KETAMINE

Frequently Asked Questions Regarding Ketamine Infusion Treatment

What is Ketamine?

Ketamine was developed in 1962 by Parke-Davis.  It has been used safely as an effective anesthetic since the 70’s for a variety of medical purposes for both children and adults. It works primarily as NMDA receptor antagonist, commonly described as a ‘dissociative’ anesthetic.  Recently, it has been touted as the most significant breakthrough as a treatment option of treatment-resistant depression, anxiety, PTSD, chronic pain and other mood disorders.  Unlike traditional psychotropic medications, which can take weeks to months to take effect, ketamine infusion works within hours of an infusion.  This can be especially useful for severely depressed individuals with suicidal thoughts.  The immediate relief could be lifesaving.

How likely is it to work?

Our experience, along with several clinical studies, have shown a 70-80% response rate.

How do you know if it is working?

Most report a noticeable feeling of hope, calmness, lightness and increased functionality. It could be as subtle as being able to do daily chores and self-grooming, to being able to be more social and meet up with friends.  The effects could happen hours after infusion; but, generally it could take 2-3 days to be noticeable.

How many infusions will I need?

We will schedule you for a series of 6 infusions over 2-3 weeks.  Most patients will feel the improvement after 2-3 infusions. If this is not the case, we will adjust your infusion accordingly.  If there is still no response after this, we generally terminate the treatment.  If you do see an improvement, however, we will finish the full 6 infusion course to maximize the brain’s synaptic repair and its duration.

What happens after the initial series of infusions?

We will schedule you for ‘booster’ infusions for your continued recovery and to maintain the brain’s neuroplasticity.  The timing is highly dependent on each patient and based on subjective reports and filled out inventory scales. We highly recommend that you continue talk therapy with your mental health clinician to make full use of your newfound openness and the neuroplasticity offered by your infusions.   If you need a mental health provider, we have partnered with the expert team at Gateway Solutions to monitor and guide your progress through goal-oriented psychotherapy.

Are there any side effects?

Occasionally, some patients feel nausea during or after the infusion.  Your heart rate and blood pressure may increase with IV Ketamine. We can give you medications to counter these, should they happen.  Tiredness is also not uncommon after treatments.  There are no reported long term side effects with low dose ketamine infusion therapy.

Will I be asleep?

At this low dosage, ketamine will not cause you to be unconscious.  Although some patients will feel fully calm and relaxed that they may doze off on their own.

How will I feel after the infusion?

You may feel a bit groggy right after the infusion; but, you will quickly be back to baseline shortly after.  We recommend that you do not engage in any physically taxing activities, avoid driving and using machineries, and avoid making important decisions for the rest of the day.

Will it cause hypomanic/manic episodes in Bipolar patients?

The treatment can treat the depressive phase of bipolar disorder.  We are not aware of any reports of this happening in our and other’s practice.

Will these treatments cause bladder damage?

No. Bladder inflammation has been linked only to ketamine abuse, which are at doses up to 20 times the amount used for our infusion therapy and over the course of many years. There have been no reported cases of bladder damage with low dose, subanesthetic ketamine infusion therapy.

Do I need someone with me during my treatments?

Most people feel relaxed and clam during and after the infusion. Feel free, however, to bring someone along in our ketamine clinic if it makes you feel more comfortable.

Can I eat of drink before my treatments?

You do not need to fast.  We recommend, however, that you refrain from eating 4 hours prior to your treatment.  You may drink clear fluids up to 2 hours prior.

Is this treatment FDA approved?

Even though ketamine has been FDA approved since the 70s as an anesthetic, it as not been FDA approved for this particular treatment and is considered “off label”.  Ketamine has been safely used for the treatment of depression and other mood disorders, and chronic pain for almost a decade now by prominent university hospitals and private practices.  It has been considered as an important breakthrough in the treatment of depression and other mood disorders.

Will my insurance cover my treatments?

Because this is an “off label” treatment for ketamine, insurance companies will not cover it as an in-network procedure. Some insurance companies may cover the treatment as an “out-of-network” benefit.  We recommend contacting your insurance company to find out if this is the case with your particular insurance plan. If covered under your out-of-network benefits, reimbursement can range from 50-90% depending on you plan. We will provide you with the necessary paperwork to submit to your insurance company. We also have teamed up with <Advance Care), a medical funding company, to offer you affordable financing options.

Due to its widespread successes against depression and other mood disorders, ketamine treatments for depression and mood disorders are being fast-tracked for FDA approval.

What is the experience like during the infusion?

The ketamine experience has been classically described as being “dissociated”.  This means your mind will shift focus from your physical body to a more mentally active inward-directed reflectivity.  Most patients find this experience calming and pleasant, being able to access thoughts and memories without their emotional burden.  We provide a calm environment during this experience. You may listen to our carefully selected sounds, or you may listen to your own playlist.  We recommend, however, that you play calming music during this time to avoid anxiety and allow for deep relaxation.

Is this an outpatient procedure?

Yes. The infusion will be performed in a private, comfortable room, and will take approximately an hour.

Is it addictive?

While it is true that ketamine works and has been abused as a party drug, it is not considered addictive.  It is imperative that the proper dosage is given based on weight, and carefully monitored by a medical personnel.  It has been used safely as a medication for decades and has been included on the World Health Organization’s Essential Medicines list since 1985.

Can I take my other antidepressant medications?

Yes. Ketamine is safe and can be taken with most medications including SSRIs(Celexa, Lexapro, Paxil, Prozac, Luvox, Zoloft, etc,), SNRIs(Pristiq, Cymbalta, Effexor, etc.), Lithium, Wellbutrin, tricyclics, and other psychiatric medications ( Rexulti, Abilify, etc).

Are there medications that will interfere with my ketamine treatment?

Yes.  Lamictal (Lamotrigine), when taken at higher doses, may attenuate the effects of ketamine.  Benzodiazoapines such as Xanax (Alprazolam), Ativan (Lorazepam), Valium (Diazepam), and Klonopin (Clonazepam), at higher doses may also reduce your response to ketamine. Please contact us on how to schedule taking this medications around your ketamine initiation and booster treatments. We want to ensure the best possible chance of success in your recovery.

Do I need a mental health referral?

While it is not required, we highly recommend it.  We have <forms you can download> to fill out and and send back to us.  We believe that in order to get the full benefits of ketamine infusion therapy and neuroplasticity, the you should be monitored by a psychiatrist, and fully engaged in talk therapy to solidify the new brain connections being made.  If you need a mental health provider, we have partnered with the expert team at <Gateway to Solutions> to monitor and guide your progress through goal-oriented psychotherapy.

Are there any contraindications to treatments?

There are a some conditions and situations that will prevent treatments including unstable medical conditions, substance abuse, use of alcohol prior to the session, pregnancy, among others.  Please  <call us at 347-687-1120> to discuss this further.

Is your office handicap accessible?

Yes. Our office is handicap accessible and ADA compliant.

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