Frequently Asked Questions
Ketamine is classified as an NMDA receptor antagonist and was first synthesized in 1962. In 1970 the FDA approved ketamine for use in the United Sates for sedation and anesthesia. The World Health Organization added Ketamine to its list of essential medicines in 1985. Ketamine has been used in anesthesia for decades. It has a demonstrated history of safe and effective use as it does not depress breathing or lower blood pressure. The use of ketamine for depression and pain are considered off-label. This means the drug has been approved by the FDA but not for the specific conditions which we use these medications to treat. Doctors routinely use many drugs off-label to treat patients.
Ketamine works on two main mechanisms in the central nervous system. First, ketamine increases the activity of brain derived neurotropic factor improving the health of neurons (brain cells) and increasing the connection between the neurons which improves the brain’s ability to adapt (neuroplasticity). Second, ketamine blocks the NMDA receptor and stops the activity of over sensitized or wound up receptors. Common medical treatments for depression, pain, anxiety or PTSD often just dull or mask the receptors in the central nervous system and do little to attack the root of the problem. What your system truly needs in order to heal is a reboot to your neurotransmitters, which is what Ketamine Infusion Therapy has been shown to achieve.
No. Addiction has not been found in individuals who receive low-dose ketamine inftision therapy under the care of a medical professional.
No, however, you will need to provide documentation from your primary care, pain specialist, psychiatrist, therapist or surgeon regarding your diagnosis and past treatment. We are serving you as a consulting physician and recommend you continue your regularly scheduled appointments with your primary provider.
Studies and treatment information show low-dose ketamine infusion therapy may provide relief for about 75% of patients with even severe and treatment-resistant symptoms. Many patients know whether the treatments will be effective after the first infusion. For a small minority of patients it may be difficult to notice positive changes after years of depression. For these patients we suggest three infusions before making a decision to continue with treatments. Ultimately, the number and frequency of treatments is variable for each patient depending on such factors as the severity of symptoms, current medications and response to treatment dose.
For appropriate pain conditions, ketamine infusion therapy can be an excellent option. Research and clinical results indicate that ketamine works at the neuronal level to improve their healthy function. If your pain stems from the neuronal level then ketamine can help. We treat a variety of pain conditions including: CRPS/RSD, Fibromyalgia, chronic pain, Cancer pain, Trigeminal Neuralgia, Occipital Neuralgia and Pudendal Pain. The most appropriate ketamine infusion option to treat pain can vary significantly. Generally, you should be able to tell if the treatments will be beneficial after the first infusion. Once established that ketamine infusions are effective for your pain, we will carefully titrate your dose for optimal results.
You should have nothing to eat or drink 6 hours before your scheduled appointment. You can wear your comfortable street clothes the entire time. Once you have arrived at our office, you will be connected to our vital signs monitor in one of our private, quiet and restful treatment rooms. An IV will be placed with a very small gauge needle. We are highly experienced at starting IVs and understand how your condition may make you more sensitive to even a small needle. If necessary, we will numb the area with a local anesthetic prior to starting your IV. You will be continuously monitored during the infusion. The amount of ketamine administered will not cause you to lose consciousness. Patients frequently describe the experience of a low-dose ketamine infusion as floating or “floaty” and may experience mild visual hallucinations and other mild side effects such as sensitivity to light and sound that wear off quickly after the infusion. Most patients tolerate these side effects without discomfort and many report them as pleasant. For a small minority of patients where these side effects are unpleasant, rapid acting medications are given to relieve any discomfort. Remember we will be continuously monitoring you and work hard to avoid any uncomfortable experiences.
We will monitor you for at least 20 minutes following your infusion. (Longer recovery periods are required for infusions greater than 40 minutes). Patients commonly feel tired and report “cloudy thinking” for a few hours following an infusion. You cannot drive, make any major decisions or drink alcohol following your infusion until the next day. So, you must have a driver bring you home after your infusion.
Patients should have nothing to eat or drink 6 hours before your scheduled appointment.
Patients commonly feel tired and report “cloudy thinking” for a few hours following an infusion. Occasionally, it may also cause nausea and vomiting, or a transient increase in blood pressure and heart rate.We pretreat all of our patients with medications to avoid any uncomfortable experiences.
There are a few conditions that would rule out a patient from having a ketamine infusion including: uncontrolled high blood pressure, unstable heart disease, untreated hyperthyroidism, persistent pulmonary issues, seizure disorders, severe glaucoma, active substance abuse, active manic phase of bipolar disorder, and active delusions or hallucinations.
Do not adjust your dose or frequency of use of any medication without first consulting your prescribing physician. Patients taking aminophylline or MAOIs should not have ketamine infusion therapy. SSRIs and Tricyclic antidepressants DO NOT interfere with ketamine infusions. Patients taking large doses of benzodiazepines may have a reduced response to ketamine. This does not mean that you cannot receive ketamine infusions while taking benzodiazepines, but your response may vary and your dose may need to be adjusted.
Reimbursement policies vary widely among insurance companies. Currently, insurance does not cover this therapy. Upon request, we can provide you with a superbill that you can submit to your insurance company. We will also work with you to set up a payment plan.