Our Services
We provide psychiatric evaluation and treatment to Adults and Adolescents. Our main focus is treatment resistant depression and anxiety conditions such as PTSD, complex PTSD, OCD, GAD, Social Anxiety etc.
We use an individual based and nuanced approach combining therapy and if needed medications. Ketamine or Spravato treatment options are available to appropriate candidates. If you are interested in our services , please schedule an Initial Consultation using Contact Page.
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Ketamine Treatment- 1 hour - $350 unless covered by Insurance
Initial Consultation for patients interested in Ketamine Therapy - $50
General Psychiatry Consultation - fee varies based on Insurance Coverage .
We accept Aetna, Cigna and United Health Care.
Reasons to Chose Our Practice
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Expertise
Dr. Giorgadze opened one of the very first in the US practices specializing in ketamine therapy in 2012. Since then, we have successfully treated thousands of patients. Prior to 2012 Dr. Giorgadze was involved in clinical research on ketamine and es-ketamine for Depression. Because our focus is on ketamine treatment , we are able to work very efficiently and pass the cost savings to our clients, it is also easier to constantly polish and improve the technique of ketamine therapy.
Specialization
It is important that ketamine therapy is integrated with other interventions as part of a comprehensive treatment plan. At our clinic , we combine Ketamine therapy with therapeutic exercises designed to increase connectivity between pre-frontal cortex and amygdala through an FDA approved prescription app-based digital therapy administered via the patient's smartphone device. The app delivers a proprietary , interactive cognitive-emotional and behavioral therapeutic intervention including brief CBT-based lessons to learn and apply key therapeutic skills.
Method
We specialize and focus on infusion (e.g intra-venous administration - IV ) of ketamine as a preferred method of administration. Multiple studies indicate superiority of IV administration of Ketamine. Here is the link to the article discussing this more in depth- study link
While intra-mascular and intra-nasal methods are also viable and require less expertise from the staff administering them, they do not provide the same degree of control, dose adjustment and effectiveness as IV therapy.
Environment
Ketamine therapy is very dependent on mindset and setting of the treatment. It is important that the setting is neither too casual ( IV-spas ) or overly medical.
On the casual side, it is important to note that according to regulations a crash cart must be available on site wherever ketamine is administered. Administration of ketamine requires ACLS certification by staff. Spa settings or IV-therapy centers do not carry crash carts, and are not medically equipped to provide ketamine therapy. On the other end of things , busy and noisy hospital environment or pain clinic with several patients getting treatment in a large room separated by curtains is not private and too overstimulating for a relaxing experience.
Practical considerations
When looking for a treatment center, it is important to have an easy access to scheduling and communication with the treatment team. All patients are seen by Dr. Giorgadze in person during the treatment and have an easy access to physician in between treatments via phone or email.
We can usually schedule a new patient for a consultation within days and can accommodate an urgent treatment request. We also provide treatments on Saturdays.
We work with several insurance companies and assist with billing which minimizes the out of pocket costs.
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Ketamine Therapy advantages
​​Ketamine ( esp. in the form of IV infusion ) is a rapidly acting antidepressant. Recent studies compared the effectiveness of Ketamine IV to ECT ( Electro-convulsive Therapy ). Historically , ECT has been the most effective treatment for Treatment - Resistant Depression. The results of the studies indicate that Ketamine IV therapy is non-inferior to ECT for Treatment-Resistant Depression without psychosis- study link
Most traditional antidepressants do not work for a lot of patients with Treatment-Resistant Depression.
Recent analysis of Star-D trial ( one of the most significant studies with antidepressants) shows that only 35% of patients with Depression achieve remission ( e.g complete resolution of depression ) even after 4 different medication trials- study link
Unlike traditional antidepressants, Ketamine may help address not only symptoms of depression but also underlying causes - e.g unprocessed adverse experiences through life- study link
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Indications
Major Depressive disorder
Chronic Depression
Depression not responding to standard antidepressants treatments
Inability to take standard antidepressants due to side effects
PTSD - post-traumatic stress disorder
Anxiety Disorder
Chronic Neuropathic Pain
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Contra-Indications
Current manic or psychotic symptoms
Hx of psychotic episodes
Current serious substance abuse issues
Intent to get pregnant in the near future
Certain unstable medical problems
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Treatment Protocol
Usually, six initial treatment are recommenced over a period of 3-4 weeks
This may result in complete resolution of symptoms which is called remission
Some patients with severe or chronic depressive symptoms may require additional treatments
Some patients benefit from ongoing maintenance treatment after initial six treatments , frequency is established on a case by case basis and usually tapers off as patients become more stable
Ketamine could be delivered in several different ways . The most effective way is a slow intravenous infusion which provides maximum dose flexibility and control over the experience
American Psychiatric Association advises to receive ketamine therapy in a medical , supervised environment
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Mechanism of Action
Current theory suggests that ketamine treatments when done repeatedly stimulate growth of neurons and connections between neurons - this is called "neurogenesis" and "neuroplastiticty" . This in turn enhances psychological flexibility and ability to adapt
Other mechanisms including psychotherapeutic experiences and increase in meta-cognitive skills are possible

