What kinds of disorders does ketamine treat?
Ketamine is useful for the treatment of bipolar and unipolar depression, anxiety disorders, postpartum mood disorders, PTSD, OCD, chronic migraine, fibromyalgia, addiction, and pain. Additional studies have shown that ketamine can rapidly reduce suicidal thoughts, as well.
How does ketamine work?
While research continues to clarify the complex role ketamine plays in brain health, at its most basic level, the anesthetic temporarily blocks neurotransmitter receptors in specific areas of the brain responsible for sensory integration, memory, and learning. By blocking these pathways, ketamine creates a favorable chemical environment for neuron growth. This allows time for repair and regeneration of neural pathways, which often reduces symptoms associated with mood disorders, PTSD, and chronic pain. Ketamine has also been noted to have strong anti-inflammatory effects, which may assist in alleviating chronic pain.
Is it safe?
Ketamine has seen wide usage as an anesthetic in adults and children since the 1950s, and even at anesthetic doses (about 2-6 times higher than the dose used to treat depression), it is considered very safe. To greater ensure the safety of our infusions, all patients are monitored by a board-certified medical professional during treatment.
Is it effective?
Ketamine is remarkably effective. Clinical trials have shown relief of symptoms in 70% of patients after just one infusion. Furthermore, these trials indicate 85-90% relief of symptoms in patients undergoing our recommended three-week follow-up infusion regimen. Some patients will require maintenance or “booster” infusions every three to four months afterwards, depending on their unique symptoms and physiology. Ketamine does not cause side effects that oral antidepressants often cause (weight gain, sexual dysfunction, etc).
What can I expect during the ketamine infusion?
At Texas Ketamine Specialist locations, comfort and safety are our key concerns. Each patient will have a private room where a family member or friend is welcome to stay throughout a session. Each infusion lasts about 40 minutes. Some patients may feel drowsy or intoxicated during treatment, while others may feel a floating sensation. Euphoria, talkativeness, blurry vision, and tingling sensations around lips and fingers have also been noted to occur. These sensations rapidly resolve soon after an infusion is complete.
If you wish. Some patients do choose to nap during treatment. That said, the dose administered during the infusion is not high enough to cause unconsciousness.
How long are the infusions?
Ketamine infusions will be administered over 40 minutes, followed by a short recovery period. You should expect to be with us in the clinic for about an hour and a half.
Why won’t my insurance cover this? And why isn’t this FDA approved?
Ketamine has been used since the 1950s. It has been generic for a very long time, approved for use as an anesthetic. Because it has become generic and readily available to the medical community, there is no drug company willing to fund trials to get a new FDA approval specifically for treatment of depression. Insurance companies generally do not cover therapies that are not FDA-approved. Nonetheless, there have been many studies of ketamine as a treatment for depression, and the research shows that it is unique, effective, fast-acting, and above all, safe.
Will I get addicted or “hooked” on ketamine?
At these low doses, addiction, tolerance, or dependence is rarely seen.
What side effects might I feel?
In clinical trials, feeling of euphoria, “strange” or “unreal” sensations, blurred vision, and drowsiness were the most common side effects reported after each infusion of ketamine. While uncommon, these side effects resolve within an hour of treatment.
Less commonly, patients may experience elevated blood pressure, heart rate, dizziness, and mild nausea during an infusion. Medical treatment and trained personnel will be on hand to monitor and threat these symptoms, should a patient experience them.
Can I drive myself?
You may drive yourself here, but we require that someone else gives you a ride home and that you do not operate a motor vehicle for the rest of the day.
Can I stop my medications?
We do not recommend stopping your medications during treatment, with the exception of any benzodiazepenes you may be taking (which should be stopped 12 hours before an infusion). We have found that many people ultimately require reduced doses of their medications, or can stop certain drugs altogether. We leave that important decision to you and your psychiatrist.
Will Dr. Kim be my new psychiatrist?
No. We will be providing an initial evaluation, the procedure of IV ketamine infusions, and course-long monitoring of your well-being, but we do ask that you stay with your primary care physician or psychiatrist to manage your medications. We are happy to collaborate with your primary physician, and strongly encourage this line of communication.
Are there any medical conditions that will exclude me from treatment?
To maximize safety, we do have circumstances that will exclude you from treatment. These include:
- Uncontrolled hypertension or heart disease
- Raised intracranial or intraocular pressure
- Urinary incontinence, urgency, or pain
- Interstitial cystitis
- Significant medical illness
- Psychosis, schizophrenia or current mania
- Active substance abuse
- Seizure disorder
- IV access difficulty
- Prior adverse reaction to ketamine
- MAOI antidepressant treatment
- High doses of lamotrigine (brand name Lamictal), opioids, or benzodiazepenes
How much does it cost? Will insurance cover it?
Ketamine infusions are generally not covered by insurance. You may use a health savings account or flexible savings account. We also accept cash, check, and credit card. Please see the OUR THERAPY section for pricing and protocols.
Do I need a referral for treatment?
We require a signed referral from your psychiatrist, other physician, or other mental health professional before an evaluation will be scheduled. We believe that collaborative care with a mental health provider who already treats you and knows you well ultimately provides the best care for you. A referral form can be downloaded from this webpage.
How long will the results last?
Typically, patients will experience extended periods of improvement in mood and other symptoms, especially those patients who have not been suffering from long-standing chronic depression. Some patients will need to return for “booster” infusions as frequently as every three to four months, depending on their unique symptoms and physiology.
How soon will my symptoms improve? How will I know it worked?
Most patients will feel better during the infusion, if not within hours of its completion. You may not notice a drastic change in your symptoms, but once an initial response has been verified, you should expect to feel progressive improvement over the course of your therapy.
How will you track my progress?
Tracking your progress is very important to determine if ketamine is an effective therapy for you. We partner with a company called Osmind, who provides an app that can work on your phone, tablet, or computer. Once you are active in therapy with us, we will use the Osmind app to ask your daily mood score and occasionally ask you to take a PHQ-9, a standardized scale for depression. Our office can review your scores and make a customized treatment plan based on your objective data. It is of no charge to you. For more information about this app, go to the Osmind Webpage