The New Hope in Treatment
At low dose levels, ketamine infusion therapy has been proven to redevelop the neural pathways in your brain that have been damaged by depression, anxiety, post-traumatic stress disorder (PTSD), and chronic pain.
Ketamine is an effective treatment for treatment-resistant depression, PTSD, post-partum depression, anxiety and other health conditions. In fact, the well-respected Cleveland Clinic named “Ketamine for Treatment-Resistant Depression” as one of the Top 10 Medical Innovations in 2018.
Not only is ketamine a highly effective treatment, it has had a long history of safety since its development and first use in humans in the 1960s. Two key features that make low-dose ketamine safe for outpatient use is that it does NOT cause respiratory depression and it has a short half-life.
Clinically-proven Depression treatment! The symptoms of Depression can place a massive burden on a patient and their family.
Ketamine infusions offer hope for a major reduction in your depression symptoms.
In the last 7-10 years, dozens of Ketamine research studies have shown promising results for the treatment of treatment resistant depression (TRD). Even in the most difficult-to-treat cases, Ketamine can be successful up to 80% of the time. Ketamine is currently the only fast-acting treatment proven to reduce the symptoms of even the most severe forms of depression.
Postpartum depression affects up to 15% of mothers.
The negative effects on child development are well-established. Previously, the only two treatment options were psychotherapy and anti-depressants. Neither option was very effective and took weeks to take effect. Families were also faced with exposing the infant to anti-depressants through breastmilk. THANKFULLY, there is now a FAST-ACTING option.
Unlike conventional anti-depressants that take weeks to take effect, Ketamine infusions are RAPID ACTING. And since they work so fast, breastfeeding can continue between infusions. Zulresso (brexanolone) was approved to treat post-partum depression in 2019. This infusion is SIXTY HOURS (2.5 days)! The infusion causes excessive sedation and the mother must be continuously monitored throughout... which likely means re-admission into a hospital. During this time, someone else has to care for the infant. Breastfeeding and bonding are significantly interrupted. The total estimated cost is $38,750.
Ketamine infusions are around $350 per infusion and most people obtain relief around the 4th infusion. Mom is only away from her baby for two hours at a time. And Ketamine is actually the preferred procedure drug for pediatrics... so it has been safely used in thousands of children. This means Mom can continue breastfeeding.
Post-Traumatic Stress Disorder (PTSD)
PTSD is a chronic and often disabling condition. Initial research has shown that glutamate plays a major role in the stress response. Ketamine acts as inhibitor of glutamate. Research has been published which indicates even a single Ketamine infusion administered for the treatment of PTSD can rapidly and effectively reduce symptoms. Literature has shown that a single 45-minute Ketamine Infusion can produce rapid reductions in PTSD symptoms as measured by the Clinician-Administered PTSD Scale to increase the duration of effect a series of 6 infusions.
Ketamine is most effective with neuropathic pain like Complex Regional Pain Syndrome, post-herpetic neuralgia (shingles) and phantom limb pain. We often hear that it is “life-saving.” It has also shown promise with non-neuropathic pain conditions like fibromyalgia. Chronic pain is a complex condition. Therefore,
we require a referral from your pain management team or CRPS specialist. If you are transferring here from another area, we will accept records from your other ketamine and pain clinic until you can establish with a local pain management clinic.
Most of the time, patients with anxiety disorders are treated with an antidepressant and/or benzodiazepine. Unfortunately, 30-40% will not achieve remission with conventional treatments. Also benzodiazepines cause drowsiness and are physically addictive, making them poor options for routine use. For the non-responder, there are currently no good options except for possibly Ketamine. Evidence for the use of Ketamine is accumulating for an array of anxiety disorders, including general anxiety disorder (GAD) and social anxiety disorder (SAD).
Migraines can be debilitating. There are great oral and home-use treatments, but what happens when those don’t work?
We offer multiple fast acting acute migraine treatment options. These treatments include IV Ketamine infusions, Toradol injections
and IV micro-nutrient therapy (Magnesium and B-vitamin infusions). Depending on what you have tried in the past
and what works, will determine the best treatment course.
Our typical order of treatments are magnesium infusion, Toradol shot, then a ketamine infusion.
If a treatment is effective we stop there and repeat that
treatment for future migraines and only progress if needed.
What to Expect
Ketamine infusions should be a part of a comprehensive treatment plan. For all patients, your overall mental health care must be directed by a primary care or mental health provider. We have found that many providers are not familiar with the amazing benefits of ketamine therapy or actively resist it. Therefore, a referral is not always required.
However, we do require that all patients schedule a history and physical exam with our Certified Nurse Practitioner prior to your first Ketamine Infusion. This exam determines if you are a candidate for ketamine and assesses if you have any health conditions that make Ketamine unsafe. These conditions include, uncontrolled hypertension, increased intracranial pressure, heart failure,
and allergy to Ketamine.
We are happy to meet with you to answer your questions about whether ketamine is a good fit for you. Just schedule a free consult.
What’s the last resort when other antidepressants don’t work for severe depression?
Ketamine intravenous (IV) infusion is a breakthrough therapy for people with severe or treatment-resistant depression (TRD). TRD is a condition where at least two adequate antidepressant treatments didn’t work.
