Day 1. Ketamine-Based Therapy: The Current State of Ketamine Therapy

Didactic Modules:

Overview – Why Consider Ketamine?

Mood Disorders An Overview – Depression, Anxiety, Bipolar, PTSD

Multi-factorial Etiologies Contribute to Causation and Treatment Failures
Monoamines Are Not As Effective As We Had Hoped
Current Treatment Options – Therapy, Medications, rTMS, ECT, Ketamine, Psychedelics
Reasons to Add Ketamine Therapy to Your Therapeutic Toolbox
My Experience and Qualification with Ketamine

The Issues Surrounding Ketamine Therapy

Ketamine Therapy is Misunderstood by Many
The Hype, The Reality, The Better Way

What's Important to know about Ketamine Therapy

Where do we go from here

Structure of the Course – This Is Not a TED Talk

Module 1D – Ketamine - A New Approach for the Treatment of Mood Disorders

The Best Place to Start is at the Beginning

Zarate: A New Approach for the Rapid and Effective Treatment of Mood Disorders

A Deeper Look into The Evolution of Ketamine Therapy

Seminal/Landmark Research Studies – Key Players
Significant Researchers In The Field
1994 - The Origins of the Standard Ketamine Infusion
The 2000 Berman/Krystal Study – A Landmark Study
2006 – Ketamine Becomes Recognized

New Keys to Understanding Depression

The Human Connectome and Mood Disorders
A New Model: Depression - A Neural Disconnection Syndrome
Ketamine and Neuroplasticity

Questions Arise About Ketamine as a Therapeutic Modality

The Non-FDA Drug Trial Approach to Ketamine Development
The Issues: Administration – Durability – Dosage - Frequency

How To Standardize and Facilitate Ketamine Treatment

Large Randomized Placebo-Controlled Drug Trials
Whom Do You Ask? Anesthesiologists, Psychiatrists, or Bench Researchers

Use What We Know – An Existing Model?

What Model To Use?
Administration – Durability – Dosage – Frequency
The "Standard Ketamine Protocol" Emerges

Module 2D – The Standard Ketamine Infusion

The Standard Ketamine Infusion Protocol

Qualifications, Training, Equipment, and Safety Recommendations
Who Is A Candidate For Ketamine Therapy - Patient Selection
The Infusion – Version 1 and – Version 2
Patient Follow-Up and Maintenance
Best Outcome studies – Research studies

The Protocol Doesn't Tell The Whole Story

Ketamine Infusion Timeline and Experience
Physiological and Psychological Variables
Transpersonal Experiences – Do They Matter?
Ketamine Safety, Abuse, and Adverse Effects

Houston, We Have A Problem…

Clinician Don't Always Follow The Protocol
Compliance with guidelines and recommendations
Do clinicians adhere to the "Standard Ketamine Infusion" Protocol

The Wild West of Ketamine Therapy - It's Dangerous Out There!

How Bad Is It? – A Video Example of a typical infusion
The "Zappy" Syndrome
Worse Yet – Big Business Gets Involved: Franchising & Home Delivery of Ketamine
What Has Been The Result?
Effectiveness-Adverse Effects-Worsening Symptoms-Suicidality
Malpractice Suits, DEA/DOJ Intervention, and Legislation

Clinical Modules:

The clinical modules allow clinicians to gain experience administering ketamine infusions under the close supervision of more experienced clinicians. Clinicians perform and practice all the necessary steps essential to a successful infusion. The first day provides the framework required to comply with professional regulatory agencies and evidenced-based best practices.

Module 1C - The Basics: Rules, Regulations, and Requirements

Professional Regulatory Agencies

American Psychiatric Association:

APA Skill Set Review:
Overview of mood disorders and the use of ketamine as a treatment option
Proper dosing and administration of ketamine
Patient monitoring and safety measures during and after treatment
Potential adverse effects and side effects of ketamine treatment
Patient selection and evaluation for ketamine treatment
Alternative treatment options for mood disorders
Current research on the long-term effects of ketamine use
Proper documentation, communication, and collaboration with other healthcare providers
Legal and regulatory considerations in ketamine treatment
Risks of off-label use of ketamine
Use of ketamine in special populations
Ongoing patient follow-up and monitoring
Ethical considerations in ketamine treatment
A multidisciplinary approach to ketamine treatment
Opportunities for continuing education and professional development.

American Society of Anesthesiologists
ASA Skill Set Review:
Anesthesiologists Keyword – Vigilance
Patient selection and evaluation for ketamine treatment from an Anesthesiology Perspective
Use of ketamine in special populations
Proper documentation, communication, and collaboration with other healthcare providers
Patient monitoring and safety measures during and after treatment
The critical difference between continual vs. continuous monitoring
IV insertion techniques and the use of vascular access devices
Monitoring – How to use, apply and understand – NIBP, EKG, SpO2, EtCO2, and Capnography
Street Level Airway Management from A to Z
Potential adverse effects and side effects of ketamine treatment - What to do in an Emergency

State Medical Boards
Drug Enforcement Agency

Who Is A Candidate For Ketamine Therapy

Patient Selection - Being "eligible" is not the same as being "suitable."
Evaluation – Labs, Medical and Mental Health Records, Referrals
Cautions and Contraindications

Avoiding Medico-Legal Issues: It's All In The Documentation

Examples: Metrics – Forms – Notes - Logbook
Screening Metrics, Brief Medical History
Initial Evaluation and Consent
Pre-Procedural Evaluation
Ketamine Infusion Record
Post-Procedural Note
Discharge Instructions
DEA Controlled Substance Logbook

General Operational Concerns

Space Requirements
Personnel Requirements
Equipment Requirements/Vendors
Supply Requirements/Vendors
Pharmaceutical Requirements/Vendors

Module 2C - Introduction to the Infusion Room

The Clinical Encounter – What Does It Look Like?

The Ketamine infusion Suite:

Physical Space and Setting
Patient preparation and monitoring
Equipment and Supplies
Infusion/syringe pumps
Safety Issues, Transporting, and Patient Discharge

Click here to go on to day 2 of training

Here is what our graduate have to say

Dr. Landauro:

I am an Austrian psychiatrist. One year ago, I started using ketamine for the treatment of my depressive patients without formal training using the standard protocol published in the literature. I decided to attend the Ketamine Institute’s training program to enhance my skills.The Ketamine infusion therapy for mood disorders” training course for physicians went above and beyond my expectations. Dr. Grass' brilliance and profound professional expertise made this course an unforgettable and truly eye-opening experience. I can now understand Ketamine from a pharmacological, anesthesiology, psychiatric, medico-legal and therapeutic perspective. I could put the contents I learned immediately into practice and my patients are already profiting from the knowledge I gained."

…thank you!"

—Dr. Med R Febres Landauro – Saltsburg, Austria

To Learn More About Our Programs - please click the links below:

The "Mini-Fellowship" Intensive Training Program

A Detailed Course Overview