Ketamine has been used for over 50 years as an anesthetic in battlefields, operating and emergency rooms. Ketamine is an FDA-approved anesthesia drug that is considered very safe as it does not suppress the respiratory drive or lower blood pressure. It is one of the most widely used medicines in the world for sedation and on the WHO's essential medication list. In the 1980's Ketamine was found to antagonize the NMDA Receptor. Researchers began to study the effects of Ketamine on the brain more in depth. In the early 2000's Ketamine was found to have astounding results on Depression, PTSD, Suicidal thoughts and much more. Although the FDA has not approved intravenous Ketamine use to treat mental health conditions, the studies and results prove its benefit. In March of 2019, the FDA approved intranasal Ketamine (Spravato/Esketamine) for the treatment of adults with treatment-resistant depression
Ketamine is thought to work in a few different ways, but the exact mechanism of action is unknown. Ketamine is an NMDA Receptor Antagonist. This means that it binds to these receptors in place of other neurotransmitters. This action causes a cascade of events. One thing that happens is that the amount of the neurotransmitter Glutamate is increased in the spaces between neurons. Glutamate helps with the strengthening of signals between neurons to shape learning and memory. Glutamate is also responsible for making the calming neurotransmitter GABA. When Ketamine binds to the NMDA Receptors it also blocks the transmission of pain signals decreasing the perception of pain.
The infusions are administered intravenously. Each patient has their own private room where they can relax in a recliner with massaging capabilities. The patient's blood pressure, heart rate, oxygen saturation, respirations, and End Tidal CO2 are monitored continuously throughout the infusion. The patient is also given a call button and monitored via camera by our medical staff the entire infusion. One of our Nurses and Physicians are always present just right outside the door if needed.
During the infusion patients can listen to music on the television, a Bluetooth speaker, or their own headphones. They are also able to watch shows and movies on the television if interested. The intention for the room is to be peaceful. It is a time for rest and reset so calming music/television is recommended and phone use is disfavored. Patients may undergo a variety of experiences during their Ketamine infusion. It is often an emotional experience for many, that means that the set and setting are important. Ketamine is a dissociative anesthetic; therefore, it is not uncommon for patients to dissociate or have an out-of-body experience. Ketamine is considered a very safe drug and our medical staff will be with you to help keep your experience as comfortable as possible.
During the infusion, the most common side effects are: Nausea and Vomiting, Headache, High Blood Pressure, Dissociation (out-of-body or looking down on ones body), and Perceptual Disturbances (intense colors, heightened sounds, no sense of time, blurry vision).
Long-term use and abuse of Ketamine has been associated with damage to the bladder. This is known as Ketamine Bladder or Ketamine Cystitis. The overuse of Ketamine may cause structural damage to the cells in the bladder and may be reversed when Ketamine administration is stopped.
Contraindications for Ketamine therapy are those with abnormal liver function tests, elevated and uncontrolled high blood pressure, pregnant, glaucoma, active psychosis or schizophrenia, and certain cardiac disease.
The FDA still views intravenous use of Ketamine to treat mental health as experimental. This means that insurance companies will not cover the infusions. We will provide our patients with a superbill so that they can submit the information themselves for reimbursement. Speak with your insurance provider to discuss reimbursement.
Ketamine is a treatment, not a cure. This means that it may be a medication that you need continuously. The frequency of the need for an infusion varies, although it is not nearly as often as most medications. In fact, Ketamine has helped patients decrease use of their other medications. For this reason, we call Ketamine the "anti-medication medication". Studies have shown that after a series of infusions that are administered 1-3 per week for a total number of infusions recommended by our physicians, single booster infusions may need to be given when results begin to decline. Some patients experience long lasting relief from their symptoms while others require more frequent boosters. Every patient is different, and we will work with you to achieve the best results you possibly can.