SOLARIS INTEGRATIVE PSYCHIATRY

Ketamine has been safely used as an anesthetic in the US since the 1960s. Since that time, several studies have been done that demonstrate the efficacy of ketamine in treating a variety of mental health conditions. Depression can cause parts of the brain to decrease in size, which impacts memory and cognition, and can affect various other functions of the brain. Ketamine works differently from traditional antidepressant medications. While most typical antidepressants interact with the same few chemicals in your brain, ketamine stimulates the production of a different chemical called Brain Derived Neurotrophic Factor (BDNF). BDNF is a substance that helps the brain to be more efficient and can stimulate brain growth. Additionally, while traditional antidepressants typically require weeks or months to take effect, ketamine has been shown to produce antidepressant effects in the first 24 hours.

Ketamine has been safely used as an anesthetic for decades. At the doses used in the clinic setting, there is minimal risk of respiratory depression or cardiac issues. At Solaris Integrative Psychiatry, you will be under the observation of medical professionals. During treatment, your vital signs, such as blood pressure and oxygen levels, will be monitored several times.

Intramuscular ketamine must be administered under the supervision of healthcare professionals. While there has been a rise of take-home ketamine pills, this and other take-home options are less effective than ketamine injections. Intramuscular ketamine is a more potent form of ketamine, and the medical supervision provided in our clinic ensures your safety.

No. Ketamine may cause sedation, dizziness, or disassociation (feeling disconnected from yourself). In order to ensure your safety, you should not operate any machinery or do anything that requires alertness until the day after treatment.

Ketamine comes in various forms, which can impact treatment cost. At Solaris Integrative Psychiatry, we use intramuscular injections, which requires minimal equipment, thus keeping costs low. Initial Ketamine Package $2299* 6 ketamine treatment sessions Must be used within 4 weeks of first treatment This package is required to initiate treatment *Intake appointment fee is $250. Contact us to inquire about using insurance for this appointment. Add-On Ketamine Package $2099 6 additional ketamine treatment sessions Scheduling of add-on sessions to be determined based on treatment response Add-On Ketamine Treatment $424 Priced per additional session Scheduling of add-on sessions to be determined based on treatment response We offer a $50 discount for packages when using ACH to pay for packages. Discount not applied to individual add-on treatment sessions. Military personnel, emergency responders, and licensed medical professionals receive a 15% discount for all out-of-pocket expenses, including packages. Must be able to provide appropriate documentation to qualify.

At Solaris, we are committed to providing exceptional care and support to each of our patients. We understand that everyone's experience with ketamine treatment can vary. Therefore, we want to ensure that you are fully informed about our refund policy before beginning treatment. We maintain a strict no-refund policy for ketamine treatments, except in rare circumstances where a refund may be warranted due to a severe medical issue. Before starting your treatment, we encourage you to discuss any concerns or questions with our clinical team to ensure you have all the necessary information. Your mental health and satisfaction with your treatment are our top priorities, and we are here to support you every step of the way.

Treatment with ketamine for mental health conditions is not currently covered by health insurance plans. Payment is due by the client at the time of treatment. While ketamine treatment is considered out-of-pocket, you may be able to use your health insurance for your intake appointment, which we require prior to initiating treatment with ketamine. We are currently able to accept the following health insurance plans for intake appointments: Cigna Aetna Colorado Medicaid United UMR Anthem Blue Cross Blue Shield/Carelon Some insurance carriers will reimburse you for certain expenses, even when they won’t pay for the ketamine itself. At your request, we are happy to provide a “superbill” which lists the services provided and the cost you paid out-of-pocket. You can submit this form to your insurance plan for consideration of reimbursement. We cannot guarantee how much you may be reimbursed, if at all.

No. Unfortunately, Medicaid does not have specific billing guidelines for treatment of depression and other mental health disorders using ketamine, and therefore does not reimburse for this treatment. You may have seen clinics advertising that they accept Medicaid clients and bill Medicaid for ketamine treatment. It is up to a clinic's discrepancy to determine whether they use alternative/less standardized billing codes and practices. Our clinic is currently not able to bill Medicaid for ketamine treatment. We are able to accept Medicaid clients for Spravato (esketamine) treatment and would be happy to discuss this option with you!

