What to Expect

Whether you’re exploring ketamine therapy, TMS, Spravato, psychotherapy, or medication management, here’s what you can expect before, during, and after each type of care.

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973-270-9881

Request a Consultation

Ask us anything

973-270-9881

Request a Consultation

Ask us anything

973-270-9881

Associations and Accreditations

Overview

Before, during, and after TMS, Spravato, Medication, Psychotherapy and Ketamine

Entering your first appointment can be a confronting experience. We hope to ease your concerns about beginning and continuing your treatment with this guide to understanding each treatment procedure.

Straight to:

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What is ketamine therapy?

Ketamine Therapy

Ketamine has been used traditionally as an anesthetic agent in the medical world. Growing research has demonstrated promising results in managing depressive symptoms by modulating the neurotransmitter glutamate. It is believed that this modulation of neural activity reduces depressive symptoms. It can be administered in different forms: oral, intravenous (IV), and intramuscular (IM).

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Medical screening: It is important to obtain a medical history to ensure there are no significant health factors that may increase the risk of side effects occurring.

Understanding preferences: Ketamine therapy can be invasive. Some clients may be averse to IM or IV and prefer the oral route. Understanding this prior to creating a treatment plan is crucial for creating a comfortable therapy environment.

Oral: Ketamine can be administered as a tablet, capsule, or liquid.

IV: A low-dose ketamine solution is delivered directly into the bloodstream over a set period, typically 40 minutes to an hour.

IM: Ketamine is injected into a muscle, where it is rapidly absorbed with effects lasting 45 minutes to an hour.

Induction phase: This initial phase typically involves more frequent sessions aimed at achieving a therapeutic response. The number of sessions is tailored to each individual based on their clinical needs and preferences.

Maintenance phase: Once a therapeutic response has been achieved, the frequency of sessions is gradually reduced. This phase is also customized to the client’s ongoing response and treatment goals. An individualized treatment plan is developed collaboratively between the clinician and the client.

Side effects: Due to the chemical traits of ketamine, common short-term side effects can include dizziness, headaches, nausea, drowsiness, or feeling sedated.

2-hour monitoring period: To ensure clients do not have serious adverse reactions to ketamine, our clinicians monitor any possible symptoms for around 2 hours following their treatment before they leave the clinic.

Getting home: Due to the short-term side effects of ketamine, clients are not allowed to drive or engage in activities that require a high level of alertness for 24 hours after their treatment. It is required that clients return home with a support person.

A woman is applying a nasal spray to her nose.

What is Spravato?

Spravato

Spravato uses an ingredient that is derived from ketamine, called esketamine. It acts similarly on the glutamatergic system to modulate neurotransmitters that impact depressive symptoms. Unlike ketamine, it is administered through a nasal spray, where the medication is absorbed through the nasal mucosa.

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Medical screening: There are some contraindications for Spravato, and as such, some individuals are not eligible to undergo Spravato treatment for safety reasons.

Selecting dosage: A treatment plan is devised and outlines the frequency of treatment and appropriate dosage. Spravato can be delivered as 56mg or 84mg dosages.

Supervised intranasal spray: Clients are able to self-administer Spravato; however, it is performed in a clinical setting with their medical professional present to ensure medical guidelines are followed for safety purposes.

Induction phase: For the first 4 weeks, clients undergo 2 sessions each week.

Maintenance phase: After the initial stage, where clients generally notice the most change in symptoms, the frequency of sessions can decrease to once every week or once every 2 weeks as per their needs and preferences.

2-hour monitoring period: To ensure clients do not have adverse reactions to Spravato, our clinicians monitor any possible symptoms and measure blood pressure before they are cleared to leave.

Getting home: Due to the short-term side effects, clients are not allowed to drive or engage in activities that require a high level of alertness for 24 hours after their treatment. It is required that clients return home with a support person.

A woman is sitting in a dental chair while a dentist holds a machine.

What is transcranial magnetic stimulation (TMS)?

Transcranial Magnetic Stimulation

TMS is a brain stimulation technique that can increase or decrease neural activity in targeted regions of the brain. This is achieved with cutting-edge technology that delivers magnetic pulses to the brain, non-invasively and painlessly.

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Medical screening: Although TMS is non-invasive and generally a safe technique, there are some contraindications that prohibit some individuals from undergoing treatment. For instance, people with a history of epilepsy will be carefully evaluated before being approved for treatment.

