What exactly is ketamine? How does it treat depression? And are you a good candidate for it? Get the answers to your questions about ketamine infusion therapy, the breakthrough interventional psychiatry treatment for depression.

Ketamine stimulates the development of new receptors and synapses in the brain by interfering with and rebalancing the glutamatergic system to stimulate new synaptic connections. Ketamine works as an NMDA receptor antagonist and an AMPA receptor stimulator.

Ketamine was first used (and still is) as general anesthetic agent. It has been approved for use in hospitals for 50+ years and has a proven record of safety. Recently, it is being used to treat depression (also PTSD and neuropathic pain) via an IV injection of small doses of ketamine.

Ketamine works by quickly increasing the activity of the neurotransmitter glutamate in the frontal cortex of the brain which allows new synapses to form in the same area. The speediness of ketamine in producing an antidepressant effect occurs because this drug bypasses the traditional serotonin route and goes directly to activating glutamate. This is very different from traditional antidepressants, which first increase the activity of serotonin in multiple different areas of the brain, and then ultimately affect glutamate. This process usually takes two to four weeks to take effect, while ketamine yields an almost immediate effect.

We are more than happy to provide you with an initial evaluation to see if ketamine infusion therapy is a right choice for you. If you suffer from depression and have not had relief with prescription medication or other traditional treatment modalities, then ketamine infusion therapy may be an option for you.

Ketamine infusion therapy can be tremendously beneficial for people with serious illness but just like other medical therapy or procedures, there are some individuals with specific medical conditions who would not be appropriate candidate for this type of therapy. The conditions, which would represent a “contra-indication” to ketamine therapy, include anyone with a known:

  • Hypersensitivity to ketamine
  • Recent heart attack (less than 6 months ago)
  • Recent stroke (less than a year ago)

Prior to arranging for treatment, we would like to speak with you and discuss your current medical issues and medications. You should not adjust your dose or frequency of use of any prescribed medication without first consulting with your prescribing physician.

The benzodiazepines as listed below will interfere with the treatment:

  • Klonopin
  • Xanax
  • Ativan
  • Valium

If you are taking any of the above mentioned at the dose above 100 mg per day, you may be asked to skip a dose 24-48 hours before the start of your infusion and wait until 6 hours after before resuming your benzodiazepine.

In addition, there are currently three other medications that are known to significantly interfere or block the response to ketamine, and these include:

  • Lamotrigine (Lamictal)
  • Risperidone (Pisperdal)
  • Olanzapine (Zyprexa)

They are “relative contraindications” to therapy and may need to be reduced or discontinued prior to treatment.

Not yet. There are dozens of studies done by researchers from prestigious medical centers and the National Institute of Mental Health for over the past two decades. They have proved ketamine’s safety and efficacy in treating major depressive disorder (MDD) and suicide ideation. Yet, without very large, controlled studies generally required by the FDA to get approval for any psychiatric drug, approval has been delayed. Meanwhile, ketamine is being used as “off label,” as is true with many other medications prescribed by physicians.

Yes. You will need to have someone who can drive you home after the infusion. However, they do not have to stay with you during the infusion. It is highly recommended that you do not drive a vehicle, operate heavy/dangerous machinery, sign any contracts or partake in other similar activities until the following morning.

You will receive a total of six sessions over six weeks (once a week). That will maximize the effectiveness of ketamine infusion therapy. Thereafter, you can choose to do a maintenance therapy where you return once a month for the first year after six infusions. The second year of maintenance would be one infusion for every six weeks.

The length of the infusion will be about 40 minutes to one hour and you can have a little bit of extra time before discharge.
No. Ketamine has been proven safe. Although ketamine has been abused recreationally in high doses as a club drug, there is no evidence that ketamine is addictive to those who have used it for treatment. In fact, ketamine infusion has been found to be remarkably effective in preventing withdrawal symptoms and medication craving. There is current research which indicates that ketamine may be used to combat alcohol, heroin and cocaine addiction.
You cannot eat solid food for six hours prior to your scheduled appointment. However, you may have clear liquids such as water, clear broth, apple juice or clear tea/coffee (no milk or leaves) up to two hours before your appointment.

The answer varies from person to person. Some patients feel the change within an hour of their first infusion. Some can take a day or up to the second infusion to feel the change. Others gradually see the improvements throughout their six infusions.

Most patients experience a mild dissociation or inner reflective experience that is tolerated well.
No. Ketamine infusion therapy is, perhaps, the most exciting and successful new treatment for severe depression and you should not have to do it again, though there’s a possibility you could benefit from it again later.
No. Other antidepressant medications do not interfere with ketamine.

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