Frequently Asked Questions about Ketamine
This is a very old medication with NEW possibilities! Ketamine has mainly been used as an anesthetic medication; but in the last 20 years, research has shown Ketamine to be highly effective in treating depression, anxiety, bipolar, PTSD, OCD, and chronic pain. Ketamine works by binding to various receptors in the brain to promote regrowth and connections between brain cells that help regulate one’s mood. For patients experiencing chronic pain, longer infusions have been shown to “reset” nerves and decrease neuropathic pain.
No. Our primary focus is to provide safe and effective Ketamine infusions, we will not be managing any of your other medications or refill prescriptions. Ketamine infusions are meant to be an adjunct to your current mental health treatments and we are happy to collaborate with your psychiatrist and/or therapist. It is recommended that you wait at least 3 weeks after changing your medications before starting infusions. Please let the doctor know if you have recently changed any of your medications.
A patient’s “set and setting” are the most important aspects of a good infusion. “Set” refers to the patient’s mindset coming into the infusion. Having an open mind to the experience and avoiding any negative triggers prior to your appointment, will help you have the best outcome. Examples would include avoiding any confrontational conversations with loved ones, watching the news, With that said, 99% of our patients have expressed feeling nervous before their first infusion; this is completely normal!
We highly recommend setting up appointments with your therapist during the first two weeks of treatment. The dissociation that occurs during your first couple Ketamine infusions can be intense and most patients find it helpful to process the experience. Let us know if you need a referral for a therapist.
The most common side effects are Nausea and Fatigue. We offer Zofran, a preventative anti-nausea medicine, before your infusion. If nausea persists after your infusion, speak with the doctor and he/she can make adjustments to your dose and how fast or slow we run the infusion.
Plan to eat something light at least two hours prior to your infusion. Ketamine can cause nausea in some patients, so we will pretreat you with nausea medication (Zofran) when you arrive.
Since Ketamine is only approved for anesthesia, insurance will not cover treatment for mood disorders or chronic pain. We will bill your insurance for your initial consultation, but all treatments (infusion appointments) will be self-pay with payment due at the time of service.
We are saddened to inform you that as of November 16, 2020, we will no longer accept insurance for Ketamine infusion appointments. This change is due to Blue Cross Blue Shield of Illinois medical policy criteria which deems intravenous infusion of Ketamine for the treatment of chronic pain and psychiatric disorders as experimental, investigational and/or unproven. While we believe Ketamine is an effective treatment for those who are struggling with mood disorders, PTSD and chronic pain, Blue Cross Blue Shield of Illinois has indicated it will not cover this service.
As a certified SPRAVATO® treatment center, we do offer the option of Esketamine to patients. As of Spring 2019, Esketamine (Spravato) is now FDA approved for treatment resistant depression. This is the nasal spray version of Ketamine and must be given in the office by a certified Spravato Provider. Although this is a great step for those suffering from depression, there is only a 30% success rate versus the 80% success rate of Ketamine infusions.
We advise you to go directly home after your first infusion. After you have had a couple of treatments, you’ll have a better idea of how the medication makes you feel. It’s normal to feel a little intoxicated, tipsy or nauseous directly after your infusion. You may even feel tired and fatigued for the remainder of the day. Many people are able to return to work 1-2 hours after their infusion, but we advise you to take the remainder of the day off after your first visit to see how you feel.
No driving for 12 hours after EVERY infusion. We require all patients to sign a waiver acknowledging that they will not drive for 12 hours following their infusion. Ketamine is a controlled substance and for you safety physically and legally, we take this seriously. You do not need to be accompanied by anyone; Uber, public transportation or walking are all okay.
Driving under the influence of a controlled substance is illegal and will result in immediate dismissal of care from Innovative Ketamine.
A total of 6 Ketamine infusions are recommended within a 14-day period. That will maximize the ketamine effect on new dendrite and synapse growth. Thereafter, patients are placed on a maintenance program where they return when they feel it necessary for a single infusion booster (usually once a month). During the maintenance period, the duration of relief following the initial infusions and the first booster, and between subsequent single booster infusions varies between patients. The average duration of relief between booster infusions is 3 to 4 weeks. There is no way to predict what your needs will be.
We recommend everyone does at least 5 infusions before terminating. If you do not feel any effects after 5 infusions, we deem you a non-responder. This happens 15-20% of the time. It is frustrating both for you and Innovative.
Mood infusions run for 45 minutes. We recommend patients plan for 75 minutes in the office to allow time for IV placement and relaxing after the infusion is complete before leaving our office. Infusions for our pain patients run for 3 hours.
One of the main effects of Ketamine is dissociation. Dissociation is a temporary state of consciousness where a person feels ‘detached’ from the physical world. It has been described as a dream-like state with a floating calm sensation. Some patients report visions of colors and shapes. This out-of-body experience is why it is sometimes categorized as a psychedelic. Each person’s experience of dissociation is very different and can vary from infusion to infusion.
Most medications are very safe with Ketamine. Some medications can decrease the effectiveness of the infusions; these include Lamotrigine, Benzodiazepines (Xanax, Valium, Klonopin, Ativan).
Ketamine is a very safe medication overall. Patients with a history of uncontrolled high blood pressure, liver disease, kidney disease or neurological disorders may require a letter of clearance from their primary care physician.
We do not provide therapy in office, but we do have clinical staff that we could recommend pursuing for therapy. Currently, all our therapists are doing telemedicine visits during COVID-19.
Ketamine itself has not been shown to have addictive properties. In fact, there is research to suggest that Ketamine can be an effective treatment for overcoming addiction. If you have a history of substance abuse, it does not exclude you from receiving Ketamine infusions. It’s important to disclose this to the doctor so they can develop the right treatment plan for you.