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Psychedelics are transforming the way we understand depression and its treatment – Robin Carhart-Harris

While we suspected that psilocybin might perform well compared to the SSRI, we had not expected it to perform as well as it did. In fact, the initial main hypothesis for this trial was that the psilocybin therapy would have superior effects on psychological wellbeing, but not on depression severity scores. This prediction was generally supported, but people in the psilocybin group also showed evidence of greater improvements across most depression measures, as well as anxiety symptoms, work and social functioning, suicidal feelings and the ability to feel emotion and pleasure.

‘The ketamine blew my mind’: can psychedelics cure addiction and depression?

In the meantime, practitioners of this new kind of mental healthcare can use ketamine as their psychedelic agent; and some studies, such as the one Grant participated in, are even government funded. The Ketamine for Reduction of Alcoholic Relapse (Kare) study is a novel attempt to ease the huge burden on the NHS caused by alcohol-related illnesses.

Hamilton’s Pharmacopeia – Ketamine – Season 2 Episode 5

Hamilton Morris spent 3 days with Dr. Raquel Bennett (founder of KRIYA Institute) talking about therapeutic ketamine. Filmed in Hillsborough, CA in July 2017.

Ketamine Explained, The Next Big Antidepressant | The War on Drugs

Can LSD and psilocybin provide relief to people suffering from difficult-to-treat conditions such as depression and anxiety? Robin Carhart-Harris is a neuroscientist and head of the Imperial Centre for Psychedelic Research, which builds on over a decade of pioneering work psychedelic research, including a clinical trial that has kick-started global efforts to develop psilocybin therapy into a licensed treatment for depression.

The Science of Psychedelics

Can LSD and psilocybin provide relief to people suffering from difficult-to-treat conditions such as depression and anxiety? Robin Carhart-Harris is a neuroscientist and head of the Imperial Centre for Psychedelic Research, which builds on over a decade of pioneering work psychedelic research, including a clinical trial that has kick-started global efforts to develop psilocybin therapy into a licensed treatment for depression.

Treating PTSD With Psychedelics

A mind-altering drug called ketamine is changing the way some doctors treat depression.

I Use Ketamine for Depression – Here’s How It Works

The powerful effects that ketamine has on the brain’s neurons have led doctors to further explore its medical potential, and now, ketamine infusion therapy and ketamine nasal sprays are giving those with severe depression new hope.

The Next Big Anti-Aging Drug: Everything You Need To Know About “NAD”

It just so happens that a friend of mine, Thomas Ingoglia, known as one of the best NAD scientists on the planet and is also in contact with the best NAD clinicians on the planet – both with decades of experience second to none.

NAD+ in Aging: What It Is & Why You Need It

Rhonda Patrick explains what NAD+, why it is so important for aging and why it declines with age. She discusses some of the popular NAD+ boosters like nicotinamide riboside and nicotinamide mononucleotide, what animal and human data says and some concluding thoughts.

How Cellular Reprogramming Could Slow Our Aging Clock (and the Latest Research on NAD)

Petter Attia MD in conversation with David Sinclair PhD about aging, longevity, NAD and more.

Trial of Psilocybin versus Escitalopram for Depression

Psilocybin may have antidepressant properties, but direct comparisons between psilocybin and established treatments for depression are lacking.

Comparative Efficacy of Racemic Ketamine and Esketamine for Depression

Intravenous ketamine appears to be more efficacious than intranasal esketamine for the treatment of depression.

Antidepressant Actions of Ketamine Engage Cell-Specific Translation via eIF4E

Sub-anaesthetic doses of ketamine, a noncompetitive N-methyl-d-aspartate receptor antagonist provide rapid and long-lasting antidepressant effects in these patients, but the molecular mechanism of these effects remains unclear.

Ketamine Can Reduce Harmful Drinking by “Rewriting” Your Memories

Maladaptive reward memories (MRMs) are involved in the development and maintenance of acquired overconsumption disorders, such as harmful alcohol and drug use. Here we demonstrate that the N-methyl D-aspartate (NMDA) antagonist ketamine is able to disrupt MRMs in hazardous drinkers when administered immediately after their retrieval.

Ketamine for Unipolar and Bipolar Depression

Due to unmet clinical needs for efficient drugs with a rapid onset of antidepressant effects, we aimed to evaluate the efficacy of single-dose ketamine in different subgroups of patients with major depression and establish whether repeated ketamine administration could be a viable strategy to maintain treatment gains.

Psychedelic Psychiatry’s Brave New World

After a legally mandated, decades-long global arrest of research on psychedelic drugs, investigation of psychedelics in the context of psychiatric disorders is yielding exciting results.

NAD+ in Aging: What It Is & Why You Need It

Rhonda Patrick explains what NAD+, why it is so important for aging and why it declines with age. She discusses some of the popular NAD+ boosters like nicotinamide riboside and nicotinamide mononucleotide, what animal and human data says and some concluding thoughts.

Study: Ketamine for Chronic Posttraumatic Stress Disorder (PTSD)

The authors’ previous proof of- concept randomized controlled trial of single-dose intravenous ketamine infusion in individuals with PTSD showed significant and rapid PTSD symptom reduction 24 hours postinfusion.

