Ketamine is a medication mainly used for starting and maintaining anesthesia for surgical procedures and treating pain. In small, sub-anesthetic doses, it is being used to treat depression, anxiety, PTSD, suicidal thoughts, OCD, migraine headaches and chronic pain. It is currently not FDA approved in treating mental health conditions, but is being used as an "off-label" treatment. "Off-label" use means that it is being administered as a treatment that the FDA did not originally approve it for, but due to clinical experience a broader use of medications develops over time. There are currently several studies being conducted and a push to get approval for it's use for depressive disorders and mood related illnesses.
Ketamine infusions work quickly by increasing the neurotransmitter glutamate (NMDA receptor) in the frontal cortex of the brain, allowing new neuronal synapses to form. It works quickly because it bypasses the traditional serotonin route and works directly activating glutamate. The stress response caused by depression, anxiety and PTSD decreases these connections causing a breakdown of communication among brain cells. It changes the brain's neuroplasticity by increasing synapse connections, allowing the brain to reestablish, reconnect and to change and grow. A proliferation of neurons empower the synapses to communicate, increase coping mechanisms by opening doors and windows of the brain, letting in light and giving way to new thoughts and hope. Currently, there are no traditional anti-depressant medications that work on the same pathway as ketamine, making it a "break through and cutting edge" treatment for depressive disorders.
A series of 6 infusions is recommended over a 2 - 3 week period. Rapid results can be seen within a few hours of treatment, but some patients may take a longer time to respond. It is the process of repeating ketamine infusions that add to and rebuild neuronal pathways. It's like rebuilding a highway, one layer at a time. The effects of ketamine can last from a few weeks to a few months, the results varying from person to person. Subsequent maintenance infusions are typically needed and recommended. Maintenance infusions are usually administered approximately once every 2 to 8 weeks. According to increasingly extensive research involving the use of ketamine for treatment in a broad spectrum of pschological ailments, the medical community reports approximately 70% or greater, success rate in the reduction of symptoms in patients receiving ketamine treatments.
Yes, benzodiazepines such as Klonopin, Xanax, and Ativan interfere with the effectiveness of ketamine if used daily. Lamictal in doses above 100 mg/day can block ketamine efficacy.
Pregnancy, uncontrolled high blood pressure, cardiac dysrhythmias, and heart failure are contraindications for ketamine therapy. We will evaluate and use caution with glaucoma patients, as there may be a transient increase in intraocular pressure.
The infusion is 40 minutes. Your first appointment will include a 30 to 45 minute intake and assessment. Subsequently, you'll need to plan for approximately 1.5 hours for each infusion appointment. You will need a ride home, driving after therapy isn't recommended for 12-24 hours. Taxi/Uber/Lyft, or any form of paid transportation, are acceptable if you are unable to arrange a ride by other means. A ride must be established prior to receiving infusions.
The fee for each infusion is $500. There is no charge for the initial assessment/consultation. Insurance does not currently cover the cost for ketamine therapy, therefore all appointments are self pay and due at the time of infusion. Although it's not covered by insurance, ketamine infusions can be paid using both HSA and FSA accounts. We offer a military discount on all services, please inquire about the discount during your initial phone call or office visit.