KETAMINE INFUSION THERAPY
Frequently Asked Questions
What is Ketamine?
Ketamine has been widely used as an anesthetic in surgical and diagnostic procedures and was placed on the World Health Organization's "Essential Medicines List" due to it's safety profile and efficacy. In recent years, research has shown that in sub-anesthetic doses ketamine acts as a fast-acting antidepressant that can substantially reduce depression symptoms in hours or days, rather than weeks. Traditional antidepressants work by affecting neurotransmitters such as serotonin, dopamine, and norepinephrine, while ketamine is a selective antagonist of the NMDA receptor and primarily affects the glutamate neurotransmitter system. Mechanisms that may contribute to ketamine's antidepressant effect include inducing neurogenesis, new neural pathways, and increasing key areas of the brain including the hippocampus and prefrontal cortex.
Will Ketamine Therapy Help My Treatment Resistant Depression?
Based on a landmark study conducted by the National Institute of Mental Health, up to 70% of all patients can expect significant relief after a series of six ketamine infusions. We have found that by curating the patient experience, providing an exceptional level of support, and setting realistic expectations, we consistently see outcome metrics that outperform the NIMH study. It is important to understand that it is impossible to predict an outcome for a specific patient.
Are Ketamine Infusions Addictive?
No. While it may be possible to develop a tolerance or addiction to ketamine in instances of abuse, the protocols used in Dr. Mastis' clinical practice, while extremely effective at reducing or eliminating symptoms, do not create an increased tolerance or addiction.
Do I Need to Bring Someone With Me?
You do not need to have someone bring you or accompany you during the infusion, but we require that you have someone bring you home. We advise you not to drive a car until the following morning.
Can I Eat or Drink Before My Appointment?
You cannot eat for the 4 hours prior to your scheduled appointment. You may have clear liquids up until 2 hours before your appointment.
Do I Need to Stop Taking Any of My Medications Before I Begin Ketamine Therapy?
No. You should not make any adjustments to your current medications without specific approval from the prescriber. It is important to note that while there is some speculation related to benzodiazepine and lamotrigine and their effect on ketamine infusions, there is no actual evidence to support adjustments in either in advance of therapy. While these medications may reduce the dissociative effects of ketamine during an infusion, our experience suggests that they have no negative impact on outcomes.
Will My Insurance Pay for Ketamine?
Because IV ketamine therapy is used "off label" for mood and anxiety disorders and is still viewed as experimental, insurance companies do not provide reimbursement.
Will I Require Ketamine Infusions for the Rest of My Life?
Some patients seem to achieve long-term relief after the intial series of six infusions and others require additional infusions at varying frequencies to maintain relief. Aftercare is an important part of ketamine therapy and Dr. Mastis will work with you to determine the best approach for you to achieve lasting relief.
What Should I Expect During a Ketamine Treatment?
Ketamine is administered over a period of 40 minutes. The dose is determined by your weight. The amount of ketamine administered is not enough to cause a loss of consciousness, so you will remain awake. During the infusion some patients experience odd perceptions—like seeing bright colors. Some report what is referred to as a “dissociative” or “out of body” experience. These are side effects of ketamine that may be important for ketamine’s ultimate effectiveness. Most patients tolerate the experiences with no trouble, and many people find them pleasant. Once the infusion is complete, the dissociative effects of the drug rapidly dissipate. There are no delayed “flashbacks” and patients generally leave the office within 30 minutes following the infusion and feel quite normal. It is important not to drive, operate any dangerous machinery, or make any important decisions until the day after a ketamine infusion.
Do I Need to be Referred by a Psychiatrist?
No, you do not need to be referred directly by a psychiatrist. Dr. Mastis is a board certified psychiatrist and will meet with you to discuss your diagnoses prior to beginning treatment. Patients who are already seeing Dr. Mastis will work with her to determine readiness during a pre-infusion consultation. If you are currently being treated by another psychiatrist, Neural Health Therapies will want to discuss your treatment and progress with that physician.
Where is the Treatment Performed?
All treatments are performed on an outpatient basis in our relaxing and comfortable treatment room.
How Many Ketamine Infusions Will I Receive?
Initially most patients receive a series of six infusions spaced over two or three weeks. This follows the protocol developed during the NIMH trial and is the best predictor of efficacy.
What Happens After My Series of Infusions?
Following the initial series of infusions most patients choose, in consultation with their doctors, to begin a maintenance program returning for single infusions intermittently. The interval between maintenance infusions varies from patient to patient and often increases over time (infusions are required less frequently).
If Ketamine Therapy Works for Me How Soon Will I Feel Better?
A small group of patients will begin to feel better within hours of the first infusion. Patients with thoughts of self-harm often notice those thoughts dissipating first. There can be a dramatic relief of dread and hopelessness. Most patients may not notice any mood improvement until their third or fourth infusion. Almost all patients who will respond notice improvement after a series of six infusions.
Is Oral, Nasal, or IM Ketamine a Comparable Alternative to IV Ketamine?
The bioavailability of ketamine delivered intravenously is far superior to any other form of administration. This means that a much smaller dosage yields a superior result.
What Medical Conditions Could Prevent Me from Receiving IV Ketamine?
There are very few. Dr. Mastis will discuss contraindications with you before you receive your first infusion.