We offer a $50 discount for packages when using ACH to pay for packages. Discount does not apply to individual add-on treatment sessions. Military personnel, emergency responders, and licensed medical professionals receive a 15% discount for all out-of-pocket expenses, including packages. Must be able to provide appropriate documentation to qualify. Additionally, the add-on ketamine package is discounted, saving a total of $445 over the course of 6 treatments, compared to purchasing 6 individual add-on ketamine treatment sessions.

Ketamine treatments are scheduled for 90 minutes and require a minimum of 60 minutes following administration of the medication. Your treatment time may vary depending on your response to the medication.

We require 6 treatment sessions in a period of 4 weeks an initial treatment. This is to ensure that you receive the most benefit from the medication. To get started with ketamine treatment: You will first have a 60-minute intake assessment during which your psychiatric history will be reviewed. In this appointment, we will work with you to determine which treatment option is best for you. After your intake assessment is completed, we will schedule you for treatment as soon as possible. Each treatment session lasts for approximately 1 hour. The ketamine treatment schedule is as follows: 2 sessions a week for the first 2 weeks 1 session a week for the following 2 weeks Additional sessions for maintenance, as determined by your response to treatment. Many clients need at least 1 treatment every 1 to 2 months during maintenance treatment. After completion of your initial treatment package, ongoing treatment will be individualized based on your treatment response.

Ketamine is a fast-acting medication. Most people will feel the benefits of ketamine during the first session. Lasting improvements are often noticed after one or two treatment sessions with continued improvement over time.

Each person receiving ketamine treatment may have a different experience. The most common sensations that one might experience include: A dream-like state Chilled, relaxed, and/or happy An out-of-body experience Sedated and/or sleepy Changes in thought, vision, and/or speech Nauseated and/or dizzy

The most common side effects of ketamine are nausea and fatigue. We offer anti-nausea medication to treat this potential side effect. In order to minimize this risk, we encourage you to eat a snack or a small meal 2 hours prior to treatment. We also recommend giving yourself time to rest following treatment.

Ketamine therapy is not appropriate for everyone, including: Pregnant individuals or individuals who are planning on becoming pregnant soon Breastfeeding individuals People with active psychosis People with uncontrolled hypertension (high blood pressure) Those with other cardiac diseases may require prior approval from their provider Those with active addiction issues may not be appropriate for ketamine treatment If you are unsure whether you are an appropriate candidate for ketamine treatment, contact us!

Ketamine does not cause physical dependency. At the dosage and frequency provided in the clinic setting, ketamine has not been demonstrated to have any addictive potential.

We accept Colorado Medicaid for Spravato treatment! We are currently able to accept the following health insurance plans: Cigna Aetna Colorado Medicaid United Anthem Blue Cross Blue Shield/Carelon We are unable to accept any Medicare plans, including managed Medicare, at this time.

Esketamine (Spravato) is a reformulation of ketamine that has been FDA approved specifically for the management of treatment resistant depression. Depression can cause parts of the brain to decrease in size, which impacts memory and cognition, and can affect various other functions of the brain. Spravato works differently from traditional antidepressant medications. While most typical antidepressants interact with the same few chemicals in your brain, ketamine stimulates the production of a different chemical called Brain Derived Neurotrophic Factor (BDNF). BDNF is a substance that helps the brain to be more efficient and can stimulate brain growth. Additionally, while traditional antidepressants typically require weeks or months to take effect, Spravato has been shown to produce antidepressant effects in the first 24 hours.

