Could Ketamine-Assisted Psychotherapy Be Your Path to Hope and Healing? Insights into Eligibility and Contraindications

This post has been shared by our colleagues at Temenos Center, offering Psychedelic and Ketamine-Assisted Psychotherapy in Petaluma and at Hill Park Integrative Medical Center in Sebastopol.

Have you been feeling stuck in the cycle of treatment-resistant depression, anxiety, chronic pain, or other conditions like addiction, PTSD, OCD, ADHD, grief, or long COVID? Ketamine-assisted psychotherapy (KAP) is emerging as a groundbreaking treatment offering hope for many individuals. When exploring KAP, it’s important to be aware of any contraindications—specific conditions or factors that might make the treatment less suitable for some individuals.

We understand that navigating a new treatment can feel overwhelming. Our goal is to make this process as straightforward and supportive as possible. At Temenos, we’re trained to help you examine whether KAP might benefit you. Email [email protected] for a complimentary 20-minute consultation to discuss how we can support your journey to better health.

Contraindications

Understanding who should avoid KAP is as vital as knowing who might benefit. At Temenos, our staff members are dedicated to offering personalized assessments to determine if KAP is a good fit for your unique needs. We understand that some conditions may require further evaluation, and we’ll guide you through the process every step of the way. Please note that this overview is a starting point, not a substitute for professional medical advice. 

Contraindications can be broadly categorized into psychological and physiological groups:

Psychological:

  • Severe mental health conditions: Individuals with a personal or family history of psychosis or schizophrenia and active mania (as seen in bipolar disorder) are typically advised against undergoing KAP. People with bipolar disorder may be eligible if they are using a mood-regulating medicine prescribed by their psychiatrist.
  • Current mental state: For those experiencing intense emotions or suicidal thoughts, prioritizing stabilization is key. We can help you find resources to get you the support you need before considering KAP.

Physiological:

  • Cardiovascular issues: People with uncontrolled blood pressure are ineligible, as ketamine can induce changes in blood pressure and heart rate.
  • Neurological conditions: Individuals with a personal or family history of seizures or epilepsy are at risk of exacerbating these symptoms with ketamine use.
  • Medication interactions: Certain medications, like Benzodiazepines or MAOIs, can interact with KAP. If you’re currently taking any medications, we’ll discuss them during your consultation to ensure a safe and effective treatment plan. This may involve adjusting your medications under the careful guidance of your healthcare team.

General Medical Considerations:

  • Substance use: A history of substance misuse may complicate treatment and increase the risk of dependency on ketamine and is best addressed before pursuing KAP. Temenos can help you find support.
  • Pregnancy and breastfeeding: Due to potential risks to the baby, pregnant mothers are typically excluded from KAP treatments. There are potential breastfeeding protocols that may make KAP possible (i.e., the “pump-and-dump” method).

Safety and Supervision – Am I Still Eligible with Contraindications?

If you have identified any contraindications from this blog that could apply to you, don’t worry – gathering the right information is the first step towards making informed decisions about your treatment. 

First, it’s recommended that you speak with your primary healthcare team and set up a free 20-minute consultation with Temenos staff. Be upfront with all information so your providers can make the most informed decision— while certain contraindications could make KAP harmful to the patient, others can be mitigated for a safe KAP experience. For example, medications like MAOIs can be managed by working with your care team to gradually reduce medication use under clinical supervision. Never do this by yourself, only under the supervision of medical staff.

If your care team agrees, the next step is a thorough evaluation by a Temenos medical professional who can assess the full spectrum of your mental and physical health profile, ensuring that it is a safe and effective service. 

Final Considerations

Your safety is our top priority. KAP is always administered in a controlled environment, with experienced medical professionals monitoring you closely during and immediately after treatment. If you live in the North Bay Area and beyond, email [email protected] to set up a complimentary 20-minute consultation with our Sonoma County providers to see if KAP may offer a safe and effective treatment for you.

Temenos Center’s Psychedelic and Ketamine-Assisted Psychotherapy is available at their location in Petaluma and at Hill Park Integrative Medical Center in Sebastopol.

