KETAMINE FAQS

General Information

Ketamine is an innovative, evidence-based, and FDA-approved dissociative anesthetic initially developed in 1962 to assist with pain during surgery. Today, when professionally administered in healthcare settings at lower doses as an intravenous (IV) drip, ketamine can positively affect regions in the brain that control behavior and mood. As a result, it’s become commonly used to enhance an individual’s sense of well-being and promote long-lasting healing for those with treatment-resistant conditions. 

On a basic neurochemical basis, it is an N-methyl D-aspartate (NMDA) receptor inhibitor.  Blocking the NMDA receptor allows for modulation of glutamate (an excitatory neurotransmitter) and ultimately increases levels of Brain-derived neurotrophic factor (BDNF) and mammalian target of rapamycin (m-TOR), which create protein synthesis in neurons.

Many ketamine experts consider this process a “reset” button for the brain, just like you would reset your computer.  A ketamine infusion allows the unhealthy neuronal pathways that are constantly “on” in your brain to turn off for a period of time.  One can consider all the unhealthy thoughts that continuously occur – such as automatic negative thoughts, obsessive thoughts, anxious thoughts, persistent pain – as these unhealthy pathways.  When your brain comes back “on-line”, you can then access the more healthy pathways or loops in your brain.

Simply put, ketamine works by shutting down overactive neurons while improving the healthy function of the existing neurons. In addition, ketamine improves neural connectivity in the brain that enhances daily, healthy brain function.  Ketamine helps a patient restore executive control of their thoughts and emotions.

Please bring a complete and accurate medication and allergy list and prior physicians’ diagnostic/treatment information. It is recommended that you bring a family member or trusted friend to help you understand if ketamine is right for you.

Infusion Day & Inner Healing

Accompanied by one of our providers, you will have a private room. Music and eyeshades are provided as you relax in a soft recliner chair. We encourage you to wear comfortable clothing and bring a cozy, light blanket. You are welcome to bring a companion to sit with you during the infusion.

Ketamine is administered over 55 minutes for mental health disorders and over four hours for chronic pain disorders. The amount given will not cause you to lose consciousness. Most patients have a mild dissociative experience during the infusion, with increased sensitivity to sound and light and an altered perception of color and time. Most patients tolerate these experiences without discomfort, and many people find them pleasant. In rare cases, these side effects are considered unpleasant, and rapid-acting medications can be used to relieve or eliminate this discomfort.

Once the infusion is complete, the dissociative effects rapidly dissipate and are often mostly gone within 20-30 minutes. There are no delayed “flashbacks.’  For mental health disorders, patients generally leave our clinic within 30 minutes following the infusion, and for chronic pain disorders, patients leave around two hours. Patients usually leave the clinic feeling much like themselves, aside from mild fatigue.

Temporary side effects may include dizziness, a floating or dissociative sensation, fuzzy vision, and mild hallucinations. However, once the infusion is complete, the main side effects resolve in approximately 15 to 20 minutes. We ask that you arrange to have a trusted friend or family member transport them home as an added safety precaution.

Also, as with any treatment that involves an IV, there’s always a risk of infection. Although it’s not very likely, if the infusion is improperly administered or if any non-sterile equipment is used, bacteria can be transmitted directly to your bloodstream and then spread quickly. Blood clots or vein inflammation are other risk factors to consider, although these can be rapidly addressed and managed. 

Before starting your treatment, our team will review your prescribed medication and discuss all possible side effects with you. Furthermore, each infusion is monitored by either a provider or a registered nurse to lower these risks.

Unlike conventional antidepressants, ketamine doesn’t need to build up in your system over time to be effective. Generally, mental health patients report feeling better within a few hours after their first ketamine infusion, while others don’t feel substantially better until they’ve had at least three or more infusions. So we typically plan for a series of six ketamine infusion sessions over three weeks. After this series is complete, some patients have opted for periodic maintenance or “booster” sessions that help in sustaining the positive benefits they’ve attained. The average time is 4-6 weeks, but it can be as long as several months.

 

 For treatment of chronic pain conditions, it is uncommon to see substantial relief after just one to two infusions. Generally, these conditions require a complete series of 3-6 infusions before patients see meaningful and lasting relief. Most patients will return for single “booster” infusions as needed monthly to quarterly if treatments are successful. 

 

It’s important to understand that even though ketamine can produce dramatic changes in brain function and mood, such results aren’t universal. You’ll likely experience subtle symptom relief that gradually improves from one infusion to another.

Ketamine Safety

Ketamine is an FDA-approved drug for anesthesia and surgical sedation. However, ketamine infusion therapy is not FDA-approved for psychiatric disorders or chronic pain, as this is considered an off-label treatment. Off-label prescribing is when a provider gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

 

The American Society of Ketamine Physicians, Psychotherapists & Practitioners, the Integrative Psychiatry Institute, and the American Psychiatric Association Council of Research have agreed that there is compelling evidence to support ketamine’s role in managing various psychiatric disorders. 
 
The American Academy of Pain Medicine, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists, have agreed that the collective evidence supports ketamine’s role in managing pain for the conditions listed above.

Ketamine infusion treatments are very safe when administered by highly trained anesthesia or mental health provider with Board Certifications.  In fact, according to the World Health Organization, “Ketamine [is] one of the most essential medications due to its therapeutic effects and wide margin of safety.” 

”Yes” ketamine has the potential to lead to addiction; however, it is extremely unlikely in the setting of professionally monitored infusions. Special care is given to the frequency, dosage, and method in which the ketamine is administered so that you are safe and protected from any possibility of addition. 

Mental Health & Financing

Any severe hypertension, chest pain, evidence of street drug abuse (cocaine, amphetamines, or opiates), or manic symptoms during your physical exam will prohibit you from receiving ketamine.

Even though ketamine therapy is usually safe for most individuals, a few conditions may disqualify you from this treatment. These conditions include, but are not limited to the following: individuals with a history of schizophrenia, nursing mothers and pregnant women, active mania/hypomania, allergy to ketamine, poorly controlled hyperthyroidism, liver disease, uncontrolled hypertension, kidney disease, or active substance abuse. Therefore, our team closely screens each new patient during our consultation process to ensure they are a safe fit for our program.

Luvita strongly recommends that our patients have an active ongoing relationship with a licensed therapist. Studies have shown that ketamine is more effective when given in the context of therapy. We understand that many patients have tried multiple therapy modalities without success before seeking treatment with us; however, they have not tried therapy with ketamine. We’ve built a strong and trusted network of mental health professionals that understand ketamine treatment which we can refer you to.

No, our team of experts will provide a consultation to determine if ketamine infusion therapy is right for you. Our team will work closely with your provider to ensure the best outcomes for your well-being. Those suffering from a mental health disorder will have to be under the care of a mental health professional.

Most other insurance companies do not cover ketamine use for psychiatric or chronic pain conditions. Insurance companies consider the latter investigational and “off-label.”

If you wish, however, we can provide you with an outline of your treatment and a comprehensive receipt to file with your insurance provider. Some patients may receive some compensation; however, most will not. As of this time, you will be responsible for covering the ketamine treatment as an out-of-pocket expense.

Alternative treatments include electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS).