Frequently Asked Questions

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What is psychedelic medicine?

Psychedelic medicine is a term used to describe the therapeutic use of psychedelic drugs. Psychedelics provide relief from symptoms of various mental health disorders, such as anxiety and depression. They also increase creativity and improve self-awareness.

What is ketamine psychedelic therapy (KPT)?

When used in a controlled environment with proper support, ketamine psychedelic therapy (KPT) is a powerful tool to help treat depression, anxiety, PTSD, OCD, alcoholism, opioid addictions, eating disorders, and many other mood disorders. When administered via IV, ketamine allows the patient to experience different planes of consciousness in a similar manner to other classical psychedelic medicines. For more information, visit Johns Hopkins.

Are psychedelics harmful or addictive?

Like every kind of addiction: food, sex, gambling, alcohol…when psychedelics are misused they could become addictive. When given by professionals for treatment in a small window of time with proper education of the patient, psychedelics are not addictive. That’s why we put a lot of thought into designing personalized approaches for each individual.

How much does ketamine psychedelic therapy (KPT) cost?

Nushama’s ketamine psychedelic therapy program costs $4,500 and includes:

  1. Six ketamine infusions
  2. A seventh booster infusion (administered when needed)
  3. An initial medical assessment
  4. Support before, during, and after treatment:
    • Pre-infusion preparation session
    • Integration sessions immediately following the infusion
    • Follow-up calls to monitor progress

Group Pricing: Six group journeys cost $2,800 and include the first booster and approximately 6-8 participants.

What are my payment options (credit card, check, cash) at Nushama?

Nushama accepts credit card or insurance coverage.

Does Nushama have a payment plan?

We do offer payment plans. The package cost of $4,500 cost can be split into 3 payments ($1,800, $1,500, $1,200).

Does Nushama have a rescheduling and cancellation policy?

We strive to accommodate our clients with availability that meets your schedule and needs. This includes making sure that open spots and resources are available for everyone. We also understand that life happens and things change.

If you need to cancel or reschedule a session, please call us at 646-394-9996 at least 24 hours ahead of your appointment and our staff will be happy to assist you.

Cancellations less than 24 hours from your appointment will result in a last-minute cancellation fee of $50.

If you do not show up to a scheduled appointment without prior communication, you will be charged a no-show fee of $150.

Does Nushama treat patients outside of New York?

Currently, our psychedelic treatment centers are based in New York State. To keep up to date on business news and locations, sign up for our newsletter or follow us on Instagram and Facebook.

What is ketamine?

Discovered in 1962, ketamine is a synthetic compound used as an anesthetic and pain relieving drug. It has also been used as a recreational drug and like many pharmaceuticals, can be dangerous if not administered properly under the care of trained medical professionals.

Is ketamine psychedelic therapy (KPT) safe?

Ketamine for therapeutic treatment is considered safe when administered in a clinical environment by medical professionals. While dissociative, or “psychedelic” properties may be present even at low doses, a number of studies show they are positive mediators of the molecule’s antidepressant effects.

How is ketamine administered/taken during therapy?

There are four ways to administer ketamine:

  1. Intravenously (IV)
  2. Intramuscularly (IM)
  3. Lozenge (oral)
  4. Intranasal spray (Spravato)

At Nushama, we primarily use IV as we believe it’s the most effective and safest method. The benefit of an IV infusion is that it is given as a gradual drip which can be adjusted at any time should you become uncomfortable or stopped if you request that we do so.  Nushama does not offer lozenges or intransal spray. For group therapy, we use intramuscular injections.

What does a ketamine infusion feel like?

The effects of a psychedelic ketamine infusion are usually felt within a few minutes but every person has a slightly different experience. Initially you may feel deeply relaxed, calm, a heaviness in your body, and a change of your usual sensations. You may experience different colors or visual patterns. This may be followed by a separation from your usual state of thinking, and it may feel like you’re awake but on a different plane of consciousness. You may even feel a separation from your body and your verbal expression may become limited. Some patients revisit people, places, or events from their past.

Are there any side effects?

Increases in blood pressure and heart rate during a psychedelic ketamine infusion can occur but rarely require any medical intervention. Also rare at sub-anesthetic doses are slowed breathing and hypercapnia (elevated carbon dioxide levels in the blood).

