San Antonio, Texas

Ketamine can be administered by a variety of routes. The two that lead to the most predictable dosing and response are intravenous (IV) administration and intramuscular (IM) administration. The Klarisana model is based on intramuscular injections of ketamine. For the first several years of our company history we provided IV ketamine. In 2020 we did a reevaluation of our operations and switched to an IM model. There were several reasons for this.

First off, the goal of treatment with ketamine in our clinics is very different from how ketamine was used in emergency departments (ED) and operating rooms (OR) traditionally. We are using ketamine to facilitate a powerful transformational experience by leveraging a non-ordinary state of consciousness…commonly thought of as a “psychedelic experience.” The doses we use are much less than what would be used in an anesthesia context and the purpose is fundamentally different. In our setting, we refer to it broadly as Ketamine for Non-Anesthetic Indications (KNAI). This is totally different from using the medication as an anesthetic.

One of the first things we realized is that the process of starting an IV can be traumatic. Many of our patients have significant anxiety to start with. Even the best clinicians will miss IVs. Having one or two missed attempts at an IV can really put a patient in a bad mental space.

The other thing is the way in which the ketamine is delivered. With an IV, the pump starts delivering it at a set rate over an hour. The point of maximum intensity where the patient has a profound experience does not occur until well over half way through the session. When they finally have a powerful experience the session is almost over.

Our protocol is to give two IM injections spaced apart by 10-15 minutes. This allows our patients to achieve the desired effect in the first third of their session. They then have much longer to explore that space and have a more constructive experience. Additionally, they also have more time for the medication to wear off prior to being discharged from the clinic. This increases patient comfort and safety as they are in a much clearer mindset when they leave the clinic.

After the switch to an IM model we published a case series of 40 patients with major depressive disorder. The results are very much in line with (and actually better than) the published literature using an IV based model. In 2022 we performed close to 20,000 IM ketamine sessions with a great deal of success and an excellent safety record.

Our commitment is to make ketamine therapy accessible and affordable to the largest number of patients possible and we are working hard to increase the number of Health Plans we are in network with. Visit our Insurance Page for updates on which new services are covered by our in-network insurance providers.

Klarisana patients are welcome to continue to see our Licensed Mental Health providers for therapy outside of ketamine-assisted psychotherapy. However, Klarisana does not manage medications nor do we prescribe them for our patients. We are a healthcare organization that works very hard to perfect the art of administering ketamine for mental health conditions and chronic pain, as well as providing quality mental health care access.

Although in certain locations we do provide mental health services outside of ketamine therapy, we still work closely with psychiatrists and psychologists in our communities to partner with them to offer a valuable treatment option to their patients. Patients without a psychiatrist or psychologist can still access our mental health providers.

The environment in which ketamine is administered and the experience that a patient has is absolutely vital to increasing a patient’s chance of success. This is not the kind of therapy that lends itself to just being an “add-on” revenue stream for a clinic that has an “extra office.” We do it right and we do it effectively. We feel that the role of the psychiatrist in a patient’s care is vital but there is nothing to be gained from having them present during the actual session. Far from trying to replace or compete with local psychiatrists, we strive to be an effective resource that they can have at their disposal to treat their patients.