Citations

Wang, M. (2022, May 9). Interactions between ketamine and prescription antidepressants. Translational Psychedelic Research Program. https://psychedelics.ucsf.edu/blog/interactions-between-ketamine-and-prescription-antidepressants

American Psychiatric Nurses Association. (2023, August). Ketamine infusion therapy treatment considerations. https://www.apna.org/ketamine-infusion-therapy/ 

 

Can You Use Your HSA Account for KAP? Insights and Options for Funding Ketamine-Assisted Psychotherapy

This post has been shared by our colleagues at Temenos Center, offering Psychedelic and Ketamine-Assisted Psychotherapy in Petaluma and at Hill Park Integrative Medical Center in Sebastopol.

The integration of psychedelic therapies like ketamine-assisted psychotherapy (KAP) into mental health treatment offers new hope for individuals seeking relief from persistent mental health challenges. Using an HSA to fund KAP can make this treatment more accessible, providing a financial strategy to support your journey. Whether through HSAs, FSAs, or out-of-pocket payments, the goal remains to make transformative therapies like KAP accessible to those in need.

The Flexibility of HSAs

Health Savings Accounts (HSAs) are designed to provide individuals with a tax-advantaged method to save for medical expenses. This includes a variety of treatments and therapies not typically covered by traditional health insurance. Given their flexibility, HSAs may cover the costs of KAP, which is increasingly recognized for its efficacy in addressing conditions like depression, anxiety, and chronic pain.

Ketamine Treatment: A Qualified Medical Expense?

Ketamine’s use in treating severe mental health conditions has grown significantly despite its classification as an “experimental” therapy by most insurance companies. However, the Internal Revenue Service (IRS), which oversees HSA regulations, allows these funds to be used for qualifying medical expenses. Since KAP is administered for diagnosable conditions under the care of licensed healthcare professionals, it generally qualifies as a reimbursable expense under HSAs. Flexible Spending Accounts (FSAs) also offer similar tax-advantaged benefits for medical expenses and may be used for KAP treatments.

Navigating HSA Use for KAP

  • Verify with Your HSA Administrator: Some HSAs only cover medically necessary treatments, while others offer more flexible coverage. Before proceeding with KAP and expecting coverage through your HSA, confirm the eligibility of such treatments with your HSA provider. 
  • Reimbursement: Pay out-of-pocket and seek reimbursement from your HSA by submitting the necessary receipts and documentation.
  • Maintain Records: Request records of all treatments, receipts, and communications related to your KAP and HSA expenditures. This documentation may be necessary for reimbursement and compliance with tax regulations.

The Path Forward

By harnessing the financial tools available, such as HSAs, individuals seeking KAP can more effectively navigate the costs associated with this promising therapy. Consult with your HSA administrator and healthcare provider to ensure your treatment aligns with your financial planning and healthcare needs.

Temenos Center’s Psychedelic and Ketamine-Assisted Psychotherapy is available at their location in Petaluma and at Hill Park Integrative Medical Center in Sebastopol.

Sources

Internal Revenue Service. (2024, February 23). Frequently asked questions about medical expenses related to nutrition, wellness, and general health. IRS. Retrieved from https://www.irs.gov/individuals/frequently-asked-questions-about-medical-expenses-related-to-nutrition-wellness-and-general-health

Embracing Transformation: The Important Role of Psychedelic Integration Therapy

This post has been shared by our colleagues at Temenos Center, offering Psychedelic and Ketamine-Assisted Psychotherapy in Petaluma and at Hill Park Integrative Medical Center in Sebastopol.

This blog post is intended for informational purposes only and does not endorse the illegal use of psychedelics.

In the evolving landscape of mental health treatment, psychedelic therapy has become a beacon of new hope, offering innovative pathways for healing a variety of mental health disorders, including depression, anxiety, chronic pain, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and addiction. At the heart of harnessing the full potential of these psychedelic treatments lies the critical process of integration—a journey that Temenos Center is passionately committed to guiding every individual through. 

The Essence of Integration

Integration is the deliberate process of weaving psychedelic experiences into the fabric of daily life, ensuring insights and transformations are not fleeting but become catalysts for lasting change. Psychedelic integration therapy is about making sense of and working through the material that surfaced during psychedelic states, a view that is foundational to our approach at Temenos.