What disorders can ketamine infusions treat?

Anyone diagnosed with major depression, bipolar 1 depression, postpartum depression, or dysthymia can benefit from ketamine infusions. Research has also shown ketamine to be effective in treating Fibromyalgia, post-traumatic stress disorder (PTSD), and suicidal thoughts. In addition, ketamine shows promise in alleviating symptoms of obsessive compulsive disorder (OCD), alcoholism, opioid addictions, eating disorders, and a number of anxiety disorders.

Where is your ketamine produced?

Our ketamine is produced in the USA or Ireland. Given the shortage that exists today, it may be sourced from other places in the future.

Where is ketamine legal?

Ketamine is legal for medical use in the United States and select countries across the world. The use of ketamine is regulated, meaning it can only be administered or prescribed by licensed clinicians with the authority and expertise to support its effective use.

How long does ketamine stay in your system?

Ketamine can be detected in your urine for about 2 weeks, blood for 4 days, and hair follicles for 90 days.

What are the Various Uses for Ketamine?

Ketamine is most widely known and used as an anesthetic. You may be curious about the use of ketamine for treating off-label conditions other than depression and chronic pain, which includes: anxiety, addiction, trauma-induced mood disorders, trauma-related OCD, eating disorders, and IBS.

Dr. Elena Ocher is Co-Founder and Chief Medical Officer of Nushama. As a neurosurgeon in Russia and later a board-certified anesthesiologist in the United States, Dr. Ocher has more than 30 years of experience working with ketamine as an anesthetic, analgesic, and at sub-anesthetic/psychedelic doses, as a treatment for mood disorders. It is the intersection between psychological disorders and physical pain that inspired Dr. Ocher to join the Nushama team.

According to Dr. Ocher, growing evidence points to glutamate, the excitatory neurotransmitter, in meditating response to stress and the formation of traumatic memories. Ketamine’s anti-depressant and anti-anxiety effects are presumed to occur through activation of the synaptic plasticity by increasing brain-derived neurotrophic factor translation, transmission, and secretion, which inhibits the glycogen synthesis and activates neuron signaling. This neurotrophic factor is responsible for human behavioral responses. Its impact on synaptic plasticity takes significant time with traditional anti-depressant treatment but may develop in a matter of a few hours with ketamine treatment.

This effect is shown in multiple clinical trials on patients with generalized anxiety disorder, OCD (trial), eating disorders (case report), and PTSD (trial). While the trials were small in scale, the effects were proved by the dose-dependent improvement in fear questionnaire scores and EEG changes (vs. conventional anxiolytics). The treatment results were long-lasting for varying periods.

How Were Off-Label Conditions for Treatment at Nushama Chosen?

The conditions Nushama treats is based on data from ketamine clinical trials for different conditions, combined with studied applications, clinical practice, and empirical medical experience. Ketamine has multiple applications, such as managing acute and chronic pain, and it also helps with atypical headaches and migraines. Ketamine also has off-label uses for anti-inflammatory treatments, neuroprotection, anti-depressant effects, and to treat substance use disorders and alcohol use disorders.

Dr. Steven Radowitz, Nushama’s Medical Director, believes all diseases related to the mind and body have the potential to respond to ketamine. Dr. Radowitz says the body reflects our overall health and wellness. In a mental wellness state without stress, our systems will be balanced, including the immune system, nervous system, endocrine, cardiac systems, and gastrointestinal systems. With stress and anxiety, our systems become imbalanced—for example, we may feel nervousness, have loose stools or suffer heart palpitations. Diseases often manifest from an emotional imbalance to a real, physical problem.

Left unresolved, behavioral dysregulation can manifest as physical dysregulation and disease. According to Dr. Ocher, oftentimes, they combine, such as anxiety and OCD. Dr. Ocher says she sees 80% of patients with anxiety and OCD or depression and anxiety together. Dr. Ocher and Dr. Radowitz believes there is a common source or underlying cause, which is why Nushama is treating depression, anxiety, PTSD along with underlying conditions such as OCD, IBS, addiction, and eating disorders.

Where can I read the relevant studies, trials, and data?

Learn More About the Related Studies and Trials Available:

Who administers the treatments, and what are their qualifications?

