How does ketamine work?
Depression, anxiety, pain, and other forms of stress damage the communication system between areas of the brain responsible for memory, learning, and higher-order thinking. Ketamine is able to promote the materials necessary to make repairs to this damage within hours.
What can ketamine help?
Ketamine can help when someone is living with unipolar, bipolar and postpartum depression, anxiety, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), fibromyalgia, chronic migraine and addiction.
How does ketamine work for pain?
It is well known that when pain persists for a long period of time the brain begins to perceive pain as more severe. In certain types of chronic pain even non-painful stimuli such as wind blowing over the skin can solicit and intensely painful response. This phenomenon is referred to as the “windup”, we believe that ketamine works by preventing the windup that occurs and some pain disorders. It also seems to decrease the amount of pain medication patients need to treat their pain symptoms.
Does ketamine treat fibromyalgia?
Authors of a study of ketamine infusion for the treatment of fibromyalgia found that hyper analgesia and muscle pain at rest were reduced by ketamine infusion and found statistically significant differences in pressure pain threshold and pain tolerance at tender points, control points and muscle endurance with no statistically significant differences in muscle strength after Ketamine.
Can ketamine treat postpartum depression?
Postpartum depression is the most common postpartum complication with more than 20% of postpartum moms meeting criteria for a depressive and/or anxiety disorder. Breastfeeding mothers with postpartum depression often agonize about whether or not to use antidepressants to treat their symptoms because they often don’t want to expose the baby to medication and don’t want to stop nursing in order to take a daily medication. All moms, breastfeeding or not, need rapid and effective relief–for their own health and the health and development of their babies. Multiple studies show that untreated postpartum depression affects mother-baby interactions and are associated with lower cognitive functioning and adverse emotional development in the baby.
If you have postpartum depression or know someone who does, IV ketamine can treat it within hours without requiring a patient to stop breastfeeding. IV ketamine is an extremely rapid, effective treatment for depression and 75-80% of patients respond quickly and dramatically to very low dose IV infusions. This makes IV ketamine therapy an exciting treatment option for postpartum depression, where getting better quickly is what every mom hopes for, and where restoring the health of the mother positively impacts the whole family. Mood, negativity, hopelessness, anxiety and distractibility can improve within hours, and hopelessness and suicidal thoughts can evaporate. A series of low dose infusions over about 2 weeks can result in dramatic and complete remission of symptoms.
We make it a priority to see postpartum moms. We offer flexible scheduling in the late afternoon so that a breastfeeding mom can come in for her treatment and resume breastfeeding when the medication has cleared from her system, usually within 7-8 hours following infusion, so that her baby is not exposed to it.
Do you treat patients with Spravato (esketamine)?
The Ketamine Infusion Clinic is a provider of the ketamine nasal spray Spravato (esketamine). A consultation with your physician will help determine the ketamine treatment right for you and your symptoms.
Will my insurance cover this?
At present, some insurance companies may cover some of the cost for ketamine infusions. Other insurance companies are still evaluating the possibilities of coverage. Contacting your insurance company concerning benefits is always advisable prior to any medical procedure to verify and to avoid surprises. You may use a health savings account (HSA) or a flexible savings account (FSA) to pay for the cost of treatment. We also accept CareCredit for ketamine therapy. We do not accept Medicare.
Is there potential for addiction?
Some may have heard that ketamine is used as a "party drug" and worry about addiction potential. Studies and clinical experience have found that in the very low doses used, medical setting, lack of access at home, and infrequent dosing, there is virtually no potential for addiction or abuse.
Do I have to stop my other medications?
There are very few medicines that cannot be taken in combination with ketamine. For treatment planning purposes, please contact us with any questions regarding interactions between your current medications and ketamine.
How do I know it worked/what should I expect?
