Ketamine Infusions for Depression

How Do You know if your Infusion Ketamine Treatment is Working?

While the success rate of ketamine is notably high, it doesn’t work for everyone. Fortunately, in most circumstances, it only takes three infusions to determine whether or not you will benefit from this therapy. If there is not an adequate response after three infusions, we typically recommend discontinuing ketamine therapy.

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If you do not respond significantly after 3 ketamine infusions, you will be considered a non-responder. In this case it is unlikely further doses will be of benefit to you.

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How Many Ketamine Treatments Will I need and How Often?

Initiation Treatments for Depression (4 treatments total) 

• 2 treatments the first week

• 2 treatments the second week

• Our Ketamine infusion specialists will monitor your improvement and manage the dose of Ketamine during these sessions, to provide you maximum benefit.

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Maintenance Evaluation and Treatment for Depression/other Conditions

• The first maintenance evaluation treatment ( 5th treatment overall ) begins 2 weeks after the last initiation treatment.

• The second maintenance evaluation treatment ( 6th treatment overall ) is given 3 weeks after that.

• After this time we will see you solely based on your clinical response to therapy (75% of patients need maintenance infusions every 4 weeks).

• The interval between future maintenance treatments will depend on how long you feel good, after your maintenance interval evaluation treatments. If you feel good for only one week, then you will need maintenance treatments once a week. If you feel good for 3 weeks, you may need maintenance treatments once every 3 weeks. We can try to extend treatments up to 4 week intervals, or even longer, depending on your response.

Minimizing the costs are very important to us. Multiple touch points are required in the early stages of your treatment to evaluate how the dose, duration, and maintenance intervals for future treatments.

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Should I stop my medications before my treatment with Ketamine?

Absolutely Not. You may find in time, with the help of your psychiatrist or other managing physician, a decreased need for some of your medications, but this is not the norm. We do not encourage you to change any medications for pain until you get on maintenance Ketamine therapy and in direct consultation with your pain management, psychiatrist or other managing physician. Failure to continue your current medication regimen, could compromise your Ketamine response and potentially put you in danger of worsening your condition. We will need to correspond with your provider before you make any medication changes.

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Should I stop continue my medications after my treatment with ketamine?

Yes you should. You may find in time, with the help of your psychiatrist or other managing physician, a decreased need for other depression medications. We do not encourage you to change any medications for depression or anxiety until you get on maintenance Ketamine therapy and in direct consultation with your psychiatrist or managing provider. Failure to continue your current medication regimen, could compromise your Ketamine response and potentially put you in danger of worsening your condition. We will need to correspond with your provider before you make any medication changes.

 

How successful is Ketamine infusion treatment?

Ketamine infusion treatment is successful and immediate after only one treatment in about 70% of patients. The relief after the first treatment, however, can be only hours to days. Research has determined that the depression-relief can be extended like many drugs by increasing the number and dose of early treatments before determining a maintenance treatment regimen.

 

What to expect during ketamine infusion and how to minimize side effects ?

You will be with seated in a comfortable reclining chair and soft lighting.  Prior to this, you will be asked to empty your bladder before the infusion starts.  You will not be able to get up and walk to bathroom during the infusion.

 

Next, a small IV will be placed for the ketamine infusion.  We will monitor your heart rate, blood pressure, and oxygen, using a state-of-the-art monitor and you will be observed for any signs of adverse side effects. We do not encourage conversations, as your experience will be enhanced in a quiet environment.  You are strongly urged to bring soothing music and your headphones to make the experience even more enjoyable.

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Shortly after the infusion starts, you may start feeling strange and possibly have an “out of body” experience. You may also experience some blurred vision, double vision, decreased coordination, and mild dizziness. You can still talk and communicate your needs. These effects are the normal and expected response to the dissociative effect of ketamine. Having the music helps you stay connected to reality and decreases any fears you may have. During the infusion, the physician or nurse will try to minimize stimuli in the room and give you your space, but will be immediately available for any questions or concerns.

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Ketamine will heighten your senses and make you feel like you are in a dreamlike or illusionary state. Please note that during the infusion you will not process information in the usual way. 

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Near the end of the infusion you may feel nauseous, due to the blurry and double vision associated with the infusion. Closing your eyes may help stop or diminish the nausea feeling. Medication is available if this occurs. 

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After the infusion we will monitor you for approximately 1 to 1.5 hours or until we feel you are safe to be able to get up and walk around safely. Even though the majority of the side effects of ketamine resolve at the end of the treatment, some studies have shown minimal effects lasting up to 4 hours after infusions.

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We ask that  you don’t eat any solids or non clear liquids for 4 hoursor drink clear liquids for 2 hoursbefore appointment as you are getting a sedative medication.  Failure to comply with this requirement could potentially require us to cancel you infusion for the day and reschedule you for another day. There will be a $100 cancelation fee if this happens. Please setup a ride back home or to your hotel room. You may not drive or use heavy machinery for 24 hours after the infusion. 

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