IV ketamine infusions are supervised by board certified anesthesiologists. These physicians have completed an accredited residency program in anesthesiology, usually four years following medical school either with M.D. or D.O. degree. Learn more about our medical team here.

How do I prepare for treatment?

Wear loose, comfortable clothing the day of your ketamine treatment. Please avoid any kind of solid foods and/or milk 6 hours prior to your ketamine infusion. You may drink clear liquids (i.e. water, fruit juices without pulp, carbonated beverages, tea, and black coffee) 2 hours before your infusion.

Avoid alcohol or the use of any illicit drugs. These substances are extremely dangerous in combination with ketamine. We also recommend to have someone take you home after treatment.

Are there specific conditions that would prevent me from receiving treatment?

Yes. If you are experiencing any of the following conditions you will not be able to receive infusion:

  • Uncontrolled high blood pressure (hypertension)
  • Unstable heart disease (arrhythmias, congestive heart failure, chest pain etc.)
  • Untreated thyroid disease
  • Active substance abuse
  • Active manic phase of bipolar disorder
  • Active delusions and hallucination symptoms (not on medications or while taking street drugs).

Do I need a referral from my primary care physician?

No, you do not need a referral to receive psychedelic ketamine treatment. You may come to us directly, assuming you have no conditions that would make you ineligible. However, any licensed mental health care professional or physician can refer you.

Why don’t more doctors offer psychedelic ketamine treatment?

Here are three reasons why most doctors don’t offer ketamine treatment:

  • Lack of comfort with administering the medication: Few medical specialists are trained in administering ketamine.
  • Lack of awareness of its alternative uses: Many doctors are simply not educated on its success with mental illness and pain management.
  • Lack of acceptance of this treatment: There are doctors who are bound to the traditional model of pharmacology and are not willing to consider alternatives despite the growing evidence.

How long is one treatment and how many are there?

A psychedelic ketamine treatment lasts about 45-60 minutes. Clinical research suggests that patients receive the treatments twice a week for 3 weeks. However, we believe that the frequency of your treatments should be decided by you and we are there to support you throughout. Expect the time spent in the office for your infusion and integration to be about 2 hours.

How should I expect to feel after psychedelic ketamine treatment? How long will the effects last?

Once the infusion is over, the unusual sensations fade gradually over the next 20 minutes. Occasionally patients may feel a little nausea or dizziness, which is relieved with time and can also be treated with medications if appropriate. You may notice positive effects as soon as 30 minutes post infusion but typically improvements begin several hours post-treatment. The effects of a single infusion typically last up to two weeks.

Do I need someone to take me home?

Yes. You should not drive any motorized vehicle, bike or scooter after the infusion.

Should I continue seeing my therapist or psychiatrist? What if I don’t have one?

We recommend that our patients continue working with their outpatient providers for medication management and/or psychotherapy. If you do not have a psychiatrist or therapist, Nushama can facilitate a referral.

What long-term impacts or transformations are there for psychedelic ketamine treatment?

The ideal long-term impact is a permanent transformation back to your true inner self. Therefore, integration is an important part of treatment. Ketamine treatment is only an opening, you need to continue the work to make the changes you want to see last.

What happens after the initial therapy sessions? Do you offer follow-up treatments?

After the initial series of six infusions, we offer the option of a booster infusion, which is usually administered two months later. Additional boosters can be given monthly or a few times per year as needed.

WHAT IS PSYCHEDELIC THERAPY, AND HOW DOES IT WORK?

Psychedelic therapy refers to the therapeutic use of psychedelic molecules like ketamine, psilocybin, LSD, and MDMA. Studies have shown that when taken in a safe environment with therapeutic support, psychedelics can relieve symptoms of depression and anxiety after only a few hours. In psychedelic therapy, the participant must first undergo a medical and psychiatric intake to ensure the experience will be the right option for them. Next, the psychiatric team prepares them for the experience beforehand, discussing what to expect and how to ease their mindset leading up to it. 

With ketamine-assisted therapy, on the day of treatment, a medical professional administers the psychedelic intravenously, intramuscularly, or orally while the participant lays down with an eye mask and listens to music. A guide, known as an integrator, provides breathing techniques and reassurance if adverse effects should arise. The dosing session is followed by an integration session to recount their experience, describe their feelings during and after, talk through lingering questions, and glean key insights or takeaways.

