Frequently Asked Questions
What side effects can I expect during and after an infusion?
Responses to ketamine vary from individual to individual. You will be awake and most likely continue to be able to interact with those around you, listen to music, or just close your eyes and relax during the infusion. Some patients report feeling dizzy, getting a sensation of floating or flying, blurred vision, nausea and rarely hallucinations. The infusion is generally a tolerable experience for most people, though is commonly described as “weird.” It can also leave some people feeling emotionally raw or vulnerable, while others may feel a sense of well-being or openness. You will be back to your baseline about fifteen to thirty minutes after the infusion ends and will be monitored for twenty to sixty minutes before you are discharged. Some people become extremely fatigued after infusions and/or may develop headache, a feeling of “heaviness,” or some nausea.
May I eat or take anything before coming in for treatment?
Please do not consume solid food, orange juice, pulp-filled juices, or non-clear broths or soups in the six hours preceding your appointment. You may have transparent liquids such as water, clear broth, apple juice, white grape juice (not dark), black coffee (NO DAIRY OR CREAMER), or clear tea (no milk or leaves) up to two hours prior to your appointment.
PLEASE REFRAIN FROM CONSUMING ALCOHOL, SMOKING OR INGESTING MARIJUANA, OR USING COCAINE, HEROIN, OR OTHER ILLICIT SUBSTANCES. Not only can they pose a safety risk when combined with ketamine treatment, but also they can interfere with the effectiveness of ketamine therapy.
Does Ketamine help people with bipolar disorder? What about other psychiatric illnesses?
Research supports the use of ketamine for bipolar disorder. Various studies suggest it shows some promise for chronic post-traumatic stress disorder, obsessive-compulsive disorder, substance addiction, and even traumatic brain injury as well. It is not for patients with schizophrenia, psychosis, or seizures. It has also been used for chronic pain conditions including, but not limited to, fibromyalgia, chronic migraines, neuropathic pain, cancer pain, and complex regional pain syndrome (CRPS). Its cognitive protection / ability to attenuate post-operative delirium has been observed by anesthesia providers for a number of years now and may hold promise for individuals with chronic conditions in which cognitive protection / synaptic regeneration is desirable (see “How does ketamine work?” below).
Will ketamine work for me?
Ketamine has shown significant promise in the studies that have been published within the last eight to ten years. On average, three out of four people experience some benefit from ketamine treatment for depression. It is important to remember that ketamine may produce no improvement in some, and in a small subset of patients may even worsen symptoms. There is no way to truly predict your personal success with ketamine treatments. There may be certain elements of your health history that may affect your body’s ability to respond well to ketamine.
Practitioners across the country are reporting positive results for their patients. For a list of ketamine infusion providers in the U.S., please see the directory on the Ketamine Advocacy Network website.
How quickly can I expect to see change in my depression?
Some patients begin to feel a difference by the evening or day after their first infusion. Even for “responders,” periods of sadness or depressed mood may still occur between infusions, but the overall trajectory of mood symptoms should be one of improvement. Responders may also find urges to self harm and suicidal thoughts diminished and ability to cope with stress improved.
Patients may find that functional improvements – getting a to-do list done, socializing more easily, etc. – occur before improvements in mood. Family and friends thus sometimes observe that a patient “seems better” even though the patient still feels the same. Changes can be gradual.
Some patients find that the positive effects of ketamine may wear off with time. There is research to suggest that in order for the effects of ketamine to be sustained, a maintenance regimen is advisable. The response of individual patients varies. There have been rare cases of remission after ketamine infusion therapy, but these should be considered the exception rather than the norm.
Ketamine should not at this time be thought of as a cure for depression but rather as an adjunct to ongoing treatment that can help reset a person’s baseline, relieve some of the suffering and hopelessness of major depression, and give other therapies such as oral medication and psychotherapy a chance to progress.
What is Ketamine and how does it work?
Ketamine is a Schedule III anesthetic agent. It was first developed in 1962 and later FDA approved for clinical use in 1970 primarily for use during the Vietnam War. Ketamine has had a tainted history because, much like similar medications that can cause dissociative effects, Ketamine became a drug of abuse (Special K). However, Ketamine continued to be a successful anesthetic being used in hospitals, dentist offices and medical practices with an excellent safety record.
In the past 5 – 7 years Ketamine was identified as having beneficial effects on patients with depression, suicidal ideations, anxiety, Bipolar disorder, PTSD and certain neuro-pathic pain syndromes. A large number of very reputable hospitals and organizations have studied Ketamine’s effectiveness in these areas and have shown very promising results.
Ketamine’s anesthetic effects are mediated by interactions with a member of the glutamate receptor family, the NMDA receptor. It interacts with other receptors as well, including opioid receptors, dopamine receptors, and a receptor known as the AMPA receptor, which is thought to be an important component of its antidepressant effects.
Rather than targeting neurotransmitters in the brain, ketamine is thought to target gene expression and protein manufacture in certain important brain pathways or circuits. It appears that ketamine restores brain synapses, both structurally and functionally, that have been damaged by the disease of depression.
Unfortunately, since Ketamine is out of it’s patent period the race is on to replicate Ketamine’s effectiveness into a new, marketable medication.
The treatment is here and available now. There is hope. There is help.
Can I get addicted to ketamine?
Because it is abused as a “party drug” or “club drug,” there are legitimate concerns about ketamine addiction. However, addiction has not been found when ketamine is used in the low doses given for these treatments. Additionally, these treatments are administered in a controlled setting by an anesthesia professional. We work closely with your referring physician or mental health provider to monitor your treatment.
Will ketamine interact with my other medications?
Patients do not have to stop their antidepressant medications to receive ketamine. Ketamine can be used safely with most medications including SSRIs, SNRIs, lithium, Wellbutrin, and tricyclics (with caution). Patients taking aminophylline for asthma or COPD may be at greater risk for developing seizures if they receive ketamine. Patients who are taking benzodiazepines (alprazolam, lorazepam, clonazepam, et al.) or lamotrigine (Lamictal) should work with their prescribers to wean off these medications prior to beginning ketamine infusion therapy in order to maximize the treatment’s efficacy.
Is there anyone who should avoid ketamine treatment?
Ketamine infusion therapy can benefit patients with severe depression or bipolar disorder. It is not for patients with schizophrenia, psychosis, or seizures. As mentioned above, those taking aminophylline for asthma or COPD should avoid receiving ketamine. Patients who have serious medical problems such as uncontrolled high blood pressure, cardiac disease, or pulmonary problems need to have their conditions optimized and to obtain clearance from their primary care physicians before undergoing even low-risk medical or anesthetic procedures, including ketamine infusion. You will fill out a health questionnaire and discuss your medical history and undergo a brief physical exam with your anesthetist.
How can I get started?
A referral from your therapist, counselor, chronic pain, psychiatric or medical doctor is necessary and you will be required to maintain ongoing regular contact with them throughout your course of treatment. You can contact Ketamime Clinic of West Texas through the “Contact” tab and we will email you the documents necessary to begin treatment. After we have the information needed to begin treatment we will contact you to set up an appointment.
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