Frequently Asked Questions:
Ketamine is an anesthetic medication developed in the 1960s and has been in use throughout the world since its discovery. Ketamine has a broad range of clinic applications, including procedural sedation in the emergency room and as an anesthetic during major surgery. More recently, researchers have found Ketamine to be a remarkable drug for the treatment of many mental health and chronic pain conditions.
Both mental health and chronic pain conditions are associated with abnormal signaling pathways in the central nervous system. Ketamine acts by repairing these communication pathways, thereby mitigating and/or reversing the negative neurochemical effects of disorders such as chronic pain and severe depression.
A typical Ketamine infusion begins with placement of an IV catheter by an experienced provider. Next, monitors that record your vital signs such as blood pressure and oxygen saturation are applied. Ketamine is then delivered slowly at a precisely calculated, sub-anesthetic dose over a period of about 40 minutes. After the infusion is completed, there is a 20 to 30 minute recovery period. The total experience, from check in to check out is approximately 90 minutes per infusion session.
Most patient’s that receive Ketamine treatment, depending on the indication, notice immediate symptom improvement during the infusion, but many experience marked symptom improvement within a day of treatment.
A complete course of Ketamine infusions (6 infusions over 2 weeks) can provide symptom relief that lasts from weeks to months. Patients then intermittently require a single booster infusion when the effects of treatment are wearing off, restoring symptom relief.
Your response to the first two Ketamine infusions will allow us to determine if you are a Ketamine responder (approx. 70% of patients are responders). If your results are positive, we recommend a TOTAL of 6 infusions over the course of 2 weeks. The effects of Ketamine may start to wear off after weeks to months and, a booster infusion is typically scheduled to maintain response. The total length of treatment is highly individualized based on each patient’s particular needs and symptomology. We will work closely and in conjunction with your primary care physician and mental health provider to provide you with the best care possible.
Certain drugs can interfere with the effectiveness of Ketamine. These drugs include both prescription and recreational drugs. Please refrain from consuming alcohol 48 hrs prior to and after treatment. Patients that are on benzodiazepines (i.e. Alprazolam, Lorazepam, Clonazepam) are strongly recommended to wean/discontinue these medications to ensure that optimal therapeutic response from Ketamine will be acheived.
Side effects from Ketamine infusions are limited to the time period of the infusion and recovery, after which time patients return to baseline. Side effects include elevated blood pressure, mild nausea, vivid dreams, salivation in addition to others. Symptoms can be controlled by adjusting Ketamine dose to balance side effects with therapeutic effectiveness.
Screening consultations are free of cost and are generally done over the phone and include detailed review of your medical and psychiatric history to ensure you qualify for Ketamine therapy.
The cost for mental health treatments are $500 for each infusion including booster/maintenance infusions. The cost for pain treatments range from $800-$1500 depending on the pain condition being treated. Pain conditions such as complex regional pain syndrome, chronic neuropathic pain, and trigeminal neuralgia may be alleviated by way of Ketamine therapy but require longer infusion durations when compared with infusions for mental health disorders.
Currently, Ketamine infusion therapy is not covered by insurance carriers. However, each insurance carrier is different, and we encourage you to discuss coverage with your insurance company. With the growing body of evidence supporting the utility of Ketamine therapy, we believe FDA approval and insurance coverage for Ketamine therapy is on the horizon.
You will fill out mental health symptom scales and screening scales prior to the first treatment, approximately 24 hours after each infusion, and 1 week after the completion of infusion series. This will help determine response. It is possible to notice effects as soon as 40 min after the infusion, most typically starting 2-4 hours later, but sometimes taking up to 24 hours. You should not expect to wake up feeling “perfect and overjoyed”, but rather there should be a noticeable difference in feeling more hopeful, less sad, decreased thoughts of suicide, increased calmness, “weight” of depression lifted, or more inclined to engage with people. Further improvements are often seen over the course of treatment and with a multi-disciplinary treatment team including primary care physicians, psychiatrists, psychologists, and pain management specialists.
The most effective route for Ketamine administration is through slowly titrated intravenous administration. The bioavailibility of Ketamine is significantly reduced through the oral route given it’s extensive first-pass hepatic metabolism. We do not prescribe Ketamine outside of the clinic setting.
Like many other prescription medications, Ketamine has the potential to be abused. However, when administered at low doses, under supervision and without access to the medication at home, there is little to no potential for addiction or abuse.
Anyone with a history of unstable heart disease or blood pressure, untreated thyroid/endocrine problems, active substance abuse, manic phase of bipolar disorder or active psychotic symptoms.
We encourage all patients to maintain close contact with their primary care provider and psychiatrist before, during and after a course of Ketamine treatments.
Approximately 70% of people respond to Ketamine infusions.
Relax and take in the infusion experience. Some people find it helpful to listen to music during their infusion, while others just relax and close their eyes during the infusion.