To learn more, read A Complete Guide to Psychedelic Therapy.

WHAT IS KETAMINE TREATMENT?

Ketamine is a dissociative anesthetic that elicits psychedelic-like effects. It can be used as an alternative treatment for depression, anxiety, PTSD, and other mood disorders. At certain doses, similar to traditional psychedelics, ketamine allows one to experience different planes of consciousness. 

ISN’T KETAMINE DANGEROUS AND ADDICTIVE?

While ketamine has been used safely since the 1960s for pain and anesthesia, just like any psychoactive medicine, it can be misused, especially at lower doses and in recreational settings. However, when ketamine is administered by a medical professional in a clinical setting with proper education and support, the likelihood of addiction is low.

Read Myths About Ketamine to learn more.

HOW MUCH DOES KETAMINE TREATMENT COST?

Nushama’s ketamine-assisted therapy program costs $4,500 for individuals which includes: 

  • An initial medical and psychiatric assessment
  • Six ketamine infusions (plus a seventh if needed)
  • A pre-infusion preparation session
  • Integration sessions immediately following the infusion
  • Follow-up calls to monitor progress

Nushama’s group ketamine therapy cohorts of 6 to 8 participants cost $2,800 per person.

Nushama also offers 35% discount rates for first responders and veterans.

For more information on pricing, read Paying for Psychedelic Therapy.

ARE KETAMINE TREATMENTS COVERED BY INSURANCE?

Insurance coverage is not available for the use of ketamine for mental health conditions. Hopefully, with more evidence of its efficacy we will see a change in policy in the coming years. Until then, insurance may cover ketamine therapy if there’s a history of a dual diagnosis of a chronic pain condition. Insurance will not cover treatment if the diagnosis is only for a mood disorder like depression, PTSD, or addiction.

DOES NUSHAMA HAVE A PAYMENT PLAN?

Yes. The total cost can be split into 3 payments.

DOES NUSHAMA WORK OUTSIDE OF NEW YORK?

Currently, our ketamine treatment centers are based in New York.

To stay up to date on business updates and new locations, sign up for our newsletter, or follow us on LinkedIn.

IS THIS TREATMENT LEGAL?

Ketamine is FDA approved as an anesthetic which is why its use for pain treatment can sometimes be covered by insurance. The S-form of ketamine was approved in 2019 to treat depression as a nasal spray called Spravato®. Nushama uses the R-form of ketamine which is legal to prescribe, however it is not FDA approved and considered “off-label”. According to WebMD, over 20% of US prescriptions are for off-label therapies.

HOW EFFECTIVE ARE KETAMINE TREATMENTS?

There is a lot of mounting evidence that ketamine can be effective in the treatment of many psychiatric conditions, however each person is different and may respond differently. Ketamine treatments are most effective when coupled with any number of theraputic modalities including traditional psychotherapy, integration coaching, movement modalities, meditation practices, and personal reflection.

See the ketamine section, “WHERE CAN I READ THE RELEVANT STUDIES, TRIALS, AND DATA?”.

WHERE CAN I READ THE RELEVANT STUDIES, TRIALS, AND DATA?

Here’s is a list of ketamine-related studies and trials available:

IS KETAMINE TREATMENT SAFE?

Ketamine infusions for therapeutic use are considered safe when administered in a clinical environment by medical professionals. Participants will be carefully screened to ensure they’re appropriate candidates for the treatment. People are monitored throughout their treatment process for any signs of discomfort, dependence, or increased heart rate. While dissociative or “psychedelic” properties may be experienced, a number of studies show they contribute to the molecule’s antidepressant effects.

HOW IS KETAMINE ADMINISTERED DURING TREATMENT?

There are four ways to administer ketamine for theraputic use:

  1. Intravenously (IV)
  2. Intramuscularly (IM)
  3. Lozenge (orally)
  4. Spravato (intranasally)

At Nushama, we believe IV is the safest and most efficacious method. The dose can be adjusted or stopped at any time if participants become uncomfortable for any reason, which has been extremely rare at our center. Nushama does not offer lozenges or intransal spray, but for group therapy, we use intramuscular injections. Depending on the route of administration, effects are felt within five to ten minutes and last from 45 to 60 minutes.

