Ketamine Therapy
in Reno, NV
Ketamine here is not a standalone infusion. It is a precision neuroplasticity catalyst - Phase 4 of a structured six-phase biological preparation protocol authored by Josh Swigart, APRN, PMHNP-BC, KRI Fellow.
Every patient is biologically prepared - advanced labs, cortisol normalization, inflammatory workup, and objective brain-function testing - before a single milligram. That preparation is what separates a sustained response from a temporary mood shift.
Josh trained directly under Dr. Gerald W. Grass, MD - founder of the Ketamine Research Institute (Sarasota, FL), former Yale Anesthesiology faculty, and a clinician who has used ketamine therapeutically since 1998.
Plasma ketamine is tracked in real time - nanograms per milliliter, by the minute - keeping you in the targeted therapeutic range all session. Dosing follows pharmacokinetic modeling calibrated to you, not generic weight-based dosing. Precision isn't a feature here - it's the clinical standard.
6
PHASE CLINICAL PROTOCOL
72 Hrs
INTEGRATION & CONSOLIDATION WINDOW
Since 1998
THERAPEUTIC KETAMINE LINEAGE
“The ketamine infusion is Phase 4. Phase 4 cannot do what Phases 1 through 3 have not yet made possible. Biology comes first - always.”
The Mechanism
Ketamine acts on NMDA receptors to rapidly raise Brain-Derived Neurotrophic Factor - triggering synaptogenesis and restoring circuits that chronic stress and inflammation degrade. Measurable in hours, not weeks.
The Approach
Every ketamine series is preceded by biological preparation addressing the six root-cause drivers of treatment resistance - confirmed by objective laboratory and neurophysiological data, not assumption.
What This Is Not
No walk-in ketamine. No one-size dosing. No infusion without investigation. A complete biological workup and an active clinical relationship come first.
Four Pillars of the Protocol
1
Candidacy & the Biological Gate
Candidacy is determined by biology, not diagnosis alone. Labs, cortisol and inflammatory markers, hormonal status, and a neurophysiological baseline (Brain Gauge + WAVi EEG) determine readiness, and HPA-axis normalization is confirmed before ketamine begins. Pregnancy, active psychosis, and unstable cardiovascular status are absolute contraindications; certain mood-stabilizing medications require evaluation and coordination first.
2
Pharmacokinetic Dosing, Calibrated to You
Dosing uses pharmacokinetic modeling calibrated to the individual - a more biologically appropriate method than generic weight-based dosing. Plasma ketamine is monitored in real time, in nanograms per milliliter by the minute, holding you in the targeted therapeutic window and allowing session-by-session titration to measured response.
3
Integration & Consolidation Window
The 72 hours after each infusion are the highest-value window of the protocol - and we actively manage it. Biological co-deploys, plus support for slow-wave sleep and mitochondrial energy, protect the synaptogenesis window ketamine opens. This is where clinical gains are encoded or lost.
4
Objective Measurement & Response Tracking
Response is not self-reported alone. We track a validated psychiatric battery - PHQ-9 and the Beck Depression and Anxiety Inventories (BDI/BAI) - alongside Brain Gauge cortical processing (eight domains, 0–100) and WAVi EEG (P300 amplitude and latency, peak alpha frequency, brain age index, theta/alpha/beta analysis). These define your baseline and track change, session to session, series to series.
How We Work Together
Josh Swigart, APRN, PMHNP-BC, KRI Fellow
Trained directly under Gerald W. Grass, MD, founder of the Ketamine Research Institute and former Yale Anesthesiology faculty.
F.A.Q.
Typically treatment-resistant depression (two or more adequate antidepressant trials without full response), PTSD with significant functional impairment, or complex presentations where conventional care has fallen short. Candidacy is determined biologically - labs, neurophysiological data, and biological driver findings all inform it. A comprehensive evaluation is required first.
No. The six-phase framework is a clinical architecture, not a mandatory sequence. Your evaluation determines which phases apply and in what order - some patients enter the ketamine series earlier, others need more preparation.
You receive IV ketamine in a monitored setting, with plasma concentration tracked in real time (nanograms per milliliter, by the minute) to hold the therapeutic window. Specialized medications and biological cofactors are given beforehand, and vitals and clinical status are monitored throughout in a calm, supervised environment.
There is no single answer - locking in a count before a proper evaluation is assumption, not biology. Your series length, and whether maintenance is indicated, is guided by clinical response measured with validated scales and objective neurophysiological data.
Yes. Absolute contraindications are active psychosis, pregnancy, and unstable cardiovascular conditions. Certain mood-stabilizing medications require careful evaluation and coordination first. A complete medication and medical history review is part of every evaluation.
A ketamine clinic provides infusions; this practice provides a protocol. Real-time plasma monitoring, validated rating batteries, objective neurophysiological tracking (Brain Gauge + WAVi EEG), and an original six-phase framework are the standard of care here - not features found at most infusion clinics.
In most cases, yes. The default is to continue your current medications unless there is a direct pharmacological contraindication. Interactions are reviewed during your evaluation, and no changes are made without clear clinical rationale.
Objectively - not just by how you feel. We use PHQ-9 and the Beck Depression and Anxiety Inventories (BDI/BAI), plus Brain Gauge cortical processing (eight domains, 0-100) and WAVi EEG data, compared to your pre-protocol baseline at every touchpoint. The goal is measurable, documentable change.
Care Designed Around Recovery - Not Reimbursement
We’re not here to navigate insurance loopholes or fight for approvals.
We’re here to help people heal.
Our practice is built on a direct-pay model that puts patients first:
.png)
No Middleman
No insurance, no prior authorizations, no delays.
.png)
Direct-Pay Model
Transparent pricing. Upfront clarity. Zero guesswork.
.png)
Your Time Matters
Faster access to care. More time with your provider.
This is care that’s built for results, not for reimbursement.
When the system wasn’t built to help you heal, we built our practice to do exactly that.
Begin with a clinical evaluation.
Ketamine starts with your biology, not the infusion.
Every treatment plan begins with understanding your full picture. Request an evaluation with our team to determine if ketamine therapy is right for you.
Comprehensive Clinical Review
.png)
Personalized Treatment Roadmap
Evidence-Based Recommendations
Ketamine isn’t a one-size-fits-all solution.
It’s a powerful tool when used with precision.
This page is educational and is not a diagnosis or a substitute for individualized medical advice. If you are in crisis, call or text 988, call 911, or go to your nearest emergency department.