NAD+ Boosters: How They Slow Aging

Rhonda Patrick explains what NAD+, why it is so important for aging and why it declines with age. She discusses some of the popular NAD+ boosters like nicotinamide riboside and nicotinamide mononucleotide, what animal and human data says and some concluding thoughts.

Ketamine Isn’t an Opioid, and it Treats Depression in a Unique Way

Ketamine has gotten a bad rap as an opioid when there’s plenty of evidence suggesting it isn’t one, Johns Hopkins experts say. They believe this reputation may hamper patients from getting necessary treatment for the kinds of depression that don’t respond to typical antidepressants.

Administration & Paperwork

If, together with our Wellness Coordinator, you decide to proceed with infusion therapy treatments we will collect the following information via online communication:
  • Your Contact Information
  • Health Questionnaire
  • Medical Records Release Authorization (your consent to have your mental health provider release pertinent medical records to CIT Clinics.

Ideally we are able to consult with any medical professionals who have provided you with mental health services (such as your therapist, psychiatrist, social worker, primary care physician, etc.). If you don’t currently have a mental health care professional who is treating you we can help. Our Wellness Coordinator will discuss your options during your initial phone consultation.

Receiving your first treatment is contingent on us receiving the necessary documentation about your current health status, medications your are currently taking and past treatments your have received. This can take anywhere from a few days to 1-2 weeks. In order to provide you with safe and effective treatments our medical care team needs the necessary information prior to giving you any infusion thereapies.

Anxiety

It is normal for patients to feel anxious or worried about infusion treatments at first. Our approach is very meticulous and deliberate and we will slowly (but steadily) work towards finding “your optimal dose”. Every patient is different and requires different amounts of medicine depending on their biology and psychology. When you receive Ketamine at our clinic you are doing so in the safest way possible – administered and monitored by a team of medical professionals who are prepared for any possible (and very unlikely) emergencies. This allows you to relax and focus on getting the most from your treatment.

Within a few minutes of receiving Ketamine via infusion you will feel a sense of euphoria, calm and even a bit dissociated. Most patients report feeling a sense of relief and a cessation of anxiety within minutes. Depending on the dose you are receiving this may fluctuate in intensity. Our anesthesiologists can monitor how you’re feeling and adjust the dose to ensure your experience is pleasant.

Athletic Performance

Many athletes experience a notable increase in energy, mental focus, and muscular performance (strength, endurance, reaction speed, etc) from NAD+ infusions.  The process of NAD+ infusion lends itself to an athletes mentality as well.  It should be recognized that NAD+ infused alone is not a comfortable experience.  Your CIT Clinic Physician can best describe the experience and the symptoms, but suffice to say that there can be a malaise, chest fullness, belly fullness, and neck fullness during the infusion.  Rest assured, these symptoms are transient, and not harmful.  But it does take an athlete’s mentality, with a focus on the end goal of getting the nutrient in your system that helps the process.

Everybody is different, so depending on your current health you could experience noticeable effects for up to 3-4 days after your treatment. Even if you don’t “feel” effects you are likely still reaping the benefits. Patients experience the most long-lasting benefits when they receive Myer’s Cocktails on a regular basis or clustered around physically challenging events (jet lag, after a really hard work out/race, post surgery, recovery from flu/illness, etc.)

Most patients report an almost immediate sense of wellbeing, perkiness and energy within minutes of the the infusion starting. Especially if you have been athletically active, the combination of fluids and nutrients can be felt almost immediately.

If you are clicking on this FAQ, you likely have some interest in “biohacking” yourself.  There are many intricate definitions of this process to include, “the art and science of changing the environment around you and inside you so that you have full control over your own biology.”  NAD is present in every cell in your body.  It is how every cell makes ATP – the energy needed for that cell to “do its job.”  Thus, NAD+ stores are important for your muscle cells, and neural cells that control those muscles.  At CIT Clinics, we practice what we preach and take NAD+ infusions ourselves.  There is a notable increase in energy, mental focus, and muscular performance (strength, endurance, reaction speed, etc).    

Chronic Pain

If you suffer from chronic pain, you probably know all too well how difficult it can be to treat. The long road of evaluations, diagnoses, and attempts to relieve the pain can leave you mentally and physically exhausted, and no better off than when you started. Even worse, it may also lead to opiate addiction.

Pain management is a field of medicine that helps you manage your pain better through a number of different treatments, often used in combination, such as:

  • Physical therapy
  • Medication management
  • Interventional therapies and surgeries
  • Behavioral therapies
  • Alternative therapies, such as acupuncture and chiropractic care
  • While pain management can be effective, if your chronic pain resists these treatments, it might be time to give ketamine and/or NAD+ therapy a try.

First and foremost, Ketamine is an analgesic, which means it stops pain in its tracks like most painkillers. By altering your neurotransmitters with Ketamine, you can find long-lasting relief from chronic pain. Furthermore, to boost the effects of ketamine infusion therapy, we also offer nicotinamide adenine dinucleotide (NAD+) infusions, which restore your body’s energy, promote healing by activating the DNA repair process, reduce oxidative stress, reduce inflammation and better regulate body’s systems at a cellular level. The combination of both Ketamine and NAD+ offers a powerful solution to chronic pain.

