Dr. Kyle Greenway discusses his Montreal Model for ketamine-assisted therapy, highlighting the need for active therapy alongside ketamine. The podcast explores diverse effects of ketamine, differences between ketamine and esketamine, contraindications with GABA agonists, and tapering off benzodiazepines during therapy.
Dr. Greenway stresses the importance of setting an end date for ketamine therapy and mandatory therapy alongside treatment.
Communication about potential ketamine experiences should be balanced, avoiding extreme views, and promoting a nuanced understanding.
Deep dives
Approach to Ketamine-Assisted Therapy by Dr. Greenway
Dr. Greenway's approach to ketamine therapy focuses on addressing challenges faced by patients, such as the need for chronic maintenance therapy. He emphasizes setting an end date for ketamine use, making therapy mandatory alongside ketamine treatment, and tapering off benzodiazepines before starting ketamine to enhance its effectiveness and reduce potential interactions.
Discussion on Ketamine Experience and Patient Communication
The discussion highlights the importance of managing patient expectations about the ketamine experience. Dr. Greenway advises against extreme views of ketamine, balancing descriptions of potential experiences like dreaming, dissociation, and emotional changes. He emphasizes the need to communicate openly and avoid pathologizing experiences, promoting a nuanced understanding of the possible effects of ketamine therapy.
Treatment Implementation and Considerations
In implementing ketamine therapy using the Montreal Model, Dr. Greenway emphasizes integrating behavioral work and psychotherapy with ketamine dosing. He recommends maintaining psychiatric medications during treatment, with a focus on behavioral changes rather than long-term ketamine reliance. The therapy structure includes a period of active dosing followed by continued psychotherapy sessions, aiming for sustained improvements beyond ketamine treatment.
Chris Aiken, MD and Kellie Newsome, PMHNP have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.
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