In order to qualify for treatment with Spravato, potential patients must meet the following criteria: 1. Patient Eligibility: - Must be at least 18 years old. - Must be able to provide a history of at least 2 previously tried antidepressant medications - Diagnosis of treatment-resistant depression (TRD), defined as having not adequately responded to at least two different classes of antidepressants (e.g., SSRIs, SNRIs, atypical antidepressants) taken at therapeutic doses for an adequate duration (typically 6-8 weeks each). 2. Prior Treatment History: - Evidence of at least 2 antidepressant trials, medication classes including but not limited to: - SSRIs (e.g., fluoxetine, sertraline, escitalopram) - SNRIs (e.g., venlafaxine, duloxetine) - Atypical antidepressants (e.g., bupropion, mirtazapine) - TCA (e.g., amitriptyline, nortriptyline) - MAOIs (e.g., phenelzine, tranylcypromine) - Documentation of insufficient response to these treatments. 3. Medical Evaluation: - Comprehensive psychiatric evaluation by a qualified provider. - Review of medical history, including any current medications, to assess for contraindications. 4. Safety and Monitoring: - Patients must be monitored for at least two hours post-administration at the clinic. - Assessment of vital signs (heart rate, blood pressure) before, during, and after treatment. 5. Transportation: - Patients must arrange for transportation to and from the clinic, as driving is not permitted for 24 hours post-treatment. -Please be aware that Solaris is unable to assist with transportation. Patients are responsible for arranging their own reliable transportation. If a ride is not available to pick up the patient within 10 minutes of treatment completion, the patient will need to secure a rideshare or taxi service at their own expense. Thank you for your understanding. 6. Medical Contraindications: Patients should not have any of the following contraindications: - Cardiovascular Conditions: Uncontrolled hypertension, history of aneurysms, or severe cardiovascular disease. - Substance Use Disorders: Current substance abuse or dependence. - Psychotic Disorders: History of schizophrenia or other primary psychotic disorders. - Severe Respiratory Conditions: Severe chronic obstructive pulmonary disease (COPD) or other severe respiratory issues. - Pregnancy and Breastfeeding: Not currently pregnant or breastfeeding.

There are several reasons why Spravato may be a preferred treatment options for many individuals: Spravato is FDA approved, which means that many health insurance companies will cover treatment with Spravato. Spravato is a nasal spray, which is administered in the office setting. This is a painless procedure that does not require the use of needles. In a study of the effectiveness of Spravato, nearly 70% of people receiving treatment with Spravato had significant reduction in symptoms and over 50% have no symptoms of depression at 28 days. Individuals who stayed on Spravato as part of their treatment were less likely to experience a return in depressive symptoms.

Spravato is a highly regulated medication. In order for a clinic to administer it to clients, there are several specific safety protocols that must be followed. At Solaris Integrative Psychiatry, you will be under the observation of medical professionals. During treatment, your vital signs, such as blood pressure and oxygen levels, will be monitored several times.

Spravato is approved only for administration in an approved clinic location under the supervision of healthcare professionals. While there has been a rise of take-home ketamine pills, this and other take-home options are less effective than Spravato.

No. Spravato may cause sedation, dizziness, or dissociation (feeling disconnected from yourself). Federal regulations require that you have a ride home after receiving Spravato. In order to ensure your safety, you should not operate any machinery or do anything that requires alertness until the day after treatment.

To be approved by health insurance for treatment with Spravato, you must have treatment resistant depression, which has not responded to at least 2 antidepressants. Each client receiving treatment with Spravato is required to be enrolled in a specialized drug monitoring program. We will assist with the enrollment process. There are specific standards that must be met at our clinic in order to receive Spravato treatment. These include: You must have someone drive you home after each treatment session. Each treatment session is a minimum of 2 hours long. Treatment will only be administered in office. This is not a take-home medication. You must continue treatment with your current psychiatric medication provider. We strongly encourage consistent engagement in therapy sessions.

Spravato is approved by the FDA specifically for treatment of TRD. Due to this specific approval, and the guidelines for providing treatment, many health insurance plans cover this treatment option. Each health insurance plan is different, we are therefore unable to indicate how much you may owe for treatment with Spravato until your insurance plan has approved treatment. Prior to starting treatment with Spravato, and throughout treatment, we will work with you and your insurance plan to ensure that it is covered. You will be provided with information about expected out-of-pocket costs prior to starting treatment with Spravato. Payment for any uncovered portion of treatment, including any copay, is expected at the time of service. We are currently able to accept the following health insurance plans: Cigna Aetna Colorado Medicaid United Health Care

Because Spravato is covered by insurance, we are not able to offer any discounts for treatment. Any copay fees must be paid in full at the time of service.

Spravato treatments are scheduled for 2.5 hours and require a minimum of 2 hours following administration of the medication. This is a federal regulatory requirement for treatment using Spravato.

Treatment using Spravato occurs in 3 phases: Phase 1: Weeks 1-4, 2 treatment sessions per week Phase 2: Weeks 5-8, 1 or 2 treatment sessions a week Maintenance phase: Week 9 and beyond, to be determined by your overall response to treatment. Most clients need 1 to 2 treatment sessions a month in the maintenance phase.