CIT Clinics

We offer personalized Combination Infusion Therapy protocols including the following:

  • IV Ketamine
  • IV NAD+
  • IV Glutathione
  • IV vitamins/minerals (Myer’s Cocktail)
  • Ketamine Assisted Psychotherapy
  • Mindfulness Coaching
  • Intranasal Ketamine/Spravato
  • Intranasal Ketamine/NAD+/Lidocaine

Yes. Our Combination Infusion Therapy protocols include ketamine along with IV vitamins and minerals for the treatment of depression, anxiety, PTSD, OCD and more.

Yes we offer a full range of patient services including Ketamine Assisted Psychotherapy.

Clinicians

We work with providers that fall broadly into 3 categories:

Emotional Pain

  • Primary Care Physicians
  • Neurologists
  • Psychiatrists
  • Psychologists
  • Therapists/Counselors
  • Life Coaches
  • Social Workers

Physical Pain

  • Pain Specialists
  • Primary Care Physicians
  • Surgeons
  • Orthopedic Specialists
  • Neurologists
  • Physical Therapists

Healthspan

  • Primary Care Physicians
  • Functional Medicine Providers
  • Dieticians
  • Athletic Coaches
  • Life Coaches

As soon as we receive your patient referral we will reach out to your patient via phone call. The purpose of this call is to confirm their interest in Combination Infusion Therapy and answer any questions they may have. If at the end of the call they would like to proceed they will be asked to submit a New Patient Intake Form. This provides us with the necessary contact information and medical history so we can begin onboarding them. After reviewing their intake information we will reach out to you to discuss your patient’s medical condition and better understand your reason for making the referral to CIT Clinics. If we still agree that these treatments may benefit your patient our team will begin scheduling their first treatment.

We pride ourselves in being very administratively efficient because it means we can intake new patients quickly and easily. Assuming there are no medical contraindications we can usually offer an appointment for new patients within 1 week of processing their intake form and speaking with you as their referring provider. Please begin your referral by submitting a New Patient Referral. If you have any questions about our process please call 415.475.9660. We’re happy to help.

Cognitive Performance

 NAD+ is used by every cell in the human body, including our neurons (brain cells).  As we perform cognitive tasks (reading, writing, articulating ideas, etc.) our brain is consuming about 20% of the overall energy consumption of our entire body. Our brain is a highly energy-intensive organ. This means that every brain cell needs optimal stores of NAD+.  Because the brain is so intertwined with what humans consciously do, most patients experience significant changes in their cognitive performance following NAD+ Infusions.

Combination Infusion Therapy

Combination Infusion Therapy and refers to our cutting-edge approach to healing physical and emotional pain through a combination of neurotherapeutics, intravenous vitamin and nutrient therapies, psychotherapy and life coaching. By integrating treatments that focus on your brain’s health, your body’s health and your mental health, Combination Infusion Therapy offers a very real alternative to conventional approaches to treatment resistant depression, anxiety, PTSD, and chronic physical pain.

Combination Infusion Therapy is a cutting-edge approach to treatment resistant physical and emotional pain including:

  • Depression
  • Anxiety
  • PTSD
  • Migraines & Headaches
  • CRPS & Chronic Pain
  • Addiction & Withdrawals

It is also used by healthy people wishing to improve their healthspan:

  • Immunity & Resilience
  • Athletic Performance
  • Anti-aging
  • Recovery from surgery

Most of our patients come to our clinic after many years of frustration and struggles with treatment resistant emotional and/or physical pain. If you’re struggling with anxiety, depression or PTSD you’re probably also feeling physically exhausted, fatigued and run down. Similarly, if you are suffering from chronic physical pain, you are most likely also feeling emotionally depleted, anxious and depressed. The connection between our body and our mind is real and complex. Combination Infusion Therapy is a cutting-edge approach to healing physical and emotional pain by integrating treatments that address the health and balance of your brain, your body and your mind.

You can discuss your health needs with our Wellness Coordinator by scheduling a free phone consultation here.

Consultations

In order to determine whether or not our infusion therapies are an appropriate treatment for the condition you are wanting to treat, our Wellness Coordinator will ask you questions about your current medical history and treatments you have had. Together we will then be able to determine what course of treatment to pursue.

Consultations take place over the phone. When you book your free consultation be sure to enter the phone number that you want to use at the appointment time.

Consultations typically take 15 – 20 minutes.

No. The consultation is free of charge.

CRPS

Since Ketamine works on pain receptors in the brain, you will experience an immediate reduction of pain once the Ketamine infusion starts. After the infusion, you will likely feel less (if any) pain for a 24 hour period. After several consecutive treatments, many patients report a reduction/cessation of pain for days and sometimes weeks. The biggest challenge with treating CRPS is to maintain a regular infusion schedule in order to keep CRPS at bay.

In our experience 3-4 consecutive days of low-dose Ketamine infusions lasting approximately 3-4 hours each, offers CRPS patients the most relief. Some patients then take a day or two off treatments, and then repeat the treatment cycle again.

With CRPS, we believe there are changes in the central nervous system at work. These changes wind up the pain signals from your body. Normally, bumping your leg or touching a cold item would cause a small amount of pain. In someone with CRPS, those stimuli cause intense, severe pain. This type of amplification of pain is believed to be due to activation of one of the nerve cell receptors, namely NMDA receptor. Ketamine Is a potent anesthetic that works on these receptors, blocking them from firing, which decreases the pain.

