Depression is the most common mental health disorder in the United States and worldwide. Over 15 million Americans have a major depressive episode each year, and it is estimated that depression affects 300 million people worldwide. Studies have shown depression is twice as common in females compared to males. Depression and pain frequently occur together. Pain symptoms are present in 65% of depressed patients. Depression is the leading cause of suicide in the United States. Whether a decades-long fight, or recent-onset symptoms, depression can be profoundly life-altering. It is associated with increased risk of mortality, lower productivity, and high risk for developing other medical conditions and mood disorders. And when you’re struggling with depression it can be terrible – hard to get out of bed, hard to get things done, and hard on your relationships.
Effective treatments for depression can be difficult to find and some can take 6 to 8 weeks to begin alleviating symptoms. Depression treatment has traditionally consisted of medications, psychotherapy and electroconvulsive therapy (ECT). There are many types of anti-depressant medications prescribed. Unfortunately, many of these have substantial side effects including agitation, nausea, headache, difficulty sleeping and sexual dysfunction. Of the 15 million Americans who seek treatment, 30 to 40% will not get better with these traditional therapies. Fortunately, researchers have found better treatments and there have been multiple promising studies using ketamine infusion therapy for depression.
Starting in 2000 a study published by Yale University showed ketamine to be a rapid, effective treatment for depression. Additional studies by the National Institutes of Health, the Veterans Administration, Harvard and Mount Sinai School of Medicine have all shown that ketamine is an exceptional treatment option for depression, even when other treatment options have not worked. Ketamine can often relieve the negative symptoms of depression within a few hours for a large portion of those who receive the treatments.Even for patients with the most treatment-resistant and severe symptoms – often helping those who have been suffering for decades. Studies typically show between 50% and 80% of patients receive clinically significant results from even one ketamine treatment.
The most appropriate infusion option to treat psychiatric symptoms, including depression, is typically a one-hour low-dose infusion. This includes 40 minutes of active infusion and a 20-minute active recovery before being released to go home. In total, patients spend about an hour and a half with us at each visit.
The low-dose infusions typically start around 0.5mg/kg/hr and may be adjusted to the response of the patient. Patients frequently describe the experience of a low-dose infusion as floating or “floaty” and may experience mild visual hallucinations and other similar mild side effects that wear off quickly after the infusion. We work hard to avoid any uncomfortable experiences. Although serious side effects are unlikely, we provide physician administration, continuous monitoring, safety equipment, and protocols consistent with best practices for the procedure and with the Alabama Medical Board Codes for office-based anesthesia.
A series of infusions followed by maintenance treatments provide greater and longer-lasting relief – with each subsequent infusion in a series building upon the last. We often start with a series of 6 infusions, administered once or twice a week, over several weeks. The initial series is followed by maintenance treatments as needed. Maintenance treatments often start about every 3 to 5 weeks. Over time we work with patients to extend the length of time between these infusions.
Ultimately, the number and frequency of treatments is variable from patient to patient depending on such factors as the severity of the symptoms, the other medications a patient may be on, and the patient’s response to the treatments.