HOW MUCH KETAMINE IS DOSED?

Ketamine IV for psychedelic therapy is most commonly administered at doses around 0.5 mg/kg over a period of 40 minutes. There is a range of effective doses  and evidence for its efficacy at double that amount.

Its range (0.5 – 2 mg/kg) depends on the biology of the person—we start on the lower end and modify the dose based on someone’s response and individual needs. 

Read Ketamine Dosing: Low Dose vs. High Dose to learn more.

ARE THERE ANY SIDE EFFECTS?

Side effects of ketamine infusions can include: 

  • Increase in blood pressure 
  • Nausea or vomitting (we can add a medication to prevent this from happening)
  • A sense of impaired balance and coordination
  • A feeling of dizziness, drowsiness, slurred speech, and/or numbing sensation of the skin 

These side effects are normal, rarely require any medical intervention, and resolve soon after the infusion ends.

WHAT HEALTH CONDITIONS CAN KETAMINE TREAT?

Ketamine, most widely used as an anesthetic, is a breakthrough therapy for treating many mental health disorders. The conditions listed below are either being studied in clinical trials (usually combined with psychotherapy) or soon to be studied. 

Ketamine can be used to treat: 

  • major depression
  • bipolar 1 depression
  • post-partum depression 
  • fibromyalgia
  • chronic pain
  • post-traumatic stress disorder (PTSD)
  • suicidal thoughts
  • obsessive compulsive disorder (OCD)
  • alcohol use disorder 
  • opioid use disorder
  • disordered eating
  • autism
  • anxiety disorder

IS KETAMINE SIMILAR TO PSILOCYBIN?

Although they are both breakthrough therapies being studied to treat a variety of psychiatric conditions, ketamine and psilocybin are very different. Psilocybin is a “classic” psychedelic meaning it works on the 5HT2A serotonin receptors. Ketamine is a “dissociative anesthetic” that can illicit psychedelic-like experiences but it works primarily on the glutamate receptors called NMDA receptors. 

These two also have very different legal statuses. Ketamine is a Schedule III drug that is FDA approved for use in pain and anesthesia and is currently a breakthrough therapy for treatment-resistant depression which means it can be used off-label in clinics. Psilocybin is a Schedule I illegal substance that also received breakthrough therapy designation with the FDA but can only be accessed through legal FDA clinical trials at this time.

HOW DO I PREPARE FOR MY FIRST KETAMINE SESSION?

Preparation for Nushama’s 6-session ketamine program occurs well in advance. We’ll provide you with guidance on how to cultivate a positive mindset, like avoiding news or alcohol, the weeks leading up to your journey.

Our clinicians will also help you set clear intentions and provide guidelines for a safe and meaningful first experience. When preparing, it is important to know that if you do not feel ready at any point, you can let your provider know and we will support you the best we can until you are ready.

WHAT CONDITIONS WOULD PREVENT ME FROM RECEIVING KETAMINE TREATMENT?

If you are experiencing any of the following conditions you will not be able to receive a ketamine infusion:

  • uncontrolled high blood pressure (hypertension)
  • unstable heart disease (arrhythmias, congestive heart failure, chest pain etc.)
  • untreated thyroid disease
  • active substance abuse
  • active manic phase of bipolar disorder
  • active delusions and hallucination symptoms (not on medications or while taking street drugs)
  • schizophrenia

DO I NEED A REFERRAL FROM MY PRIMARY CARE PHYSICIAN?

No, you do not need a referral to receive ketamine treatment for mental health conditions. You may come to us directly, and the medical team will review your intake information, conduct a psychiatric evaluation, and confirm that you’re medically fit for treatment before moving forward.

We will, however, ask permission to speak with your therapist or healthcare provider during our screening process. Any licensed mental health care professional or physician can also refer you.

HOW LONG IS EACH SESSION?

While each person’s experience varies, a psychedelic ketamine journey lasts about 45-60 minutes. You’ll start to feel the effects 10-15 minutes after the ketamine is administered. The peak experience lasts about 30-45 minutes. Most people return to their ordinary level of awareness within 1-2 hours following administration.

HOW MANY TREATMENT SESSIONS ARE REQUIRED?