Depression

About 60% of people with depression aren’t helped by the first antidepressant they try, and about 30% don’t respond to several attempts at treatment. Researchers still don’t know why so many don’t people respond well to “anti-depressants” such as SSRIs, SNRIs, etc. Treatment Reistant Depression can be defined as Depression that doesn’t respond to two (or more) different antidepressants from different classes.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems.

Sometimes the positive effects of treatment can be seen within minutes of completion. Typically after the third infusion for patients being treated for depression, we will know if ketamine is producing the desired results. Patients and their friends or family members may notice significant changes in mood and behavior almost immediately.

Following the initial series of six treatments, we expect to see significant improvement that lasts from a few weeks to several months. Typically a “booster” ketamine infusion treatment is required after that time period to maintain relief of symptoms.

Fatigue

The connection between our body and our mind is real and complex. Oftentimes patients feel emotionally drained because they lack energy and physical vitality. Othertimes, they feel fatigued because they are chronically depressed and anxious. Combination Infusion Therapy is an integrated approach to healing chronic fatigue by integrating treatments for your brain, your body and your mind.

Common Treatments for CFS include IV Hydration, IV B Vitamins, IV Vitamin C, IV NAD+, and IV Glutathione.  Intravenous Ketamine may also be recommended in your treatment plan.  

Glutathione is a naturally occurring antioxidant (composed of 3 amino acids) that prevents the damage that free radicals, peroxides, lipid peroxides, and heavy metals inflict on your cells. It promotes a healthy immune system, improves skin texture, reduces fatigue, and enhances energy levels.  Small studies support its use for skin tone, psoriasis, fatty liver disease, peripheral arterial disease, insulin resistance, athletic performance, and Parkinson’s disease.

Any condition associated with excessive oxidative stress, inflammation and free radical damage (which includes most major conditions) could theoretically be helped by intravenous glutathione. The best-studied uses are for Parkinson’s Disease and side effect reduction associated with conventional cancer treatments. Other potential uses include conditions such as multiple sclerosis, progressive neuropathy, chronic fatigue syndrome, fibromyalgia, metabolic syndrome, diabetes and hypertension.

Although it depends on your treatment plan and number of visits, our patients usually notice a difference in their mood, energy level, and performance within 2 to 4 weeks. 

This depends on your underlying health status and the condition you are hoping to treat. After a consultation with our medical team, we will determine the most appropriate dose ane frequency of treatments for you.

Glutathione

While there is an abundance of over the counter Glutathione oral tabs available at health stores and the Internet, eating Glutathione is much less effective than intravenous therapy for treating chronic illness. Glutathione is not typically effective when ingested orally because the enzymes in your stomach dissolve the bonds between the amino acids before it can be effectively absorbed.

Many athletes experience a notable increase in energy, mental focus, and muscular performance (strength, endurance, reaction speed, etc) from NAD+ infusions.  The process of NAD+ infusion lends itself to an athletes mentality as well.  It should be recognized that NAD+ infused alone is not a comfortable experience.  Your CIT Clinic Physician can best describe the experience and the symptoms, but suffice to say that there can be a malaise, chest fullness, belly fullness, and neck fullness during the infusion.  Rest assured, these symptoms are transient, and not harmful.  But it does take an athlete’s mentality, with a focus on the end goal of getting the nutrient in your system that helps the process.

Typically, our patients elect a regimen of two infusions per month.  One longer NAD+ Infusion, and a separate, faster infusion of IV Nutrients and IV Glutathione.

Glutathione is a naturally occurring antioxidant (composed of 3 amino acids) that prevents the damage that free radicals, peroxides, lipid peroxides, and heavy metals inflict on your cells. It promotes a healthy immune system, improves skin texture, reduces fatigue, and enhances energy levels.  Small studies support its use for skin tone, psoriasis, fatty liver disease, peripheral arterial disease, insulin resistance, athletic performance, and Parkinson’s disease.

Any condition associated with excessive oxidative stress, inflammation and free radical damage (which includes most major conditions) could theoretically be helped by intravenous glutathione. The best-studied uses are for Parkinson’s Disease and side effect reduction associated with conventional cancer treatments. Other potential uses include conditions such as multiple sclerosis, progressive neuropathy, chronic fatigue syndrome, fibromyalgia, metabolic syndrome, diabetes and hypertension.

Depending on how much hydrating fluid you woul like to combine with your Glutathione, the infusions can take anywhere from 20 – 45 minutes.

This depends on your underlying health status and the condition you are hoping to treat. After a consultation with our medical team, we will determine the most appropriate dose ane frequency of treatments for you.

Healthspan

Many athletes experience a notable increase in energy, mental focus, and muscular performance (strength, endurance, reaction speed, etc) from NAD+ infusions.  The process of NAD+ infusion lends itself to an athletes mentality as well.  It should be recognized that NAD+ infused alone is not a comfortable experience.  Your CIT Clinic Physician can best describe the experience and the symptoms, but suffice to say that there can be a malaise, chest fullness, belly fullness, and neck fullness during the infusion.  Rest assured, these symptoms are transient, and not harmful.  But it does take an athlete’s mentality, with a focus on the end goal of getting the nutrient in your system that helps the process.

