How many ketamine infusions will I need and how often?
Initiation treatment for depression/bipolar depression/PTSD:
-2 treatments first week (1 hour)
-2 treatments second week (1 hour)
-total 4 treatments
Maintenance evaluation and treatment for depressions/bipolar depression/PTSD:
-your first maintenance treatment (5th treatment) will be 2 weeks after your 4th treatment.
-second maintenance treatment (6th treatment) is give 3 weeks after that
-after this the frequency will depend on your response, most people have maintenance once a month. This is basically based on the amount of time you feel good after the treatment (if you feel good for 1 week than maintenance is once a week, if you feel good for 2 weeks than maintenance is every two weeks and so forth).
-the cost will be higher in the beginning due to the initiation period and the time needed to assess your response to treatment and the frequency of maintenance treatments.
How successful is the ketamine infusion treatment?
About 70% of patients see an improvement as early as after their first treatment. However, the improvement in symptoms after this treatment could only last hours to days. For example Major depression improvement tends to last longer than bipolar depression. The response will become more persistent with the continuation of infusions based on current information we have.
Should I stop my medications before my treatment with ketamine?
You should NOT stop your medications. During your evaluation with your mental health provider you might find that you might be able to decrease some of your medications, but this is not usually the norm. Failure to continue on your medication regimen could compromise your ketamine response and potentially put you at risk of getting worse. We will need to communicate with your provider before you make any medications changes.
Should I stop my medications after my treatment with ketamine?
Usually you will find that you will be able to decrease your medications. This will have to be done by your provider during your follow up visits with them. Usually the changes are not advised until you get on maintenance ketamine therapy. We will need to correspond with your provider before you make any medications changes as they could result in worsening of your condition.
What to expect during ketamine infusion?
The treatments are administered in quiet rooms with soft lighting. You will be seated in a comfortable recliner, we recommend bringing your music and headphones. You will be asked to empty your bladder prior to the treatment.
IMPORTANT: No food or non-clear fluids 4 hours prior to your treatment and no clear liquids 2 hours prior to your treatment. This is needed because you are getting sedative medications. Failure to comply with this requirement puts you at risk of complication so the treatment will not be administered and will be cancelled. There will be a $100 cancellation fee if this is happening. Please arrange for a drive home if your treatment is cancelled.
The physician and the nurse will be available for questions.
Next, a small IV line will be placed in your arm. We will monitor your heart rate, blood pressure and oxygen levels. You will be observed for any signs of adverse effects. We discourage phone calls, email, text etc during the duration of the treatment. The nurse and physician will allow privacy for your experience but will continue to monitor you and be available for help if needed.
After the infusion starts, you might feel strange, some people report an “out of body” experience. Other reactions could be blurred visions, double vision, decreased coordination, dizziness. These are called “dissociative” effects of ketamine. You will still be able to communicate your needs. You might feel your senses are heightened, feel like you are in a dream state, you will not process information in the usual way. Listening to soft music will help you stay connected with reality and reduce anxiety.
Near the end of the infusion you might have nausea due to the double vision caused by ketamine. Closing your eyes should help.
After the infusions:
You will need to stay with us until you recover from the infusions. You will need a ride home (you cannot drive for at least 24 hours). The infusion and recovery take up to 2 hours so please be prepared to spend that time in the clinic.
We ask that you do not eat solid foods or non-clear fluids for 4 hours after your treatment. You may drink clear fluids 2 hours after the treatment ended. You may not drive or operate machinery for 24 hours after the infusion. After that, refrain from doing so if you feel you are still incapacitated.
After the infusion you will be monitored for 1 to 1.5 hours to make sure you are safe to get up and walk around. Mild side effects could be experienced up to 4 hours following the infusion.
How do you know the infusion is working?
Like any other type of treatment, ketamine infusions do not work for everybody. Fortunately, you should notice improvement in as little as 3 sessions. If there is absolutely no improvement after the 3 session we do not recommend to continue as it is unlikely you will benefit from further treatments.
What ketamine can help with:
- Major depression
- Bipolar Depression
- Postpartum depression
- Suicidal thoughts
- Consultation: you will have an initial phone consultation with our physician. You will be asked about your clinical history, medication, past treatments. We will need to obtain your records and recommendation from your treating provider in order to assess the appropriateness for ketamine infusion therapy. You will need to continue your visits and treatment with your provider while receiving the ketamine infusion.
- First treatment: your first treatment will be scheduled once all the information needed is obtained. Plan to be at the clinic for 2-3 hours (the actual treatment takes approximately one hour). You will need a ride home.
- Initial set of treatments: you will need 2 treatments per week for 2 weeks (total 4 treatments). This is called a loading dose.
- Maintenance: this will depend on your response to the ketamine infusion and can be every 2 weeks to every 3 months (average is once a month).