Ketamine is used to treat depression, anxiety and pain syndromes
A trial of Ketamine can be given when:
- Depression is severe or non-responsive to usual drug therapy
- When rapid reduction in suicidal symptoms is necessary
- When urgent improvement in depression is desired to allow patients to attend to pressing life circumstances.
- Some antidepressant outcomes may be improved by the use of ketamine early during an antidepressant course.
- Antidepressants can be safely administered to patients for whom ketamine is trialed.
- Antidepressant benefits with ketamine are usually immediate and dramatic, with patients achieving significant reduction of depressive symptoms within a day.
Ketamine Infusion Therapy In Compos Mentis
Out-Patient Procedure (OPD)
60 minutes (40 minutes Infusion and 20 minutes Rest)
Duration of Nil Per Oral:
2 Hours (Solids and Liquids)
Number of Ketamine Sessions:
Usual course is of 6 Infusions.
Maintenance Ketamine Infusions:
May be required depending on the indication
Pre Ketamine Work Up:
- The patient is expected to come empty stomach for the procedure. No solids or liquids food have to be consumed upto 2 hours before the procedure.
- Ketamine is given in a 100 ml Normal Saline bottle, through an intravenous route, via a needle.
- The patient has to lie in a bed and close his/her eyes for the duration of the procedure.
- The period of infusion is 40 minutes. During this period, some patients fall asleep and some keep laying down with eyes closed.
- Pulse and Blood Pressure are monitored every 10 minutes during the entire procedure
- At the end of the infusion, the patient, if asleep, awakens and stays in bed for an additional 20 minutes.
- Once the patient feels comfortable, he/she can be discharged.
All the below mentioned side effects are
Temporary and resolve spontaneously
within 4 hours of treatment.
- Blurring of Vision
- Dissociative State
(feeling of strangeness and unreality)
How it Works?
Ketamine creates an environment in brain which allows receptors, protein and neural pathways to work in more optimal level than before. Ketamine infusions increase expression of brain derived neurotrophic factor (BDNF). BDNF is a protein which helps the Brain to be flexible. Thus it helps in structural loss due to depression and anxiety. The regrowth and reconnection of neurons after Ketamine infusions result in sustained improvement in symptoms.
Where it is used ?
Anxiety, Depression, PTSD, OCD, Migraines, Fibromyalgia, Chronic Pain, Substance Abuse Disorders, Neuropathic Pain, Trigeminal Neuralgia.
What to expect?
Initial consultation includes history of allergies, medical history, current medication and symptoms.
During the infusion you will be awake but in a deep state of relaxation. Multiple infusion over a short period of time is a done. A minimum of 6 infusion is required over a 2 to 4 weeks period, providing 1-3 infusion per week.
If after the first 4-5 infusions there is no change in your mood or pain, then you may be a "non responder" after which it will be discontinued.
Ketamine is a medicine historically used for anesthesia during surgeries and medical procedures. It was synthesized in the 1960s and is FDA-approved for procedural sedation and anesthesia. It is widely used in hospitals and ERs and is on the World Health Organization's "List of Essential Medicines." Ketamine is now being used "off-label" to treat depression, as well as anxiety, post traumatic stress disorder (PTSD), and some chronic pain disorders. This medication has a long track record for its safety when used appropriately.
The exact mechanism of how ketamine works in depression, anxiety, and chronic pain is not fully known. However, we do know that ketamine works on the NMDA receptor to block the glutamate neurotransmitter. And scientific study is showing ketamine improves the health of the neurons (brain cells) by increasing the connection between the neurons and improving the brain’s ability to adapt (aka neuroplasticity).
Ketamine also changes the way the central nervous system processes pain, so it’s like hitting the reset button on your computer, to restore normal pain processing. Research is also showing in animal models, the potential for ketamine to increase resilience and recovery from stressful traumatic events which can trigger or cause depression and anxiety disorders.
Furthemore, ketamine decreases activity in the Default Mode Network (DMN) of the brain, which is more active in those with depression, anxiety, and chronic pain.