Typically, our patients elect a regimen of two infusions per month.  One longer NAD+ Infusion, and a separate, faster infusion of IV Nutrients and IV Glutathione.

NAD+ stands for nicotinamide adenine dinucleotide, which is an active form of a coenzyme that plays a significant role in the chemical reactions within your cells. NAD+: 

  • Turns carbohydrates, fats, and proteins into usable energy (Krebs Cycle)
  • Regulates your body’s stress response
  • Repairs and synthesizes DNA
  • Regulates your circadian rhythms
  • Promotes stem cell production
  • As you age, your natural levels of NAD+ begin to decrease. If you add sickness, disease, or addiction to the mix, your NAD+ levels deplete more rapidly.

If you are clicking on this FAQ, you may have an interest in the relatively recent phenomenon of “biohacking” ourselves.  There are many intricate definitions of this process to include, “the art and science of changing the environment around you and inside you so that you have full control over your own biology.”  At CIT Clinics, we can help you do this. We prefer to think of this in terms of maximizing our healthspan.  As opposed to just helping people live longer, we help people “live younger” for “longer.”  Sure, with some of these treatments we may add years to our lives (increasing “Lifespan”), but our primary goal is to remain vital, active, vibrant, healthy, and happy for more years than we would have otherwise (increasing “HealthSpan”).  

Glutathione is a naturally occurring antioxidant (composed of 3 amino acids) that prevents the damage that free radicals, peroxides, lipid peroxides, and heavy metals inflict on your cells. It promotes a healthy immune system, improves skin texture, reduces fatigue, and enhances energy levels.  Small studies support its use for skin tone, psoriasis, fatty liver disease, peripheral arterial disease, insulin resistance, athletic performance, and Parkinson’s disease.

CIT Clinics also utilizes IV Hydration, IV Nutrient Therapy, and IV Glutathione for patients interested in maximizing their performance and Healthspan.  In particular, Glutathione is a naturally occurring antioxidant (composed of 3 amino acids) that prevents the damage that free radicals, peroxides, lipid peroxides, and heavy metals inflict on your cells. It promotes a healthy immune system, improves skin texture, reduces fatigue, and enhances energy levels.  

Everybody is different, so depending on your current health you could experience noticeable effects for up to 3-4 days after your treatment. Even if you don’t “feel” effects you are likely still reaping the benefits. Patients experience the most long-lasting benefits when they receive Myer’s Cocktails on a regular basis or clustered around physically challenging events (jet lag, after a really hard work out/race, post surgery, recovery from flu/illness, etc.)

Most patients report an almost immediate sense of wellbeing, perkiness and energy within minutes of the the infusion starting. Especially if you have been athletically active, the combination of fluids and nutrients can be felt almost immediately.

This depends on your underlying health status and the condition you are hoping to treat. After a consultation with our medical team, we will determine the most appropriate dose ane frequency of treatments for you.

KAP

You need a valid license to practice your specific specialty in the state of California. While not required, we also prefer you have completed some form of KAP training/certification. You will need to submit our KAP Provider Questionnaire prior to scheduling your first patient.

At this time Ketamine is the only psychedelic medicine used at CIT Clinics. This only is because Ketamine is the only legal psychedelic medicine in the United States. As other medicines such as MDMA and psilocybin become legal we will also be using these medicines in our treatment protocols.

Yes. We require all providers to have an active professional liability insurance policy per their licensure requirements.

Yes, we offer treatments 7 days a week. Your ability to provide KAP on weekends or evenings is limited only by schedule availability.

KAP Admin

Treatment cost depends on the duration of the session and whether or not your patient wants other Combination Infusion Therapy medicines such as NAD+ and/or Glutathione in addition to Ketamine. For our standard Ketamine plus IV nutrients infusions you will be charged the following:

  • 45 minute session – $495
  • 60 minute session – $595
  • 90 minute session – $745
  • 120 minute session – $995

We can adjust the duration of your KAP session to any desired length of time. One of the benefits of administering Ketamine intravenously is that we can be very precise about both the dose and duration of the treatments. We can provide a 45 minute experience or a 4 hour experience. Studies indicate longer 4-hour sessions are for Chronic Pain management, while 1hr sessions are for mood disorders. Since every patient is different and every infusion experience is different, intravenous access allows us to personalize the treatment session from one treatment to the next. We have noticed that throughout the typical 6 infusion protocol (delivered over 2-3 weeks), patients are best served by adapting the treatment protocol to what they are experiencing on any given treatment day by adjusting the key variables of dose and duration.  

It will depend on mental health insurance and how patients are paying for their therapy visit, but as a medical clinic, providing a documented clinical procedure allows us to help patients submit reimbursable records to their insurance. Patients heart rate, blood pressure, respiratory rate and O2 saturation are wirelessly monitored and recorded throughout. While we can’t guarantee reimbursement, we have found that being able to document the administration of several medicines (IV Nutrients for fatigue, NAD for alcohol or opioid cravings/withdrawals, etc.) within any given treatment for a multitude of diagnoses, dramatically increases the likelihood of it being viewed as a reimbursable procedure.