You will fill out depression and anxiety scales prior to the first treatment and approximately 24 hours following your second infusion. This will help determine response. It is possible to notice effects as soon as 40 min after the infusion, most typically starting 2-4 hours later, but sometimes taking up to 24 hours. You should not expect to wake up feeling “perfect and overjoyed”, but rather there should be a noticeable difference in feeling more hopeful, less sad, decreased thoughts of suicide, increased calmness, “weight” of depression lifted, or more inclined to engage with people. Further improvements are often seen over the course of treatment.
How long will the results last?
A single infusion typically lasts anywhere from a couple of days up to 1-2 weeks. A series of 6 infusions may last anywhere from weeks to months, and often a single booster infusion when effects are wearing off can restore response. For those who have not had long-standing chronic depression, it may last much longer than that.
Do I continue with my current psychiatrist, therapist, or primary care physician?
Yes. Ketamine Infusion Clinic physicians are serving in a consulting capacity to provide this procedure. In some cases, patients may choose to see one of our doctors in his/her private practice. But in most cases, people will continue with either their primary psychiatrist or primary care doctor and are highly encouraged to either begin or continue talking with a therapist.
What are the success rates?
Approximately 70-80% of patients respond to ketamine infusions. Certain genetic factors and patient characteristics may increase the likelihood of success. Factors associated with successful treatment include: exposure to chronic stress, family history of alcoholism, suicidal ideation, increased BMI, anxious depression, cognitive dysfunction, and a Val/Val BDNF gene.
Is it more expensive than taking an oral medication?
An infusion of ketamine is more expensive than a typical doctor’s visit and medication copay. However, when also considering the financial toll of ongoing depression symptoms affecting work and social function, as well as multiple office visits and ongoing medication costs, quickly being restored to life by ketamine is an excellent value.
Why aren't other doctors doing this?
Most psychiatrists do not perform “procedures” and do not have the staff and equipment within their offices to use this medicine. The process of establishing a program like this in an outpatient clinic is a long and difficult one. In addition, because ketamine is not marketed by a pharmaceutical company, there are no conferences or sales representatives teaching doctors about this and giving them samples. Dr. Dalthorp was one of the first to make ketamine treatment available in Oklahoma.
Are there any conditions that may make ketamine dangerous or ineffective?
Uncontrolled high blood pressure, unstable heart disease, increased intracranial or intraocular pressure, interstitial cystitis, active substance abuse, current manic phase of bipolar disorder, active psychotic (hallucinations or delusions) symptoms. In addition, ketamine treatment is not compatible with MAOI medication treatment and the effectiveness of infusion treatment may be decreased with higher doses of lamictal, opiate pain medications and benzodiazepines.
What are the risks?
The dose used for the treatment of mood and anxiety disorders is very low and safe. For a few minutes during the infusion itself, blood pressure and heart rate may increase. This is monitored to ensure safety and medications administered as necessary to manage problematic increases in blood pressure, episodes of nausea or anxiety.
How do I maximize the benefits?
It is common to get advice when depressed that makes sense intellectually, but is impossible to follow through on because of the depressive symptoms. This includes things like, “eat well, exercise, engage in talk therapy, find social support, stay busy, etc”. Ketamine rapidly enables you to be able to act on these important activities, and those who have the best results support the medicine’s effect in these ways. In addition, ketamine likely “primes” the brain for learning and making new connections. Talk therapy can be an ideal way to “lock in” therapeutic learning and capitalize on this unique window of time.
How does ketamine compare to alternatives?
Typical antidepressants take weeks to months to work. There are many to choose from and no reliable way at this point to know which we will be effective and well-tolerated. Therefore, one may wait weeks and find that the medicine does not even work. These medications have common side effects of weight gain, sexual dysfunction, gastrointestinal disturbances, sleep disturbance, fatigue, and emotional blunting. Some newer “add-on” antidepressants also have risks of causing diabetes. Unfortunately, not everyone will respond to ketamine, but you will know that almost immediately and not have to waste time or money unnecessarily. Side effects are limited to the time of the infusion, with no side effects in between. In this way, outside of the infusion time, you are not “medicated”.
Are there support networks available?
Yes. Please visit ketamineadvocacynetwork.org