Ketamine infusions may be for you if you suffer from certain anxiety disorders, PTSD (post-traumatic stress disorder), pain disorders, or depression. Many who have not found relief from traditional oral medications for these disorders often benefit from ketamine infusions. This may be for you if you want to avoid side effects of more traditional treatments or if current treatments are not working for you.
Ketamine has a long proven track record of being a safe FDA-approved anesthetic since 1970. It is part of the List of Essential Medications the World Health Organization (WHO) recommends to have in every hospital. Addiction has not been found in individuals who receive ketamine infusion therapy at the dosing, treatment, & schedule in the appropriate setting with a medical professional.
Yes. We are serving in a consulting capacity to provide this infusion and recommend to continue seeing your physician.
Three main reasons: 1) comfort of administering the medication, 2) awareness of this treatment, and 3) acceptance of this treatment. Outside of emergency room doctors, anesthesiologists, few other medical specialists are comfortable with administering this treatment. Many doctors are not educated on the latest research about ketamine, and only recognize it as an anesthetic or street drug use. While there are some doctors who don’t know about this treatment, there are others who are used to the current traditional model of treatment and not ready to accept this novel treatment.
Some patients report feeling like they are in a dream or feel sedated. Some feel like they have changes in their thought process, vision, and or speech. If you experience unwanted sensations or unpleasant hallucinations, we may decrease the amount of the medication or how fast we infuse it to minimize these experiences. Remember, there will always be a healthcare professional close by making sure you are safe and well taken care of during your infusion.
Many patients recover 20-30 minutes after the infusion. You may feel a little tired, notice a mild difficulty in walking, or even “cloudy thinking” for a few hours after. We advise you to take it easy, and have a relaxing day following the infusion. We will make sure you are ready and safe after your infusion, before we let you go home!
A single infusion typically lasts anywhere from a few days to a month. A series of 4 – 6 infusions may last anywhere from weeks to months, and often a single booster infusion when effects are wearing off can restore and extend response. Every patient responds differently, and some patients get several months of relief with just a few infusions.
Ketamine infusion treatments occur in 2 steps: the Initiation and Maintenance steps. At Reset Ketamine, we recognize each individual is different and unique despite their similar diagnoses. Thus, we tailor each treatment protocol to the individual based on your experience and reaction to the medication. Our goal is to serve you!
At Reset Ketamine, treatments can be 40 minutes, 80 minutes, 2 hours, or 4 hours, depending upon what we are treating and tailored to each patient. Some factors include: diagnoses, medical problems, ability to tolerate the ketamine dissociative experience, ability to lay back for prolonged periods of time, bladder control, severity & intensity of pain, financial/timing/availability of patient.
We recommend fasting at least 3 hours prior to your first infusion. This will minimize the risk of nausea or vomiting.
There are a few select medications which cannot be taken in combination with ketamine. Please contact us so we can answer questions and discuss these medications with you. There are some medications if taken during your infusion, may reduce the effect such as benzodiazepines (Ativan, Xanax, Klonopin, Valium, etc.) and lamotrigine (Lamictal). We advise weaning your dose at your prescribing doctor’s direction prior to your first treatment. If you are unable to be off the medication, we recommend not taking the medication the night before or day of your infusion. Please restart your medications the night of your infusion or the following day.
Yes. If you are experiencing the following: Uncontrolled high blood pressure (hypertension); Unstable heart disease (arrhythmias, congestive heart failure, chest pain etc.); Untreated thyroid disease; Active substance abuse; Active manic phase of bipolar disorder; Untreated glaucoma; Active delusions and hallucination symptoms (not on meds or while taking street drugs). If you have any of the above the day of your infusions, you unfortunately will not be able to receive your infusion.
It depends upon the diagnosis, but research shows improvement in 70-80% of patients who are treated with ketamine for depression.
For some people they can experience positive effects within an hour of finishing the infusion. For others, they will not notice an effect until after their fourth or fifth infusion. Commonly the effect is gradual and subtle, noticing thoughts of sadness and hopelessness to begin to lift and go away. Occasionally some people may have a dramatic effect. Function (going out, doing things you enjoy, work) improve before mood does. With improved function you are able to more fully participate and engage in your treatment plan, thus improving your success rate!