Spravato is a fast-acting medication. Most people will feel the benefits of Spravato during the first session. In fact, in a short-term study, patients using Spravato plus an oral antidepressant demonstrated rapid and superior reduction in depressive symptoms at four weeks compared to individuals taking only an oral antidepressant. Most of the reduction in depressive symptoms was seen at 24 hours.

Spravato treatment is not appropriate for everyone, including: Pregnant individuals or individuals who are planning on becoming pregnant soon Breastfeeding individuals People with active psychosis People with uncontrolled hypertension (high blood pressure) Those with other cardiac diseases may require prior approval from their provider Those with active addiction issues may not be appropriate for ketamine treatment There may be other conditions that exclude you from treatment with Spravato. You can read more here. If you are unsure whether you are an appropriate candidate for Spravato treatment, contact us!

The most common side effects experienced during Spravato treatments are: Dissociation Nausea Dizziness Sedation In order to minimize the risk of nausea, we encourage you to eat a snack or a small meal 2 hours prior to treatment. We also offer anti-nausea medication to treat this. Due to the potential of dizziness and sedation, we recommend giving yourself time to rest following treatment.

Each person receiving Spravato treatment may have a different experience. The most common sensations that one might experience include: A dream-like state Chilled, relaxed, and/or happy An out-of-body experience Sedated and/or sleepy Changes in thought, vision, and/or speech Nauseated and/or dizzy

A Psychiatric Mental Health Nurse Practitioner (PMHNP) is a nurse who has received advanced education (Master degree) specifically in psychiatric and mental health disorders. A PMHNP's role is to assess, diagnose, and treat mental health disorders. This includes authority to prescribe medications to treat mental health disorders. In the outpatient setting, there are very few differences in the types of services that can be provided by a PMHNP versus a psychiatrist (an MD or DO specializing in psychiatry). Alternatively, a psychologist (PhD) differs from both PMHNPs and psychiatrists. The primary difference between a psychologist and a PMHNP or psychiatrist is that a psychologist cannot prescribe medications. While psychiatrists and PMHNPs typically have a stronger focus on medication management during session, a psychologist typically has more background in counseling, behavioral interventions, and psychological testing.

We solely treat mental health conditions using ketamine/esketamine (Spravato). If you are seeking evaluation and/or traditional treatment for mental health conditions, you will need to establish care with a psychiatric provider. Traditional treatment can include psychotherapy, antidepressants, anxiety medications, ADHD medications, etc.

All new clients are required to have a 60-minute intake appointment prior to starting treatment. During this appointment, we will obtain information about your psychiatric past, including diagnoses and treatments that you have tried. At the end of this appointment, we will discuss which treatment is the best option for you at our clinic, and we will begin the process of getting you scheduled for treatments. To schedule your appointment, please contact us.

We require that you have a provider to continue managing your psychiatric medications. We do not need a referral from a primary care physician for treatment.

We do not offer KAP. Many of our clients have already developed relationships with a trusted therapist. We want you to continue that relationship rather than having to establish with a new therapist. Since ketamine has been shown to increase neuroplasticity for 24-48 hours post-treatment, we recommend scheduling therapy sessions with your therapist 1-2 days after treatment.

We treat patients 18 and older in our clinic.

All initial assessments and treatment sessions are by appointment only. To schedule an appointment, please contact us!

Solaris Integrative Psychiatry accepts all major credit and debit cards, including FSA and HSA cards, for services rendered.

Ketamine and Spravato treatment can cause nausea for some individuals. We recommend that you eat a light meal at least 2 hours prior to your treatment. We can provide anti-nausea medication before or during treatment to ensure your comfort.

Ketamine and Spravato treatments are provided in comfortable and private settings. Visitors are not allowed in the treatment room. To ensure the confidentiality of all clients, we are unable to accommodate visitors in the lobby during your session. Please have your ride arrive no more than 15 minutes prior to the end of treatment. Children are not allowed in the clinic.

Please feel free to wear loose and comfortable clothing.

Although ketamine is used in the hospital setting as an anesthetic, the doses used for mental health treatment are significantly lower and are not intended to make you fall asleep. You may experience some mild sedation or fatigue, and you are welcome to nap during treatment

It is not safe to take any narcotics or benzodiazepines on the day of treatment. If you are prescribed these medications, we will provide instructions for your treatment sessions. You also can not drink alcohol on the day of treatment.