What is Ketamine?

What is Ketamine?

Ketamine is a medicine that has long been used for over 60 years as an established and safe anesthetic, but recent research has shown that at certain infusion doses, it helps with neuro-synaptogenesis in the brain and possible reversal of brain atrophy. While the exact mechanism of action on how it helps in mental health and neurologic conditions is still under research, its role as an NMDA receptor blocker and its effect on the glutamate and GABA systems may explain its rapid anti-depressant, anti-pain (analgesic), anxiolytic and neuron enhancing effects.

In fact, per Dr. Thomas Insel, the Director of the National Institute of Mental Health, “…Ketamine given intravenously, might be the most important breakthrough in antidepressant treatment in decades.”

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How is Ketamine administered?

Treatment is rendered via a slow intravenous infusion by a board certified anesthesiologist who can titrate your dosing accordingly and optimize and ensure the safety of your experience.

When is Ketamine indicated?

Ketamine is indicated with anyone who has refractory or treatment resistant depression, PTSD (post-traumatic stress disorder), general anxiety disorder, OCD (obsessive compulsive disorder), or chronic pain (neuropathic pain, fibromyalgia, chronic headaches, Complex Regional Pain syndrome, etc). In other words, if someone has failed treatment with traditional treatment such as oral medications and psychotherapy, they are an ideal candidate for Ketamine treatment

Why is Ketamine NOT performed by most providers in mental health?

There are several reasons that inhibit the availability of Ketamine Infusion as a treatment modality. First, while Ketamine can be given as an outpatient treatment, it requires the appropriate space and equipment, and extensive training and experience. Setting up the facility for a proper outpatient center or department in a hospital is a long and expensive endeavor. Second, most psychiatrists do not perform “medical procedures” and do not have the necessary equipment, training or appropriate space in their office to develop an outpatient infusion center. Third, the pharmaceutical companies do not make their profits on Ketamine infusion, hence, they promote and continue to push their usual staple of anti-depressant and anti-anxiety medications, which brings in billions of dollars for their “pill mill” industry.

Where is the Ketamine procedure performed?

Infusion will be provided in a private, safe and medically appropriate facility, ensuring that you are being both monitored medically while still maintaining the privacy of a unique “meditative state” during your infusion. You will be connected to appropriate monitors that will continuously measure your vital signs, including blood pressure, heart rate, respiratory rate, oxygen saturation and your continuous heart rhythm (EKG).

How long are the Ketamine infusion sessions?

Generally, each session takes about 45 minutes plus another 30 minutes for post infusion monitoring. You can expect your total appointment to last about 1.5 hours. Treatment is outpatient.

How many Ketamine sessions will I need?

Generally, for mood disorders, you will do a series of 6 sessions total over two weeks. Then you will have occasional follow up sessions on an as needed basis.
For treatment of chronic pain, the sessions will be daily for one week, and will be about 4-6 hours in length.

How well does Ketamine work?

The research shows that about 70% of patients demonstrate improvement in their symptoms. Most patients claim that they notice an improvement after their first few sessions.

Are the results from Ketamine permanent?

Usually, people see an improvement that lasts from weeks to months. Often, patients will have to come back in for an occasional maintenance session or “booster dose.”

How long after taking Ketamine will I see an improvement in my symptoms?

While each patient is unique, some patients see instant results after the first session. Others will see an improvement in their symptoms after the first few sessions; and many patients don’t see an improvement until several weeks after their treatment series is complete. Ketamine mainly ameliorates and attenuates the symptoms of mood disorders, it does not make you “instantly happy or overjoyed.”

Do I continue to see my psychiatrist and/or therapist while taking Ketamine?

Yes. Ketamine is not a definitive and final treatment for your condition. You might still have to maintain some kind of medication regimen. You would still continue to see your psychiatrist or therapist as indicated. If you do not have a psychiatrist or therapist, we can help you coordinate your additional care.

Does the Ketamine procedure hurt?

No, the procedure is pain free and similar to receiving IV fluids in a hospital or urgent care.

Is Ketamine addictive?

While Ketamine may have a reputation as a “party drug,” in the low infusion doses given in a scheduled medical setting, it is not addictive and is very low risk.

Is Ketamine safe for patients in recovery from alcohol or drug addiction?

Yes. Being in recovery is not contraindicated, and often times helps treat the underlying dual diagnosis conditions that led to self-medicating and addictive behaviors in the first place; such as trauma, anxiety, depression etc.

What does Ketamine feel like? Do I need to be under general anesthesia?

While each patient has their own distinct experience, most patients feel a very calm and sedated dissociative state, and they describe their brain as “synapsing” and often claim it feels like a “meditative state.” You will be relatively awake, and general anesthesia is NOT needed. Upon 15-30 minutes after the infusion ends, you will be fully alert and oriented.

Is Reach Ketamine an outpatient treatment?

Yes. Each treatment session is outpatient and that does not require prior lab work, unless there is an extenuating circumstance.

Do I need to stop my current medication before starting Ketamine?

No. Almost never. Generally, your medication regimen does not have to be interrupted.

Is Ketamine dangerous?

No. Ketamine has a very long history of established medical use and strong safety profile, and in the low infusion doses it has a very low risk profile. It is well tolerated and its dissociative effects wear off very quickly. It is also much safer and a better alternative to ECT (electroconvulsive shock therapy); and shorter treatment course and yields better results than TMS.

Is Ketamine covered by insurance?

No. As Ketamine’s use in the treatment of mood disorders and chronic pain is still technically off label, it has only formally been approved by the FDA as an anesthetic in the operating room. At the moment, insurance companies do not reimburse for Ketamine treatment. However, given the amount of research and the success Ketamine is yielding, we are optimistic that this will change in the future.

With that said, Ketamine treatment is very affordable and much cheaper in the long run than medications, ECT, TMS and other modalities.

What does “off label” mean?

Off label refers to the use of medications for medical purposes other than what the FDA has technically approved them. Nearly 25% of all medications in the United States are dispensed for “off label” use. This is very common in the medical community as long as it is done under the medical standard of care and the indications are appropriate.