Ketamine Infusion Therapy FAQs
Ketamine was first synthesized in 1962, and quickly gained notoriety as a “dissociative anesthetic” that could be used safely on the battlefields of Vietnam to treat wounded soldiers without compromising their ability to breathe well and maintain a good blood pressure.
Since then, ketamine’s use has become a staple in ambulances, emergency departments and operating rooms across the country, and is particularly useful for procedures in the pediatric population given its unique properties.
In fact, ketamine’s safety and effectiveness profile is so good it is on the World Health Organization’s List of Essential Medicines. Only those medicines that are most effective and safe make it to this list.
Ketamine works on a number of brain chemicals (neurotransmitters including NMDA, and BDNF – brain derived neurotrophic factor) and receptors. Ketamine also appears to be an opioid receptor agonist (stimulates opioid receptors), which may account for its effectiveness in treating pain disorders and also provides benefits for mood disorders. (IF YOU ARE TAKING OPIOID BLOCKING MEDICATIONS SUCH AS NALTREXONE IT MAY INTERFERE WITH THE EFFECTIVENESS OF KETAMINE TREATMENTS- please discuss this with your doctor)
Ketamine’s rapid effects appear to be related to its ability to form new brain nerve connections (receptors and synapses, vital connections between brain nerves- neurons). Research has shown that a lack of these connections is associated with major depression and other mood disorders.
More than 70% of people treated for depression with Intravenous Ketamine infusions have a significant reduction in depressive symptoms (even the people with difficult to treat depression who had minimal or no response to antidepressants).
No. As with all chronic illnesses such as hypertension, diabetes and others, we have no cures for depression but we do have effective treatments, Ketamine infusions being one of the most rapid and effective. Many people experience weeks or months of improvement of their depressive symptoms after a ketamine infusion series and may require periodic “booster” infusions thereafter. Each person’s need for this is quite variable and treatment is tailored to your needs. (People often have booster treatments on average every 4 weeks)
Ketamine has been used at very high doses, illegally obtained for recreational use. It can be misused on the streets and is often referred to as “Special K” that sends its users into a psychedelic “K-hole”. The doses used for depression and pain treatments, however, are much lower. Using ketamine in a clinical setting, such as ours, under the careful supervision of our highly trained practitioners, there is little risk of addiction occurring but a great opportunity to have your depression fully treated.
Yes, used as an “off label treatment”- non-FDA approved treatment.
In a recent study published 2/1/2020 in the American Journal of Psychiatry, a single infusion of ketamine combined with motivational enhancement therapy significantly increased the likelihood of abstinence, delayed the time to relapse, and reduced the likelihood of heavy drinking days … Infusions were well tolerated, with no participants removed from the study as a result of adverse events.
Two published studies have demonstrated that ketamine is effective in treating opioid use disorder. Krupitsky et al. conducted a randomized controlled trial of 70 heroin-addicted participants in which they compared the efficacy of high dose ketamine (2 mg/kg IM) vs. low dose ketamine (0.2 mg/kg IM) in conjunction with psychotherapy. Abstinence rates at 1 month approached 85% in the 2 mg/kg group and were 24% at 1 year in the 2 mg/kg group. Craving was also notably reduced. They noted significantly greater reductions in heroin craving in the repeated treatment group as compared to the single treatment group. The Hefter Review of Psychedelic Research
A recent systemic review of the efficacy of ketamine infusions in treating substance use disorders published in Frontiers in Psychiatry suggest that ketamine may facilitate abstinence across multiple substances of misuse and warrants broader investigation in addiction treatment.
No. Intranasal ketamine does not get absorbed into the body as efficiently as IV ketamine, and thus has a weaker effect at the same dose as IV ketamine. Even when adjusting to a higher dose, to account for the lower absorption rate, intranasal Ketamine does not appear to have as robust effect as IV ketamine infusions. In addition, compounded intranasal ketamine can have a lot of variability due to the different methods and delivery systems used by compounding pharmacies.
Unlike a conventional antidepressant, ketamine causes minimal side effects, all of which are short-term, so patients enjoy better quality relief without the additional challenges of weight gain, loss of libido, dry mouth, and other undesirable side effects often associated with antidepressant medications. There are no known long-term side effects of ketamine when used in a clinical setting. (Used illicitly on the street at high doses for prolonged periods of time there can be serious side effects, the most common of which is cystitis- severe inflammation of the bladder lining)
While ketamine for depression has been researched thoroughly for more than 20 years, ketamine has been used for sedation and other indications at much higher doses for over 60 years and has proven itself to be a very safe medicine—so safe, in fact, that it’s the preferred choice for pediatric cases.
The most common short-term ketamine side effects are:
- Dissociation- (a floaty feeling, confusion, sensory illusions)
- Feeling tired or groggy following the infusion
- Mild nausea
- Mild elevations of heart rate and blood pressure (which are continuously monitored and treated as needed during your infusion)
Most Ketamine treatment side effects are temporary and gradually subside following treatment. Typically, any side effects go away completely after a full night of sleep.
If you are concerned about potential short-term side effects, you can ask one of our practitioners for tips on how to minimize or prevent them. For example, antiemetics (medication for nausea and vomiting) may be helpful for IV ketamine therapy patients who are prone to nausea.
If any of the side effects of ketamine infusion therapy persist, become bothersome, or you have questions, we are always available to discuss and assist. Minor changes in other bodily systems may occur during an infusion in some cases. For instance, the blood pressure, pulse rate, or heart rate may increase. These changes in vital signs usually normalize without intervention soon after an infusion is completed, if not sooner. In some cases, medication may be used to minimize or prevent these side effects.
Most medications can be continued. There are very few medicines that cannot be taken in combination with ketamine. For treatment planning purposes, please contact us with any questions regarding interactions between your current medications and ketamine.
Insurance companies do not generally cover IV ketamine treatment. We can provide you a receipt for services and a super bill with the diagnosis and treatment codes on it. While we cannot guarantee any reimbursement, some of our patients with “out of network” benefits or an HSA have been able to recoup a portion of their out of pocket costs.