20 minutes of stimulation (shorter protocol options are available): Clients are able to relax in a comfortable reclining chair during the TMS session. They are provided with ear plugs as TMS devices create intermittent loud clicking sounds, similar to MRI machines. Our TMS rooms have large windows with a relaxing nature view or clients can watch from a selection of curated TV programming.

Tingling sensation: TMS is not known to cause pain, however, clients may experience tingling of the scalp, which may be an unusual, novel sensation at first but is not indicative of an adverse reaction.

Muscle twitching: The magnetic pulse that activates neural tissue is also capable of activating other types of excitable tissue, such as muscle fibres. As such, muscle fibres that are within the range of the magnetic pulse can be activated as well. Clients may experience twitching of muscles in the head, jaw, or neck, however, this is not painful, although it may be unexpected.

Resuming daily activities (immediately after each session): TMS does not involve altering consciousness in any capacity. Clients are free to drive home and resume their daily schedules as usual.

Scalp discomfort/headaches (immediately after each session): After each treatment session, some clients report discomfort on the scalp at the site of stimulation or mild headaches; however, it is easily managed with over-the-counter pain relief. Importantly, most clients report that this effect dissipates over the course of treatment.

Maintenance sessions (long-term): After a single course of treatment, clients generally report a significant reduction in symptoms. However, over time, some individuals may experience a recurrence or increase in symptoms. In these cases, undergoing maintenance courses of TMS can be extremely beneficial for long-term symptom management.

A man and a woman are sitting in chairs talking to each other.

What is psychotherapy?

Psychotherapy

Psychotherapy, colloquially referred to as talk therapy, is a treatment that is founded on exploring one’s emotional, behavioral, and cognitive patterns. With support from compassionate and skilled therapists, you can develop coping mechanisms to manage mental health symptoms.

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Understanding the client: Developing a positive, compassionate connection between the therapist and client is highly valuable for the therapy process.

Developing treatment goals: Identifying what clients are aiming to achieve through therapy is crucial to having meaningful appointments that help the client see results.

Address the root of mental health symptoms: Together, the client and therapist may explore the lasting impacts of previous experiences or current adversities that contribute to their current mental states.

Exploring the connection between behavior, cognition, and emotion: Collaborative discussions allow clients to gain insight into their mental states and increase their self-awareness. This can aid them in understanding what stressors may trigger them and how to avoid adverse reactions.

Developing coping mechanisms: Clients develop skills to cope with a variety of things, from triggers to negative thought patterns to emotional dysregulation. This may involve breathing techniques, mindfulness, journaling, exercising, replacing maladaptive behaviors, and more.

Implementing newly acquired coping strategies: Translating the skills learnt during therapy sessions to everyday life can be a difficult transition. This is the ultimate goal we work towards with our clients to support them in maximizing their quality of life.

A bottle of pills and a tray of pills on a white background.

What is medication management?

Medication Management

Psychiatric medication has a long-standing history in the treatment of mental health disorders. Nonetheless, ongoing scientific developments enable pharmaceutical options to expand, providing clients the best chance of symptom relief.

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Assessing your needs: Understanding the therapy goals and symptom profile of the client is a key step to selecting the right medication.

Evaluating your medical history: This is a necessary step to ensure safety. Comorbidity of medical disorders may eliminate certain classes of medication due to possible exacerbation of symptoms or adverse reactions.

Understanding potential risks: Like all treatments, psychiatric medication can be associated with side effects. It is important for clients to understand any risks before beginning treatment

Prescribing medication and dosage: The psychiatrist will prescribe clients a medication that aims to address their symptoms at an appropriate dose.

Monitoring side effects: To ensure safe, effective treatment, it is crucial to monitor side effects. This helps clients and psychiatrists to understand whether the medication is beneficial or incompatible.

Discontinuing medication: Some clients may choose to continue medication indefinitely. However, others may find it more fitting to take medication according to their environmental factors. For instance, when faced with stressors or adversity, this may be the appropriate time to take their medication. The decision to discontinue medications should be a collaborative decision made after the client and psychiatrist discuss the risks and benefits of stopping treatment.

Changing medication: Clients who find their medication incompatible or ineffective may choose to try alternative options that may prevent possible adverse reactions or have stronger effects.

Follow-up appointments: For those who find treatment effective and remain on medication, psychiatrists may overtime reduce the frequency of visits to bi-annual or quarterly check-ups to ensure maintenance of symptoms is going smoothly.

Your Next Steps

We hope that this guide has provided you with some clarity on how mental health treatments are carried out. We understand that navigating your mental health journey can be a daunting or tiring task. We welcome you to reach out to us! Book a consultation to explore your options and follow the pathway to living a fuller life.

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