Most of the clinical research with ketamine has involved people who receive the treatments twice a week for 3 weeks (6 ketamine sessions total). However, at Nushama we are exploring the potential of fewer sessions with increased support in the form of group sessions, or with wellness protocols throughout the treatment period.

If you are curious about how ketamine’s effects can be increased with supporting modalities, read How to Continue Integration After Psychedelic Treatment.

WHAT DO THE PSYCHEDELIC EFFECTS OF KETAMINE FEEL LIKE?

The effects from a psychedelic dose of ketamine are usually felt within 10 to 15 minutes but every person has a slightly different experience. Paticipants may experience: 

  • deep relaxation
  • calm sensation
  • heaviness in the body
  • visual patterns and colors 
  • separation from usual states of thinking 
  • sense of being awake but on a different plane of consciousness
  • separation from the body
  • limited verbal expression 
  • people, places, or events from their past 

Since some of these experiences in an altered state may be novel, they can be frightening or challenging if you are not prepared. Therefore we review the range of possibilities with each person.

CAN I RECEIVE KETAMINE TREATMENT WHILE ON ANTIDEPRESSANTS?

Yes. Ketamine does not have negative medication interactions with antidepressants and does not interfere with their effectiveness at the subanesthetic doses used to treat depression and anxiety.

To learn more, read Is Ketamine Safe to Take with Antidepressants?

WHAT MEDICATIONS SHOULD I AVOID?

You should not stop any medications without consulting with your perscribing mental health provider. Any modifications to your medication will be discussed during your medical intake before being cleared for treatment. 

But, generally, these are some medications that can effect your response to ketamine: 

  • stimulants (Adderall, Concerta, Ritalin, Vyvanse)
  • benzodiazepines
  • lamotrigine
  • memantine
  • opioids

WILL I HAVE A “BAD TRIP”?

Studies have shown the likelihood of a challenging experience is very low when two conditions are met: a positive mindset going into the experience and a comfortable physical environment. However, even when someone reports having a “bad trip”, with the right integration support afterwards, the insights gleaned from those difficult experiences often end up being some of the most valuable take aways from the treatment. To learn more, read 3 Ways to Mitigate the Risks of Ketamine.

 

HOW SHOULD I EXPECT TO FEEL AFTER TREATMENT?

Once the infusion is over, sensations like dizziness fade gradually over the next 20 minutes. You may notice positive effects, like elevated mood, as soon as 30 minutes post ketamine infusion.

Studies have shown that peak antidepressant effects occur about 24-48 hours after treatment and typically last up to two weeks.

Read Creating Lasting Change with Psychedelic Therapy to learn more.

DO I NEED SOMEONE TO TAKE ME HOME?

It’s best to have someone to pick you up after ketamine treatment. If this is not possible, for reasons such as privacy, you will have to take a car service home and show proof of the reservation. You may need to stay longer in the center as you will only be released once you are completely safe to leave.

SHOULD I CONTINUE SEEING MY THERAPIST OR PSYCHIATRIST? WHAT IF I DON’T HAVE ONE?

The importance of a continued theraputic process in conjuction with ketamine cannot be understated. The neuroplasticity effects of ketamine may make you more receptive to tools that maybe haven’t worked before or new tools you’ve never used. The more tools you have to address the ups and downs of life, the longer the effect of ketamine can last.

We recommend our members continue working with their outpatient providers for medication management and/or psychotherapy. If you do not have a psychiatrist or therapist, Nushama can facilitate a referral.

HOW LONG WILL THE EFFECTS LAST AFTER ALL 6 TREATMENTS?

Many people report improvement in symptoms for 3-12 weeks, however this range depends on many factors and can last even longer depending on how much you are willing to participate in developing new ways of living.

One of the best ways to prolong the effect of ketamine is to learn and apply new tools for dealing with the stressors that come as a normal part of life.

DO I NEED TO KEEP COMING BACK AFTER 6 INFUSIONS?

Every person is different, and ketamine is very much a personalized medicine—dosing, frequency, and effect can all vary and require an individualized approach. The need to return after the 6 sessions depends on whether or not symptoms return.

However, for some people, even when symptoms return, they are much less intense, which makes them manageable with the new skills they have learned during the treatments.