KAP Benefits

Ketamine is a controlled substance and may only be prescribed and/or administered by a licensed medical provider. By providing KAP to your patients at CIT Clinics you are able to do so legally without yourself needing a medical license. All of our sessions are administered by experienced anesthesiologists thereby making the sessions safe, legal and hassle free.

Liability insurance, staff, room/office, cleaning, etc. are all provided for. You simply pay a prescribed fee based on KAP session duration and Combination Infusion Therapy medicines used. We handle all of the rest.

Your KAP session is fully supported by our clinical staff. We provide experienced anesthesiologists, nurses and other clinical support staff so your patient feels safe and you can focus on providing them the best KAP sessions

We make the process easy and hassle free. You can simply book a room at one of our clinics on a day that works for you and your patient. We take care of all of the administrative details so you can focus on providing your patient a successful KAP session.

Dose increase – Imagine yourself nearing the end of a therapy session with a client who appears to be on the edge of a breakthrough. They just need a subtle nudge of dissociation to really dig into what has been holding them back for years. You simply press the call button and a CIT Anesthesiologist visits the treatment room with a small 5mg IV bolus of ketamine. Your patient is able to explore the issues further, the session extends 15-20 minutes, and they are able to conclude a successful session that would have otherwise been unachievable had the Ketamine been administered orally or via intramuscular injection.

Dose decrease – Conversely, consider a PTSD patient that you have been working with for years: They are in the midst of a session when their experience begins to darken as past memories are re-visited. You press the call button and a CIT Anesthesiologist arrives to turn down the Ketamine infusion rate and explores the option to administer a small amount of benzodiazepine medication (Versed). A small dose is given, the experience softens for the patient, just enough so that they can continue exploring the thoughts and emotions that just surfaced. Compare this to a dark experience with oral or IM Ketamine whose administration cannot be rescinded. 

KAP Clinical

We’ve found that pretty much every patient that comes to us for mental health issues (mood disorders, anxiety, depression, PTSD) is also incredibly fatigued and physically run down. They struggle to find a foothold with their mental health in part because they are physically depleted from chronic stress. Adding NAD+, Glutathione, Vitamins C & B complexes to their treatments gives them a considerable physiological boost and allows them to really capitalize on the efficacy of the Ketamine experience. Our success rate is 85-90% in terms of patients experiencing a noticeable positive shift in their motivation, resilience and capacity to engage with their mental health issues. In addition, other medications, like Magnesium Sulfate, can work synergistically with Ketamine. The science, peer reviewed literature, and explanations regarding Combination Infusion Therapy likely entail an additional conversation if you are interested. Suffice to say, the benefits, experience, and protocols you have access to via our clinic is not something found at a “regular Ketamine Clinic.”. And, of course, all additional CIT Medications are discussed with providers and patients prior to administration.  

Intravenous medication administration has an extremely fast and predictable onset/offset. Unlike psychedelics that are ingested orally or injected intramuscularly, KAP providers find benefit in the predictable session durations of intravenous ketamine, allowing them to schedule multiple patients in a single day. As Anesthesiologists, we are familiar with facilitating fast turnover for our surgical colleagues and running multiple operating rooms. Imagine yourself scheduling multiple patients on a predictable schedule, as you move from one room to the next. Meanwhile, our CIT staff takes care of all pre/post infusion monitoring and patient care.   

There are specific benefits of intravenous infusions compared with intramuscular and/or oral administration of Ketamine. Dose management (precision, customization). Absorption speed, duration flexibility. Please see additional FAQ for specifics.

The appropriate/effective dose of Ketamine used during your patient’s KAP session is contingent on their prior experience with Ketamine and other psychedelic medicines. First-time patients are typically started at a dose of 0.5 mg Ketamine per kg of bodyweight. Since all of our KAP sessions are administered by experienced anesthesiologist MDs, we are able to customize the doses for each individual as well as from session to session. In fact, for some patients we will increase/decrease the dose during a treatment in order to provide the most impactful experience for the patient. Please be sure to discuss your session goals with the MDs so they can best support you.

We can literally adjust the dose up or down within minutes. We routinely give patients boosters (boluses directly into their IV line to increase the dose) and/or turn down the intensity of the Ketamine. The impact of changes in IV doses are felt within 2-3 minutes of adjustment allowing us to precisely manage the patient experience. It is quite common for us to adjust the dose multiple times within a single session to give the optimal experience. 

Yes. You can offer your patients all of the benefits of Combination Infusion Therapy. In our experience, treating the whole patient – brain, body, and mind – is the best way to support their healing. If your patient is interested in receiving additional medicines during their KAP session, please discuss options with the CIT Clinics anesthesiologist administering treatments.

Ketamine

Chronic use of benzodiazepines (e.g. Ativan and Xanax) and Lamictal (Lamotrigine) may render ketamine therapy less effective, and we may recommend those medications be stopped or dosages significantly reduced at least 5-14 days before treatment. Patients on MAOi’s should not take ketamine. Consult with your prescribing doctor prior to stopping any medication.

Ketamine developed a reputation as a drug of abuse and is also known as Vitamin K, Special K, Kit Kat or an animal tranquilizer. Addiction has not been described when following the low-dose infusion protocols at CIT Clinics. Ketamine has been used extensively in the hospital setting as an anesthetic agent since being FDA-approved in the mid-1960’s and has a proven track record of safety and good patient tolerance.