Why Integration Matters

Following a psychedelic session, integration becomes the bridge between experience and actionable change. At Temenos, we emphasize the critical importance of these follow-up sessions. They serve not just as debriefings but as opportunities to translate and anchor the teachings from the psychedelic realm into tangible, life-enhancing practices. Whether insights relate to past trauma or offer new perspectives on personal beliefs and behaviors, our integration therapy provides a compass for navigating the aftermath of psychedelic journeys.

The Temenos Approach to Integration

Drawing on the nuanced perspectives of various psychedelics, our therapists offer tailored support, recognizing the individuality of each journey. Our ethos emphasizes the importance of integration in achieving therapeutic goals, helping individuals navigate the complexities of their experiences with professional guidance. Incorporating intentional neuroplasticity skills is a key component of integration at Temenos, which can support the durability of the effects of the psychedelic experience.

While Temenos does not endorse the illegal use of psychedelics, we recognize the reality that individuals who engage with these substances, under any circumstances, may require support. Our approach is one of understanding, not judgment, offering professional guidance to help patients navigate the complexities of integration.

Psychedelic integration therapy is more than a post-experience requirement; it’s a vital part of the journey toward holistic healing and personal growth. By fostering a deeper connection between the psychedelic experience and daily life, integration therapy ensures that the doorways opened by these profound encounters lead to lasting, meaningful change.

At Temenos Center, we’re dedicated to supporting you through this transformative process. We offer expert guidance to help you weave the insights from your psychedelic experiences into the fabric of your life. Visit our website or contact us to schedule a consultation to explore how integration therapy can benefit you.

Temenos Center’s Psychedelic and Ketamine-Assisted Psychotherapy is available at their location in Petaluma and at Hill Park Integrative Medical Center in Sebastopol.

Works Cited:

Welcome Jessica McIninch, PsyD Providing Ketamine-Assisted Psychotherapy at Hill Park

Dr. Jessica McIninch is a licensed clinical psychologist of 18 years that is certified in the practice of psychedelic-assisted psychotherapy via the Center for Psychedelic Therapies and Research program at the California Institute of Integral Studies. Jessica is the owner and psychological director of Temenos, a psychedelic-assisted psychotherapy center in Petaluma, California, where she has provided ketamine-assisted psychotherapy for the past 5 years.

Dr. McIninch views psychedelic medicine work to be the singularly most rewarding aspect of her career thus far, describing it as potentially a catalyst, life-changing treatment for many people suffering from depression and anxiety.

In Jessica’s words, “I have never before seen in my 18 years as a psychologist the accelerated healing that can occur in psychedelic-assisted psychotherapy. It is such an honor to be a part of the psychedelic movement and I am delighted to bring this treatment to Hill Park’s patients.”

Jessica incorporates neuropsychological principles to amplify the effectiveness and durability of psychedelic-assisted psychotherapy and views psychedelic integration work to be equally as important as the psychedelic medicine experience itself.

Recently, Jessica was selected by MAPS (Multidisciplinary Association for Psychedelic Studies) to begin providing MDMA-assisted psychotherapy. As a Psychologist for the MAPS Expanded Access program, Jessica is providing MDMA assisted psychotherapy for individuals suffering from severe PTSD. This program, located in Washington DC, is the final phase required to achieve FDA approval of this medicine. As one of 20 clinicians in the world selected for this program, she is excited to bring this treatment to Hill Park once it becomes approved by the FDA.

Dr. McIninch is now providing Ketamine-Assisted Psychotherapy (KAP) at Hill Park.

Prostate Biopsy: Is it Necessary? How to Decide and What to Do

by Eric Yarnell, ND

If you have an elevated PSA level and it has been recommended that you have a biopsy, consider these important tips before you do.

