KETAMINE THERAPY

Ketamine was developed in the 1960’s for surgical anesthesia. It has been in wide use ever since and is on the World Health Organization's "List of Essential Medicines.” For the last two decades ketamine has been used at much lower doses than those for surgery, to treat depression, anxiety, PTSD, and multiple acute and chronic pain disorders.

The exact mechanism of how ketamine works to treat these illnesses is not fully known. However, scientific study is showing ketamine improves the health of the neurons (brain cells) by increasing the connection between neurons and improving the brain’s ability to adapt (neuroplasticity). Ketamine also changes the way the central nervous system processes pain, allowing it to “reboot”, and return to processing pain normally. Recent research shows ketamine may increaseresilience and improve recovery from stressful traumatic events. Furthermore, ketamine decreases activity in the Default Mode Network (DMN) of the brain, which is more active in those with depression, anxiety, and chronic pain.

When you arrive at the office, you will be greeted and shown into a treatment room, where you will relax into a zero-gravity chair. This is important, as infusions appointments are 2 to 5 hours long, depending on the condition being treated. We want to make sure you are comfortable! Then, we will check in with how you are feeling and take your blood pressure. We will also give you an eye mask and headphones (with music playing) to wear during the session. These will help you relax and enjoy the dream-like state that most people experience while under the effects of ketamine. Once you are comfortably seated and enjoying the music we will give you a ketamine lozenge to dissolve in your mouth. This will allow us to see how you respond to ketamine and help us determine the best dosage to use for your IV infusion. It will also reduce the discomfort of the IV insertion. When the lozenge has had a chance to take effect the IV will be placed and the infusion begun. What you experience during this time will be as unique as you are and will vary from infusion to infusion. Common experiences include profound: relaxation, a decreased sense of your body and dream-like or surreal visuals. Most patients find all these experiences pleasant. If for some reason you are uncomfortable in any way you only have to tell the doctor or assistant and they will adjust anything that needs to be changed: the chair, the dosage, the music, etc. You will always have someone with you and the doctor will either be with you or very nearby. Once the infusion is complete you will need to rest for at least a half hour to let the effects of the ketamine wear off. When you are feeling steady on your feet and ready to leave, we will see you out to whomever is picking you up. You won’t be able to drive or work for the rest of the day. After an infusion and we recommend spending time relaxing, sleeping or going for a stroll in nature.

A single infusion’s benefits can last anywhere from a few days to a month. A series of 4 – 6 infusions along with at home ketamine lozenges effects may last anywhere from weeks to months. Often a booster infusion can restore and extend the benefits of the original infusion series.

One of the aspects of ketamine that makes it so useful in medicine is that there are very few medications that don’t work well with ketamine. Part of the intake and screening process will include a request for a list of all of the medications you are taking, and we will ensure that there is no conflict. However, it is reassuring to know that the most common drugs prescribed for the conditions ketamine treats (SSRIs, SNRIs) can be continued while undergoing ketamine therapy.

Every patient responds differently to ketamine both during and after treatment and your treatment plan will be based on how you respond to treatment. We use both ketamine infusions and ketamine lozenges in our practice. Generally, treatments occur in two steps: the Initiation and Maintenance phases. During the Initiation Phase you will receive a series of IV infusions, usual 4 to 6, once a week. In between those sessions you will take ketamine lozenges on a specific day. This will continue the benefits of the IV ketamine sessions, reducing the frequency of the IV sessions and extending the overall treatment period. This extended Initiation Phase allows more time for your central nervous system to heal. Once the Initial phase is over you will be in the Maintenance Phase and will likely continue to use ketamine lozenges at home for some weeks. During that time we will be monitoring your progress and if necessary we may suggest you receive a booster IV infusion. This is just a general outline of our treatment protocols. Every individual is unique, and we tailor each treatment protocol to meet your needs.

Ketamine infusions can help with certain anxiety disorders, PTSD (post-traumatic stress disorder), pain disorders, and depression. Patients who have not found relief from traditional oral and IV medications often benefit from ketamine infusions. Ketamine also helps avoid the side effects of more traditional treatments.