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.
Yes! We recommend having something light to eat for breakfast or lunch, depending on when your appointment is. Coming in hydrated is also key!
We bill your insurance for your visit as a specialty care provider. You are responsible for your copay at the time of visit; any remaining out of pocket fees will depend on your plan’s coinsurance and remaining deductible. Since Ketamine is only FDA approved for anesthesia, insurance will not cover treatments for mood related disorders or chronic pain. To make treatments more affordable for our patients, we do not charge you for the Ketamine.
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.
It is normal to feel intoxicated/tipsy and nauseous directly after your appointment, and fatigue for the remainder of the day. It is best not to return to work or make any important decisions after your first infusion. After 2-3 infusions you will know what types of activities you can engage in after Ketamine treatment.
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.
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.