First, it is becoming more and more clear that a prostate MRI should be done before any biopsy. There are several reasons why:

    1. Many MRIs show there is no cancer, and thus a biopsy would be a waste of time.
    2. If an MRI does show a spot that might have prostate cancer, the biopsy can be targeted to that area instead of being somewhat random.
    3. Almost always, this means a prostate biopsy can be limited to just 1–3 samples being taken, instead of the standard of 12 or more.
    4. The MRI can also show other important information such as the size of the prostate, if the seminal vesicles, urinary bladder, lymph nodes, or bones in the area are being affected.

Overall, prostate MRIs help reduce the number of prostate biopsies, which is a very good thing, while providing lots of other information ultrasound-guided biopsies can’t deliver, or aren’t as good at assessing.

It is crucial that the MRI is done on a 3 Tesla strength machine (older MRI machines had 1.5 Tesla magnetic fields and are not sufficient for seeing the prostate). If you have concerns about the contrast material used in MRIs, we have natural therapy options to help counter the low risk of side effects they may cause.

A proper MRI will give what is known as PI-RADs score. This is a standardized assessment of how likely it is that serious prostate cancer would be found on a biopsy. Generally speaking only PI-RADS 4 or 5 lesions should be biopsied, and sometimes even these prove not to be cancer. If there is only a PI-RADS 3 lesion, then usually it means no biopsy is needed and a repeat MRI should be done in a year (almost always without contrast on this follow-up imaging). PI-RADS 1 and 2 lesions never need to be biopsies.

There are other tests Dr. Yarnell can discuss with you as well to help determine if a prostate biopsy is necessary in the first place.

Second, if the MRI shows an issue or a prostate biopsy is going to happen, it is imperative that it be a transperineal, not a transrectal biopsy. Currently over 90% of prostate biopsies are done through the rectal wall, which does provide good and fairly easy access to the prostate. However, this brings with it a quite high risk of infection, including potentially deadly sepsis. This risk is so high, that the entire country of Norway has essentially abandoned transrectal prostate biopsies, and in 2021 the European Association of Urology agreed, saying only transperineal biopsies should be done. In this type, the needle or needles are placed through the skin between the base of the penis and the anus. While a bit more challenging for the urologist, it provides just as good information and is dramatically safer.

Dr. Yarnell can help explain all these options to you, and help advocate with your urologist to make sure you get an MRI when appropriate. If it appears a biopsy is recommended, Dr. Yarnell will help support you getting a transperineal prostate biopsy focusing only on problem lesions, and not a transrectal prostate biopsy or a fishing expedition all over your prostate. Furthermore, he can provide natural treatments to go with the biopsy to reduce the already very low risk of side effects even further.

Some patients are concerned that a biopsy will spread cancer. Two studies have looked into this concern with prostate biopsies. One found that while very rarely you could find evidence of prostate cancer cells in the blood after a biopsy (just 4 cases out of 42 studied). This supports the long-held naturopathic notion that the immune system can take out a few errant cells that might escape during a biopsy. Another study found that in just 2% of prostate biopsies was there any evidence of cancer cells being pushed around inside the prostate by the needle. Given that the rate of prostate cancer mortality has gone down despite the near tripling of the number of prostate cancer biopsies being performed, it is highly unlikely that prostate biopsies cause any significant amount of cancer spread. Again, Dr. Yarnell can recommend some supplements to help reduce this already extremely low risk if you wish.

If you want a forward-thinking doctor who really puts patients first, stays up-to-date on the latest findings, and can implement a science-informed natural approach to prostate problems of all kinds, then call and make an appointment to see Dr. Yarnell.

 

References

Bastacky SS, Walsh PC, Epstein JI (1991) “Needle biopsy associated tumor tracking of adenocarcinoma of the prostate” J Urol 145(5):1003–7. 

Midiri F, Vernuccio F, Purpura P, et al. (2021) “Multiparametric MRI and radiomics in prostate cancer: A review of the current literature” Diagnostics (Basel) 11(10):1829.

Moreno JG, O’Hara SM, Long JP, et al. (1997) “Transrectal ultrasound-guided biopsy causes hematogenous dissemination of prostate cells as determined by RT-PCR” Urology 49(4):515–20.

Wolinsky H (2023) “Death Spurs Country’s Shift to Safer Prostate Biopsies” Medscape Medical News, March 15, https://www.medscape.com/viewarticle/989696