For our mood disorder patients, that will depend on your response. We begin with two (or, in some cases, three) infusions 48-96 hours apart to see if Ketamine Infusions are effective for you. Most of our patients who respond see some improvement the day of or after their 2nd infusion. If not, we may attempt a longer and/or higher dose infusion. If there is still no response, we generally stop further treatment. If ketamine does improve your mood, outlook, and functionality, we suggest that you receive 4 additional infusions over the next two weeks to maximize ketamine’s brain-repairing abilities. That is a total of 6 infusions for one full series.
For our CRPS/RSD or other pain condition patients, we provide five 4-hour long infusions, generally done on five consecutive days. Because pain conditions require more substantial dosing, we cannot determine whether or not a patient is responding after their 2nd infusion. Results can be seen very quickly, in as little as one treatment, but are often not seen until after the full course of treatment is complete.
Our commitment to you and your recovery remains long after your last infusion. We know how vital it is that ketamine therapy be part of a bigger treatment plan for our patients, and that’s why we combine it with an extensive aftercare plan at no additional cost to our patients.
For mood disorder patients, some will begin to feel better within 1 hour of their first infusion. Patients with thoughts of self-harm or suicidal ideation often notice those thoughts and feelings dissipate first, and almost immediately. There is often a dramatic relief of dread and hopelessness. Other patients may not notice any improvement in mood until the day after their 2nd infusion. Some patients will require a third infusion before feeling significantly better. It is important to note that the results of ketamine can be sudden and dramatic, but they are not always. It is more common for patients to see gradual, subtle improvement. Sometimes function improves before mood does. For pain patients, it is uncommon to see substantial relief after 1-2 infusions. It is possible, and we do have patients leave the clinic pain free after one infusion, but that is uncommon. Most of the time, pain patients need to complete the full series of five infusions before they see substantial and lasting relief.
No. Some patients achieve long-term relief after one series of infusions. Others will find that infusions enhance the impact of antidepressants or provide initial relief that is then sustained by oral medicines, other therapies, and lifestyle choices. If ketamine therapy is the only solution for you, you may be able to space your infusions apart by 3-6 months. After the initial series of infusions restores the brain to a healthy balance, it is generally easier to maintain that balance than it was to attain it in the first place. Follow-up or “booster” infusions are provided on an as-needed basis for maintenance.
For mood disorder patients, ketamine is administered over a period of 50 minutes. The amount given will not cause you to lose consciousness. During the infusion, most patients have a mild dissociative experience, with an increased sensitivity to light and sound and an altered perception of time and color. Most patients tolerate these experiences without discomfort and many people find them to be pleasant. In the rare case these side effects are considered unpleasant, other rapid acting medications can be used to relieve or eliminate this discomfort. Once the infusion is complete, the dissociative effects of the drug rapidly dissipate and are often mostly gone within 20-30 minutes. There are no delayed “flashbacks” and patients generally leave our clinic within 30 minutes following the infusion and aside from mild fatigue, feel much like themselves. For pain patients, ketamine is administered over a period of 4 hours. The amount given is significant and can increase side effects like dissociation. Patients generally take 60-90 minutes of rest following the infusion before they feel comfortable leaving our clinic. There are no delayed “flashbacks” and aside from being tired or fatigued, most feel much like themselves. We require pain patients to be picked up inside our clinic by a responsible adult.
LPatients commonly feel tired following an infusion. On rare occasion, some patients experience nausea after an infusion. If so, we have medication that will relieve this. If you are prone to nausea, we can administer a prophylactic medication before the infusion to help prevent it. Side effects usually dissipate within a few hours and are completely gone by the following day. There are zero long-term or permanent side effects of IV Ketamine Infusion Therapy.
No. There has been zero link between therapeutic ketamine use and bladder damage, also known as cystitis. The only known reports of bladder damage caused by ketamine are based on the abuse of street ketamine at doses 10-20 times the amount we administer, taken daily, over the course of years. There has been a study on this topic, but bladder cells were exposed to ketamine for 72 hours at concentrations several thousand times greater than the peak serum levels achieved in patients undergoing sub anesthetic infusions of ketamine.
You do not need a referral from a psychiatrist or therapist but we do require pre and post treatment evaluations by a mental health professional in order to verify the efficacy of the treatment for you, monitor your progress, and ensure a successful treatment plan.
Please inform us of any and all medications you are taking.
We are particularly interested in learning if you are taking:
• Lamictal (generic name Lamotrigine). Patients should allow 6 hours between taking Lamictal and the start of their infusion. They should wait 6 hours after their infusion before resuming Lamictal
• Patients taking large doses of benzodiazepines may have a reduced response to ketamine. This does not mean you can’t receive ketamine treatment while taking benzodiazepines. It is perfectly safe. We want to ensure the best possible chances for your success though, so we may ask you to skip a dose 12 hours before the start of your infusion and wait until 6 hours after before resuming your benzodiazepine. Some common brand names are Xanax (Alprazolam), Ativan (Lorazepam), Valium (Diazepam), and Klonopin (Clonazepam).
• SSRIs and tricyclics do not interfere with ketamine. There is no need to stop them.
• If you are taking opiates, muscle relaxants, or anti-inflammatories, there is no need to adjust your dose.
• We can assist you in reducing or tapering off of any medications that are contraindicated, cause a reduced response to ketamine, or that you would like to stop taking due to negative side effects, ineffectiveness, or price. You should not adjust your dose or frequency of use of any prescribed medication without first consulting with your prescribing physician.