is a higher risk of adverse reactions, potentially leading to serious harm.
Substance abuse can also be a concern of at-home treatment. Those left to their own devices may prefer taking smaller amounts of ketamine that cause a euphoric effect. Counterintuitively, ketamine can be addictive at lower doses at home with lozenges (different from in-person treatments at Nushama with higher IV doses), so there is a greater risk of dependence.
Set and Setting
Set and setting are fundamental to the psychedelic journey. Your environment should be conducive to a positive experience.
Some people may find taking ketamine at home comfortable and familiar. However, it’s still important to be cautious. At-home ketamine may be more challenging due to distractions like family members, roommates, or electronic devices. It can be hard to address wounds and traumas in your same day-to-day environment without a new setting for a fresh perspective.
Ketamine therapy in person provides a controlled environment where distractions are minimized, allowing for a more focused and potentially transformative experience. At Nushama, you’ll be placed in your own private room with warm lighting and a comfortable chair or couch. You’ll listen to a carefully curated ambient music playlist to enhance the journey.
Community & Connection
Once you complete your journey, it will be beneficial to have a trusted person present and ready such as your integrationist, to provide support if needed. Telemedicine, the method of communication for at-home remote therapy, can’t always give the required assistance. Without an in-person guide, someone can feel even more isolated than before.
There have been some studies that suggest in-person therapy may be more effective than telehealth therapy. A 2018 study published in the Journal of Affective Disorders found that for individuals with major depressive disorder, in-person treatment was more effective than online cognitive-behavioral therapy (CBT) in reducing depression symptoms (Karyotaki et al., 2018).
Receiving ketamine treatment in person also provides more of a chance for connection. At Nushama, we offer year-round integration circles and events for members onsite. This allows members to meet each other and integrate their experiences with people who have gone through the same program.
In a medical center, ketamine is usually administered via IV (intravenous) drip or IM (intramuscular) injection. Both of these methods have a high bioavailability. At Nushama, we use IV—the safest, most efficacious, and most studied approach. When administered intravenously, the medication is absorbed directly into the bloodstream. This allows for a quick and consistent experience, with the ability to stop the infusion at any time, if necessary.
When done at home, ketamine is usually administered using oral lozenges. At-home methods may be cheaper than the clinical route, but ketamine is significantly less bioavailable sublingually. This means that the exact amount of ketamine reaching the brain is unknown. The rate of delivery is difficult to control and highly variable. This can result in an inconsistent experience, making the desired state of ego dissolution more difficult to reach. Additionally, once the lozenge or tablet is consumed, there is no way to stop or pause the effects until they wear off on their own.
Many people may turn to at-home treatment options for ketamine-assisted therapy because of lower costs, but many ketamine centers offer financing options. Remember that treatment at a center provides more services to enhance your experience, such as a safe and serene environment, access to medical professionals and integrationists, and guaranteed bioavailability.
At Nushama, we offer financing through CareCredit. With this option, you can pay up to 12 months interest-free at a rate of $375/mo. You also have the ability to extend your payments for even longer at a low-interest rate.
What Do We Recommend?
At Nushama, we administer ketamine via IV for individuals or IM for groups in a serene setting under the supervision of medical professionals. Safety is our number one priority.
For optimal safety and efficacy, we strongly advise seeking ketamine treatment at a clinical facility in person, like Nushama, where you can receive comprehensive support and get the most out of your journey.
Karyotaki, E., Riper, H., Twisk, J., Hoogendoorn, A., Kleiboer, A., Mira, A.,… & Cuijpers, P. (2018). Efficacy of self-guided internet-based cognitive behavioral therapy in depression: A meta-analysis of individual participant data. Journal of the American Medical Association Psychiatry, 75(4), 351-359.