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Ketamine therapy is a protocol developed by doctors and involves the medically supervised use of ketamine. This treatment may help people who don’t get relief from other medications for depression, anxiety, PTSD, and more. The low dosage, 3-week regimen (plus monthly boosters) has shown promising results in about three-quarters of patients.
KETAMINE THERAPY FAQ
What is ketamine?
Ketamine is a medication that has been used for humans and animals since the 1960s as an anesthetic during surgery. Ketamine is a dissociative anesthetic, meaning it can cause a sense of disconnection from one’s reality and self.
More recently, doctors have found ketamine to be highly effective in the treatment of depression, anxiety, PTSD, and certain pain disorders. The World Health Organization included ketamine in its “Model List of Essential Medicines” due to its cost-effectiveness, safety, and efficacy.
What conditions does ketamine treat?
Ketamine is used to treat major depressive disorder, bipolar depression, anxiety, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and certain pain disorders. Recent research has shown ketamine is also effective for treating eating disorders and addiction.
How does ketamine work?
Mental health disorders and pain cause stress on the brain that can damage the communication system between areas of the brain responsible for memory, learning, and thinking. Ketamine is an NMDA-receptor antagonist. It works on the neurotransmitter glutamate which starts the process of producing new growth that helps the brain repair the damaged neurons. Ketamine enables the brain to form and reorganize synaptic connections (neuroplasticity).
Ketamine increases materials necessary to make repairs to this damage within hours, thus relieving symptoms of depression, anxiety, and other symptoms quickly.
Will ketamine work for me?
About 75% of patients with treatment-resistant depression experience relief in symptoms in a series of low-dose ketamine sessions. Similar success rates have been reported in those with anxiety, OCD, and PTSD. Relapses may occur and may require additional ketamine sessions.
How soon will I see results from ketamine treatment?
It is possible to notice effects within 24 hours of ketamine treatment. Many patients will know if they are responding after 2–3 sessions of ketamine, but some will require all 6 ketamine sessions before they see improvement or relief of symptoms. It is recommended to have a total of 6 sessions—2 sessions weekly for 3 weeks—and monthly maintenance (booster) sessions to maintain results. Treatment plans are individualized.
Is ketamine safe?
Yes. The dosage for mood disorder treatment is low and safe. During the treatment, blood pressure and heart rate may increase, which is why vital signs are monitored before and after each ketamine session. If your blood pressure or heart rate are not within normal parameters before the treatment, the ketamine session may be postponed until they are stabilized.
Ketamine does not depress a patient’s breathing or circulatory systems and it is fast acting.
Are there any side effects from ketamine?
Short-term side effects may include mild increase in blood pressure and heart rate, dizziness, temporary blurry vision, light sensitivity, feeling of “lightness,” anxiety, euphoria, headache, and nausea. Patients are monitored for safety, and medications are available for symptom relief.
Potential long-term use of ketamine, whether it be chronic, daily, and/or high dose use, may cause bladder cystitis, liver damage, and cognitive deficits. This is typically seen with heavy recreational use, addiction, or in pain patients. There is potential for addiction.
Is any additional information needed?
We will request medical records from primary care providers, certain specialists, and therapists. If you recently had lab work, please bring a copy of the results. Not all patients will require lab work, but some medical conditions will require lab work prior to ketamine treatment. We will advise you if you need lab work as part of your individualized treatment plan.
Conditions that disqualify patients from receiving ketamine:
Uncontrolled high blood pressure, unstable heart disease, aneurysms, untreated thyroid disorders, increased intracranial pressure, brain tumors or lesions, glaucoma, liver disease, active manic episode of bipolar disorder, and active psychosis.
What medication(s) should not be taken on the day of my ketamine treatment?
Generally, we recommend you take your prescribed medications as scheduled. However, some medications may interfere with your ketamine treatment.
If you take Lamictal (lamotrigine), Trileptal (Oxcarbazepine), benzodiazepines (alprazolam, lorazepam, diazepam, clonazepam, temazepam, etc.), Neurontin (gabapentin), Lyrica (pregabalin), or ADHD stimulants—skip the dose you would take prior to your ketamine treatment. You can resume after the session with your next scheduled dose.
If you have medications you take only as needed, such as benzodiazepines, opiates, or medical cannabis, we advise you do not take a dose within 6 hours of your ketamine treatment.
Do not drink alcohol on the day of your treatment.
What will happen on the day of my ketamine treatment?
Here are the requirements for the day of your treatment:
All patients MUST HAVE a designated driver to escort them to and from the office visit
Do not eat food 6 hours prior to your ketamine session
Do not drink fluids (not even water) 2 hours prior to infusion
Wear comfortable clothing
You will relax in a recliner with dimmable lights and soothing ambient music, and we will provide blankets. You are welcome to bring noise-cancelling headphones and your own blanket and pillow.
Prepare to be in the office for approximately 2–3 hours. The ketamine experience lasts about 30–60 minutes, followed by 60–90 minutes of relaxation.
How will you administer the ketamine treatment?
We offer ketamine intramuscular (IM) injections, which is an injection of ketamine into your muscles. There is also ketamine intravenous (IV) treatment. Both IM and IV get the ketamine into your blood stream. IM injections are unable to be adjusted compared to IV infusions, but they are quick and easier than IV infusions.
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