Ketamine infusion is fast-acting and safe. A single low dose infusion can have long term effects of up to 15 days. It’s also effective for people with TRD who exhibit symptoms of suicidal ideation.
Depression is one of the most common psychiatric disorders in the world. It affects people of all communities. If left untreated, depressive symptoms can become chronic and disabling. It hinders a person from doing day to day tasks efficiently.
A variety of medicines and psychosocial therapies are available to ease symptoms of depression. But treatment resistance was noted in about one-third of people who fail to achieve full recovery. Thus, there’s ketamine infusion therapy for TRD.
Infuse Zen will be offering Ketamine infusions for a better quality of life. If you qualify for IV ketamine therapy, or you are considering ketamine IV infusions, here are some frequently answered questions (FAQs) that we have for you:
What is ketamine?
Ketamine is a glutamate N-methyl-d-aspartate (NMDA) receptor antagonist mainly used in the field of anesthesiology. It works by blocking sensory perception in the patient and has been approved for use in anesthesia since the 1970s.
What are the uses of Ketamine?
Ketamine was originally used in veterinary medicine and for pediatric sedation. Aside from pain management, Ketamine has been noted to have bronchodilator effects (studied in the management of asthma exacerbations in children) and observed to be useful in cases of status epilepticus.
The classification of ketamine as a dissociative agent makes it very effective as an analgesic Ketamine has been widely used to provide analgesia in burn dressing changes, during excision and grafting and for sedation, and even in prehospital or battlefield settings where resources are limited. It has been used off-label in the management of chronic pain and neuropathic pain.
Is Ketamine safe?
Yes. Ketamine has been used for more than 50 years as a potent analgesic with a safe anesthetic profile. Administering it in the right doses does not affect the airway reflexes nor does cause respiratory depression, making it a preferred drug for pediatric analgesia. It also does not lower blood pressure like most anesthetics.
How does Ketamine work in patients with depression?
In simple terms, depression results from imbalances in communication systems in the brain. Ketamine works by stimulating growth of neurons within the brain, allowing the different systems to communicate effectively with one another.
Biochemically, ketamine is a non-competitive, glutamate N-methyl-d-aspartate (NMDA) receptor antagonist. NMDA-receptor antagonism is linked to the potentiation of glutamate transmission at α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors and increased brain-derived neurotrophic factor (BDNF) levels, which are associated with antidepressant properties.
It has been speculated though, that there are still other mechanisms that remain to be discovered regarding ketamine and TRD - such that studies are still being conducted further to hopefully uncover the exact mechanism responsible for the strong and sustained effect of ketamine infusions against depression.
What medications interfere or interact with Ketamine?
Ketamine is very safe, but fortunately the drug interactions are only a few. Ketamine is noted to have synergistic effects on some drugs and may decrease the effectiveness of other drugs.
People who are suffering from substance abuse or alcohol abuse are often prescribed benzodiazepines – which are known to decrease the effectiveness of ketamine. Specific examples of benzodiazepines are Ativan, Klonopin, and Xanax.
Medical practitioners prescribe these drugs for anxiety, muscle spasms, and sleep disorders. However, benzodiazepines can delay and decrease the effects of ketamine if used in conjunction.
On another note, people with epilepsy and bipolar disorders are often prescribed lamotrigine. Lamotrigine 150 mg or higher doses for bipolar disorder and seizures decreases the effectiveness of ketamine. Hence, lamotrigine decreases glutamate while ketamine increases it.
Lithium stabilizes the mood of people with bipolar disorder. Unlike benzodiazepine and lamotrigine, lithium enhances the antidepressant effects of ketamine.
Should I stop taking my prescribed medications once on Ketamine therapy?
No. You should continue taking your medications as prescribed by your psychiatrist or mental health provider. After your consultation, we will guide on which medications may need to be adjusted and you can report these recommendations to your mental health provider.
If I have other medical conditions, can I still get ketamine infusion?
People diagnosed with psychosis are not allowed to undergo ketamine IV infusion. Ketamine may increase the possibility of dissociative episodes which may aggravate the symptoms of people with psychiatric disorders.
Some medical conditions like arrhythmias make ketamine unsafe. Untreated glaucoma and untreated high blood pressure, must be corrected prior to starting ketamine infusions.
What are the current routes of administration of Ketamine?
Aside from intravenous infusions, there are other routes of ketamine administration. These are intramuscular, nasal, oral, rectal, subcutaneous, and sublingual administrations.
The most rapid method to deliver Ketamine is through the intravenous route. This also helps effectively regulate the delivery of the drug in its proper dose. Ketamine IV infusions have the fastest onset and recovery. They are also easiest to adjust the dose/rate throughout the infusion.
Ketamine can also be given intramuscularly, however, higher doses are required as compared to IV infusions and the procedure can cause localized bruising at the IM site. The intramuscular route is well studied largely through its role and application in pediatric sedation, where intravenous access is usually difficult.
The most recent route of administration is through the intranasal route, which is the route of choice for esketamine, its enantiomer, in the treatment of TRD.
