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Frequently Asked Questions

IV Ketamine assisted Psychotherapy treatment:

Over the years of clinical investigation and routine use in sedation, sub -anesthetic dosages have been found to be most effective at promoting mood recovery, while at the same time minimizing side effects. The intravenous method delivers sub anesthetic dosages more reliably than oral, nasal or intramuscular methods.

The basis of benefit is neuroplasticity, a lasting reprogramming of neural circuits that ketamine promotes. For the beneficial reprogramming effect to be sustained, it is important for the patient to have both sustained exposure to the influence of the medication and to learn new cognitive and behaviour approaches to address negative mood states.

From arrival at the clinic to meeting criteria to go home the time may vary depending on the person and the dosage in a session. However, most patients are able to complete the cycle in less than two hours.

In session hypertension and a mild dissociative state may occur. The frequency of each of these most common side effects is approximately 30%. Most patients do not require medication for these symptoms and side effects rapidly dissipate, often within 5 minutes after discontinuing the infusion. This is another reason why we prefer the intravenous method.

Cardiovascular conditions such as accelerated hypertension, unstable angina, aortic or cerebrovascular aneurysm may be worsened by the acute effects of ketamine and are considered contraindications for the treatment in professional guidelines and in drug precautions and warnings from the manufacturer.

Guidelines recommend that patients should decrease doses of drugs in the sedative, anxiolytic and hypnotic categories such as lorazepam (Ativan), zopiclone, zolpidem (Imovane, Ambien) as well as medical cannabis.

Although ketamine has been used successfully in some centres for the treatment of alcohol dependency or abuse, best results will be achieved if the person can maintain abstinence from alcohol for at least 40 days.

Dr. Cooper can prescribe medications to support abstinence, but if you are currently alcohol dependent you must have a medically supervised detoxification with the support of your family physician or other practitioner.

Our guidance is to refrain from these activities for at least 24 hours after a treatment session.  We recommend that post session you spend the time reflectively and restfully.

The initial treatment cycle costs $ 750.00 per session, included in this price is the in-person psychotherapy session.

Referral Process:

Your family doctor or treating specialist can refer you to the clinic.

You may also refer yourself to the clinic, however, we will require contact information for your family doctor so we can access your complete health records to make an informed decision of optimal treatment plan for you.

The profound impact of ketamine on the most severe and resistant mood disorders is a testament to its power to reprogram or refresh long established patterns in the nervous system. Because of this, it is crucial to give the treatment only to people who will benefit.

Improper patient selection for ketamine treatment may equally have long term negative consequences! An expert and nuanced review of indications is required, and this can only occur in a medical consultation model with a proper referral.

From a regulatory perspective, Caledon Clinic is accountable to the College of Physicians and Surgeons of Ontario and the medical consultation model is mandatory for treatment.

First, we pre-screen your referral for anesthetic considerations which may require some optimization before you can receive treatment. Next you will have a consultation with Dr. Cooper to assess your current mood state, and the treatments you are currently using. A detailed history of antidepressant medications (or others) will be required. It is very helpful if you can provide pharmacy summaries that address the six months prior to your consultation. Once we have assembled all the data and assessments from the consultation visit these will be communicated to Dr Babani

The time from referral to treatment varies depending on factors relating to you or to our clinic caseload status. If all the criteria above have been met the wait time can be as short as two weeks.

Cannabis

The main differences are in a person’s motivation for use of cannabis;

1) symptom control versus merely to feel a change in consciousness

2) medical pharmacology principles are applied in selecting minimum effective dose for a person’s symptoms so that it does not produce a significant cannabis drug effect, which would reduce the overall benefit to the person versus a deliberate goal of producing impairment

3) safe methods of administration only are chosen to administer cannabis for treatment.

Finally, to achieve the optimal effect from medical cannabis a physician’s consultation explores co-existing medical conditions and pharmacology and finds methods of finding positive drug interactions and opportunities for non-medication treatments to increase the benefit.

The 2017 National Academies of Science Medicine and Engineering publication “ The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research” identifies evidence-based indications:

1) chronic non cancer pain

2) chemotherapy associated nausea and vomiting,

3) muscle spasm in multiple sclerosis and

4) refractory epilepsy.

Please follow the links from our call to action button. We are a specialist consultation clinic and we require a doctor to doctor referral to conduct the consultation within the payment for service structure.

No, the consultation is a service for which payment comes from the Ontario Ministry of Health and Long Term Care.

The cost of medical cannabis products is not reimbursed by third party payers, except for (exceptional circumstances)an existing WSIB claim. Patients with access to ODSP benefits can receive support for the pharmaceutical cannabinoid nabilone.

The doctor will issue a medical document that specifies a daily amount , which allows the holder to possess a greater mass than is legally permitted for anon-medical use. Licensed producers will supply the cannabis to the patient, usually via an online ordering portal.

The doctor will specify treatments for your symptoms that specify product types, doses, routes of administration and when you should use medical cannabis for your symptoms.

There is no standardization in nomenclature or batch to batch potency for many cannabis products, when comparing one licensed producer to another.

Many products are nearly equivalent chemically but despite this it is hard for a patient to be confident in selecting medication unless there can be a specific recommendation from the doctor.

Further, even when a specific recommendation is made, the patient may find the recommended medication is not available when they try to order it from a licensed producer.

These problems are addressed for the most part by choosing Medical Cannabis by Shoppers as the initial Licensed Producer. There is no financial relationship between Caledon Clinic and Medical Cannabis by Shoppers.

Patients may seek to reduce the cost of medical cannabis by growing their own medication. The clinic will assist you with the application to Health Canada’s regulatory process.

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