During the infusion, some patients report changes in their vision, speech, and thought processes. They often describe feelings of dissociation from their body. It can feel like a sedated or dreamlike state. If unpleasant hallucinations or other sensations occur, we may decrease the infusion rate and/or administer medications to minimize these experiences.

Patients usually recover from the effects of the infusion within 20-30 minutes. There may be residual cloudiness and mild difficulty walking for a few hours. You may also feel fatigued for the remainder of the day. We recommend the patient have a low impact and relaxing remainder of their day following the infusion.

This varies from patient to patient and cannot be predicted. Many of our patients experience relief from their symptoms within the first few treatments. Our rate of success is 85% after the 6 treatments and most patients notice a “shift” after their first infusion.

If you meet the guidelines for Ketamine infusion therapy, you will receive 6 infusion sessions over the course of two weeks. This timeline has been shown to be most effective at treating conditions such as depression, annxiety, PTSD and drugh/alscohol withdrawals. The results typically last for one to two months or more, at which time you return for a single “booster” infusion to keep your symptoms at bay. Some patients don’t require boosters and the determination is made on a case-by-case basis.

The occasional side effects that we see from low dose ketamine treatments usually resolve shortly after treatment. We may use supplemental medications to treat nausea, anxiety, hallucinations, and/or blood pressure changes.

Migraines & Headaches

This is a cutting edge treatment and we are still gathering data, but currently results have indicated anywhere from 1 to as many as 4 treatments in severe cases with occasional boosters over time. For those patients who are ‘responders’ a noticeable shift in their migraine can be felt within hours of the first treatment. Unfortunately, however, this is not always the case and more treatments are need to determine responsiveness.

For migraines and headaches, we offer intranasal delivery of these medications and other therapeutic modalities through a specially designed nasal catheter.  This catheter allows for delivery near the Sphenopalatine Ganglion – a prime location to attack and alleviate headache pain.  The procedure is simple, quick, and painless.  Because of the consciousness-altering effects of the Ketamine, you will need to arrange transportation following treatment.

No. However, we do feel we can ascertain more definitive answers regarding the efficacy of the treatment if it is administered while a headache is present.

NAD+

When NAD+ is administered via IV it is mixed with saline solution and slowly drips into your blood stream. Some patients experience discomfort from the NAD+ infusion (eg. GI discomfort, sensations of pressure in the belly and chest) and therefore want to slow the drip rate down. This means the rate of administering NAD+ goes down and the treatment takes longer (sometimes as much as several hours longer). Since CIT Clinics physicians are board certified anesthesiologists, we are able to add Ketamine to the NAD+ infusion making the process much more comfortable and faster.

While NAD supplements are available in some health stores, they are not nearly as effective as receiving NAD intravenously because the compounds are not fully absorbed. The body’s digestive tract and liver break most of the desired compounds down thereby drastically reducing the bioavailability of the NAD (the amount of a drug or supplement that your body can actually use). As a result, oral NAD+ supplements as well as subcutanneous (under the skin) injections of NAD+are much less effective than IV infusions.

Many athletes experience a notable increase in energy, mental focus, and muscular performance (strength, endurance, reaction speed, etc) from NAD+ infusions.  The process of NAD+ infusion lends itself to an athletes mentality as well.  It should be recognized that NAD+ infused alone is not a comfortable experience.  Your CIT Clinic Physician can best describe the experience and the symptoms, but suffice to say that there can be a malaise, chest fullness, belly fullness, and neck fullness during the infusion.  Rest assured, these symptoms are transient, and not harmful.  But it does take an athlete’s mentality, with a focus on the end goal of getting the nutrient in your system that helps the process.

NAD+ stands for nicotinamide adenine dinucleotide, which is an active form of a coenzyme that plays a significant role in the chemical reactions within your cells. NAD+: 

  • Turns carbohydrates, fats, and proteins into usable energy (Krebs Cycle)
  • Regulates your body’s stress response
  • Repairs and synthesizes DNA
  • Regulates your circadian rhythms
  • Promotes stem cell production
  • As you age, your natural levels of NAD+ begin to decrease. If you add sickness, disease, or addiction to the mix, your NAD+ levels deplete more rapidly.

CIT Clinics are pleased to offer BR+NAD-Brain Restoration Plus, the highest quality NAD+ formulation available from the only manufacturer in the world certified by the U.S. Food and Drug Administration.  We are endorsed providers of this pure product that produces the best and most consistent results.  Our board-certified physicians have been trained and certified by the founders of the first clinic to offer NAD+ therapy in the country, Richard Mestayer, M.D. and Paula Norris, M.Ed. of the Springfield Wellness Center.

****Please be careful of other products marketing themselves as NAD****

NAD+, NADH and NR (Nicotinamide Riboside) are not the same. Although NAD+ plays a role in the same pathway as NADH and NR, there are certain NAD+ consuming reactions where only NAD+ can be utilized. In these reactions, NADH and NR are not effective. While NADH and NR are less expensive than NAD+, the positive effects are not nearly as potent as NAD+. BR+NAD and our REAL NAD+ tablets are the purest forms of NAD+ available.

