Is Psychedelic Assisted Therapy Right For Your Patients?

Referral Form

It could be appropriate for your patient if:

  • Diagnosed with ADHD, alcohol or substance use disorder, major depressive disorder, PTSD or complex PTSD

  • Struggling to have a shift in perspective or have not noticed lasting change

  • Suffering from anxiety, depression, suicidal ideation, or trauma

  • Tried other routes to heal and nothing is working

  • Tried psychotherapy and pharmaceuticals to no success

  • Willing to lean into the unknown areas of the mind with support

It is not appropriate for your patient if:

  • Under 18 years old

  • Pregnant or breastfeeding

  • Depending on psychedelics to be the defining difference

  • Have a diagnosed seizure disorder (especially if taking Lamotrigine or Lamictal)

  • Have a mental health disorder causing psychosis, mania, schizophrenia, or delusional disorder

  • Have experienced any of the following: aneurysm, COPD, emphysema, heart failure, hepatic cirrhosis, intracranial hemorrhage, lung fibrosis, ocular hypertension, renal failure, severe asthma, urological issues with bladder

  • Have hypersensitivity to ketamine

  • Have moderate to severe cardiovascular disease

  • Have not tried psychotherapy or pharmaceuticals for treatment. Preferably both options have been exhausted

  • Have uncontrolled or unstable hypertension

  • Rely on ADHD medication or Bupropion (Wellbutrin); medications need to be held the day of treatment

  • Unable to reach sobriety for at least 7 days

Treatment Results

Source: Roots to Thrive. Cohort 1, 2, and 3 Combined Quantitative Results. The enclosed data includes the participants who screened positive for PTSD, depression, or generalized anxiety disorder upon entry into the RTI-KAT program. The pre-results were taken within 1 month of the program beginning and post-results were taken directly after the 12-week program was completed. If data was missing, it was not included.

Current Evidence

Bipolar Depression

Possibly linked with significant improvement of depressive symptoms in individuals with treatment-resistant bipolar depression which continued for 3 days.

Chronic Neuropathic Pain

May be a reasonable pain reduction treatment for refractory chronic neuropathic pain in ambulatory outpatients.

Complex Regional Pain Syndrome (CRPS)

Moderate evidence to support pain parameter improvement for up to 12 weeks.

Major Depressive Disorder (MDD)

Associated with significant reduction of depression severity and improvement in depressive symptoms starting within 2 hours after administration until day 14.

Other Pain Conditions

Regarding conditions like fibromyalgia, cancer pain, and headaches, weak or no evidence for immediate improvement of pain post intravenous administration.

Post Traumatic Stress Disorder (PTSD)

Reported significant reduction in severity of PTSD when assessed 24 hours post-infusion.

Suicidal Ideation

Evidence exists for reduced suicidal ideation in patients with major depressive disorder (MDD), bipolar depression, cancer, and other conditions within 24 hours to 14 days.

Traumatic Spinal Cord Injury Pain

Weak evidence to support short-term reduction of traumatic spinal cord injury pain for up to two weeks.

Source: CPSA Indications of use for Ketamine—Clinical Toolkit