What should I expect during my Ketamine IV Infusion session?
Upon arrival at the clinic, you will be asked to do some standard paperwork and you will be set up on Mood Monitor, a tool that allows the clinic to monitor changes before and after each infusion.
After processing payment, you are then ushered to one of our three private treatment rooms to start IV therapy. Once you are settled comfortably, you will be set-up on the monitors and your ketamine infusion will be initiated. Please do not be afraid to raise any concern to the staff, especially your expectations on what you will be going through on your first session.
During the infusion, most patients are noted to dissociate. This is entirely normal, and the staff will be there to monitor and guide you throughout the process. You will feel dreamy or light after several minutes, a mood that some call a “reflective state”. Please do not hesitate to call the staff’s attention once you feel uncomfortable during your infusion. Once the infusion is complete, you will be given time to rest and recover for 30 minutes. In the absence of any untoward effects, your IV line is then removed, and you will be discharged.
The day following your infusion, expect to receive a questionnaire from Mood Monitor. Kindly complete the questionnaire as this is extremely important to monitor your response to the infusion.
What are the possible side effects after getting Ketamine infusions?
Patients often report feeling “strange or loopy” within minutes of the start of the ketamine infusion, and resolves within two hours. There were also reports involving minor and temporary effects such as nausea, vomiting, dizziness, double-vision, drowsiness, restlessness, and confusion.
When this happens, kindly call the attention of the staff assigned to you to assist you with your needs. Other than that, there were no serious drug-related adverse effects noted, no reports for dependency and tendency for recreational use, no significant cognitive or memory deficits noted within a three-month period of monitoring and follow-up.
Thus, the best way to get your Ketamine IV infusion is through a professional clinic where you can be monitored by a healthcare professional, and you are given the right dose for your therapy. Infuse Zen assures you that you are monitored well and given the safe dose, hence quality of care is not compromised
Ketamine is also known as a club drug. Can frequent Ketamine infusion sessions get me addicted to Ketamine?
Ketamine as a recreational drug was first reported in the 1970s. “K-hole”, “Super K”, or “kai-jai” are some of the terms associated with ketamine. The misuse of ketamine as a club drug increased at the turn of the century.
As a therapeutic substance, you will be unlikely to get addicted to it since the dosage and frequency of infusion is controlled at low and specific doses. Moreover, chances of addiction are nil unless you are self-medicating.
Ketamine is FDA-approved (for anesthesia) but is used off-label for depression. What does this mean?
Ketamine has been approved since the 1970s for anesthesia purposes. However, it does not mean that because it is “off-label’ for depression, it can’t be used safely for this indication. It only means that the drug manufacturer can’t advertise for its use in depression.
Take for example, aspirin is FDA-approved for fever and pain, but is widely used off-label for preeclampsia, emergency management of stroke or a heart attack, and even prevention of blood clots in people who have atrial fibrillation. Off-label only indicates that it is not FDA approved for depression, but a significant amount of research and data already shows that it is effective and safe, and has already been used widely by doctors and medical health professionals as an adjunct to current therapeutic methods
How often do I need to come in?
The standard regimen followed at Infuse Zen is six infusions spread over two to three weeks. Adjustments are made based on individual response.
Though randomized controlled studies have documented responses even on the first day of infusion. Our experience in the clinic is that most patients have a response by the fourth infusion.
When this occurs, remaining infusions are then spaced out a bit longer (e.g. instead of the 5th infusion occurring in two-three days, we postpone it to five or even seven days). Take note however that the number of sessions for each patient are extremely variable and is based on patient response and preference.
Please do not forget to complete Mood Monitor so we can help you get the optimal management plan for your condition here at Infuse Zen we are highly committed to give you the best experience in our clinic.
How long will each Ketamine IV Infusion session last?
Ketamine infusions for mental health are administered over forty minutes. The approximate recovery time is about thirty minutes (this is on a case to case basis – some patients take longer time to recover). All in all, most patients can expect to spend almost two hours in the clinic from the start to the end of the infusion session.
Do I need to bring someone with me to my sessions?
You can come on your own. And most of our patients prefer this. However, you may bring someone to sit with you. Since we encourage “letting go” during a ketamine infusion, we have observed that having a friend or family member can interfere with that process.
You are not advised to drive right after a session for safety reasons. You need to plan for your ride prior to the start of your ketamine session. Most of our patients have us call their ride once they enter recovery. Uber or Lyft is also allowed. Kindly inform the staff of your after-recovery plan before the start of the session.
Can I eat prior to a Ketamine IV infusion session?
You will be advised to not eat six hours before your scheduled therapy. Nausea and vomiting happens in about 50% of patients during and after the therapy. You can however drink clear liquids up to two hours before the session. Because nausea and vomiting can happen, you will be given Ondansetron (Zofran) IV prophylactically to prevent this from happening.
So, there you go! It will be so easy, and you can breeze your way through it!
New Ketamine Patients!
First-time patients will need book a Pre-Ketamine Consult prior to your first infusion. This consult reviews your history and determines whether Ketamine is an appropriate treatment option. Referrals are not required*, but you must be established with a mental health or primary care provider prior to starting treatment.