The side effects of treatment are minimal and appear related to the rate at which the NAD+ is administered. At a faster rate, patients may experience slight upper torso pressure, abdominal cramping and lower leg soreness. Flushing, mild nausea and a slight headache may also occur. These side effects typically disappear within just a few minutes of slowing the rate of infusion. Patients are able to pass the time in our relaxing clinic environment by watching TV, reading, and listening to music. You will also have access to high-speed internet and can bring your laptop or tablet.

How much NAD+ your body needs is determined your current health status, your history and the condition your are trying to treat. Depression, anxiety, PTSD and chronic drug/alcohol use are very taxing on the body and result in varying degrees of NAD+ depletion. In some cases only a few hundred mgs are required; in more extreme detox situations several thousand mgs of NAD+ are needed. Together with the CIT Clinics medical team you will determine the appropriate dose and course of treatment.

This is a cutting edge treatment and we are still gathering data, but currently results have indicated anywhere from 1 to as many as 4 treatments in severe cases with occasional boosters over time. For those patients who are ‘responders’ a noticeable shift in their migraine can be felt within hours of the first treatment. Unfortunately, however, this is not always the case and more treatments are need to determine responsiveness.

For migraines and headaches, we offer intranasal delivery of these medications and other therapeutic modalities through a specially designed nasal catheter.  This catheter allows for delivery near the Sphenopalatine Ganglion – a prime location to attack and alleviate headache pain.  The procedure is simple, quick, and painless.  Because of the consciousness-altering effects of the Ketamine, you will need to arrange transportation following treatment.

A small IV is inserted into your arm while you sit in a comfortable recliner. The NAD+ is added to a saline hydration bag allowing the NAD+ to slowly drip directly into your blood stream. Depending on the amount of NAD+ being infused as well as your tolerance for the drug, this process can take anywhere between 1 – 4 hours. Adding a small amount of Ketamine to the infusion will greatly reduce the length of time needed for the NAD+ infusion.

If you are clicking on this FAQ, you likely have some interest in “biohacking” yourself.  There are many intricate definitions of this process to include, “the art and science of changing the environment around you and inside you so that you have full control over your own biology.”  NAD is present in every cell in your body.  It is how every cell makes ATP – the energy needed for that cell to “do its job.”  Thus, NAD+ stores are important for your muscle cells, and neural cells that control those muscles.  At CIT Clinics, we practice what we preach and take NAD+ infusions ourselves.  There is a notable increase in energy, mental focus, and muscular performance (strength, endurance, reaction speed, etc).    

Nutrient Rx

Everybody is different, so depending on your current health you could experience noticeable effects for up to 3-4 days after your treatment. Even if you don’t “feel” effects you are likely still reaping the benefits. Patients experience the most long-lasting benefits when they receive Myer’s Cocktails on a regular basis or clustered around physically challenging events (jet lag, after a really hard work out/race, post surgery, recovery from flu/illness, etc.)

Depending on the amount of hydration fluid you are receiving the infusion can take anywhere from 20 – 60 minutes.

PTSD

A common misconception about trauma is that only victims of violence (war, violence, rape, accidents, etc.) experience PTSD. Other non-acute causees of PTSD include repeated and prolonged experiences such as domestic violence, emotional abuse/manipulation and illnesses. It is impossible to predict who will exeriencr PTSD and quite common that people experiencing similar events react very differently and are therefore more or less likely to suffer from PTSD.

Resilience & Immunity

NAD+ stands for nicotinamide adenine dinucleotide, which is an active form of a coenzyme that plays a significant role in the chemical reactions within your cells. NAD+: 

  • Turns carbohydrates, fats, and proteins into usable energy (Krebs Cycle)
  • Regulates your body’s stress response
  • Repairs and synthesizes DNA
  • Regulates your circadian rhythms
  • Promotes stem cell production
  • As you age, your natural levels of NAD+ begin to decrease. If you add sickness, disease, or addiction to the mix, your NAD+ levels deplete more rapidly.

Glutathione is a naturally occurring antioxidant (composed of 3 amino acids) that prevents the damage that free radicals, peroxides, lipid peroxides, and heavy metals inflict on your cells. It promotes a healthy immune system, improves skin texture, reduces fatigue, and enhances energy levels.  Small studies support its use for skin tone, psoriasis, fatty liver disease, peripheral arterial disease, insulin resistance, athletic performance, and Parkinson’s disease.

The Myers Cocktail (named after the late Dr. Myer) consists of an IV formulation of B Vitamins, Vitamin C, and other minerals.  It has a significant  anecdotal following for boosting immunity and the treatment of Chronic pain, Fibromyalgia, Aging, Fatigue, Brain fog, Depression, Anxiety & Stress,  and Addiction & Withdrawal.  The primary benefit is guaranteed, reliable delivery of multivitamins to optimal concentrations unrivaled by oral medications or a balanced diet.

Any condition associated with excessive oxidative stress, inflammation and free radical damage (which includes most major conditions) could theoretically be helped by intravenous glutathione. The best-studied uses are for Parkinson’s Disease and side effect reduction associated with conventional cancer treatments. Other potential uses include conditions such as multiple sclerosis, progressive neuropathy, chronic fatigue syndrome, fibromyalgia, metabolic syndrome, diabetes and hypertension.

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