Dr. Grande practices family medicine and addiction medicine at Pioneer Family Practice in Lacey, Washington. She is an early adopter of clinical use of ketamine in the sub-dissociative dose range, at which patients self-administer daily a minimally detectable dose of ketamine orally or sublingually, continuing in some cases for many years. She has treated nearly 700 patients since 2012 for chronic and acute pain, depression and acute suicidality, anxiety, dementia, and as an adjunct to buprenorphine for patients with opioid use disorder. At the January 2025 ASKP3 annual meeting, she and two colleagues presented 11 novel applications of sub-dissociative dose ketamine.  

Dr. Grande has four ketamine-related publications, with four additional research projects underway. Her medical degree is from the University of Washington School of Medicine, where she is a Clinical Associate Professor in the Department of Family Medicine.  

In this session she will briefly provide data and examples of ketamine’s benefits for various applications, and then turn to issues in clinical use of sub-dissociative dose ketamine including patient selection, initiation strategy, patient counseling, patient monitoring, adjusting dose to optimize benefit and minimize adverse effects, and recognizing when a patient may benefit from advancing to the dissociative dose range.