Ketamine FAQs
Ketamine treatment is an IV infusion administered in a specially-equipped medical setting by a physician anesthesiologist or nurse anesthetist.
The National Institutes of Health has been studying ketamine’s effect on depression for more than ten years. There is scientific research proving the effectiveness of this treatment, which means controlled, double-blind, peer-reviewed studies at major institutions. Researchers at Yale pioneered this research nearly 20 years ago and published the first major study in 2000. Since then, dozens more ketamine studies have been conducted at Yale and other major institutions including NIH, The VA, Harvard, Johns Hopkins, Mt. Sinai Medical School, Oxford University, and many more around the world.
Ketamine therapy is not currently covered by insurance. Therefore, ASTRE Wellness does not accept insurance. The fee for our initial treatment for depression and mood disorder patients is $350. Additional treatments, if necessary, will also be $350.
The fee for our initial treatment for chronic discomfort is $750. Additional treatments, if necessary, will also be $750. This fee is all-inclusive with no additional charges.
We accept all major credit cards, FSA, and HSA.
Yes. A well trained, highly competent medical staff member will deliver your ketamine infusion, monitor your safety, and provide any interventions you may need during your infusion.
Sensitivities or allergies to any of the medications we use are rare, but we have the appropriate interventions, if this happens. Your well-being is our top priority. When safely administered by a qualified medical professional, there is nothing to worry about except your recovery.
Ketamine works by a completely different mechanism than any of the other medications you have taken. It primarily blocks NMDA receptors in the brain. This cascade affects certain receptors and signaling pathways, and produces a protein that triggers rapid growth of neural connections. Scientists have provided evidence that neurons and nerve channels are repaired and “rewired” resulting in the lasting relief seen in so many patients.
About 75% of patients with treatment-resistant depression (including bipolar patients) experience rapid relief after a low-dose ketamine infusion. Similar success rates have been seen in returning combat veterans suffering from PTSD. These patients’ cases are the worst of the worst, lasting years or even decades, and which have not responded to any other treatments. Many have hovered on the verge of suicide for years, many have actually attempted suicide, and all have endured a very poor quality of life. Before ketamine therapy, there was virtually no way to substantially improve the condition of patients like these. The fact that ketamine works rapidly on 75% of them is astonishing, and its discovery has profoundly changed depression research, and our understanding of the very nature of depression. It’s important to keep in mind, however, that the degree of relief can vary among patients. Some sufferers get only partial relief, some do not get relief until a second or third infusion, and some do not respond to ketamine at all. And some patients have additional medical conditions in addition to depression that can reduce its effectiveness. However, most patients have significant, if not total, relief.
Just like the success seen with mood disorders, scientific research has demonstrated
ketamine to be a very effective treatment with a similar efficacy of about 75-80%. The mechanism of action is different from the medications used for acute pain such as Dilaudid, Percocet, Vicodin, Morphine and others. Ketamine blocks the NMDA receptors in the brain from receiving a constant barrage of input from receptors around the body. Results are often seen in 1-2 hours. Long term relief requires a series of infusions.
The vast majority of patients have relief within 2 hours of the first infusion. Many patients report the increased ability to function and be productive as dramatic. While individual results may vary, what can be expected is an overall improvement in outlook and attitude. Given the high rate of success, and relatively low risk, there is little to lose except your stress.
The research shows that a series of 6 treatments over 2 weeks can provide relief lasting months. Some patients can go 3-6 months before needing another single treatment while some may need one treatment every 1-2 months.
While ketamine is most commonly delivered intravenously, a few other methods are also used: intranasally, and sublingually to name a few. However, due to the reduced bioavailability, these delivery methods typically require either larger concentrated doses or more frequent applications to be equally useful. As a front-line treatment for psychiatric and physical conditions, our clinic therefore practices administering ketamine intravenously to all of our patients.
Ketamine has been used safely for surgical anesthesia and trauma management in
hospitals and elsewhere for over five decades, has been included on the World Health Organization’s Essential Medicines list since 1985, and has few side effects. Although it is sometimes abused recreationally in high doses as a “club drug,” there is no evidence that ketamine is addictive.
Ketamine produces an opioid sparing effect (mu opioid sparing and opioid potentiation)
and many patients are able to reduce their opioid intake by as much as 50% or more. Some patients are able to permanently eliminate opioids.
Ketamine therapy is NOT a first-line treatment for either mood disorders or chronic discomfort. Many people can get relief from their symptoms with medication prescribed by their primary care provider, pain specialist, or mental health specialist. However, some do not experience relief of their symptoms and are considered “treatment-resistant.” These are the people who may be good candidates for ketamine infusions. Some medical conditions may exclude you as a good candidate, such as pregnancy, acute pyschosis, or schizophrenia.
Some conditions need to be optimized before initiating ketamine infusions, such as hypertension, sleep apnea, or seizure disorders. If you have a condition called Interstitial Cystitis (IC) we ask that you consult your urologist prior to initiating ketamine therapy; they may wish to optimize your bladder health, perhaps to include a cystoscopy, to establish a baseline & optimize your bladder health prior to ketamine treatments.
Anyone with chronic liver disease will need to have lab work both before & after ketamine infusions to monitor your liver function. A consultation with one of our providers can help determine if you are a good candidate to receive ketamine therapy.
A direct referral from a psychiatrist or primary care provider is preferred. However, an initial phone or office consultation with one of our mental health providers can determine if you are a good candidate for ketamine therapy. Without a referral, we will ask you to bring in copies of your medical records showing a documented diagnosis for one of the many disorders we treat.
Qualifying for ketamine infusions is simple, but can take some time. Usually a patient will qualify as a candidate if they have not received adequate relief from two or more traditional antidepressant medications.
Once qualified, a few simple intake forms are required to be completed in order to assess your current state, medications, and your expectations for the treatment. Sometimes, this will require a signature from your physician or mental health care provider.
On the day of your first infusion, it is important to maintain a special diet to reduce the chances of developing any nausea from the treatment. Typically, this means avoiding acidic juices, and other similar foods that may irritate your gastrointestinal tract.
Please arrive at the clinic at least 15-minute prior to your scheduled appointment to ensure that you have everything ready for your health care provider.
Each patient will have the intravenous solution administered in one of our comfortable, private treatment rooms. During this process, your heart rate, blood pressure, and oxygen levels are closely monitored. The typical treatment for depression lasts 40-45 minutes, and the treatment for chronic pain varies. Some last for up to 4 hours based on the severity of the condition.
During the infusion, you will remain awake, but some patients experience some mild side effects. It is common for some to experience dizziness or even softly hallucinate. Occasionally, some patients develop nausea, however we are equipped and ready to administer anti-nausea medication, should the need arise. Most patients listen to soft music and unwind while they wait for their infusion to complete.
Following each infusion, we prefer each patient to remain at the clinic for 15 -30 minutes. This is so we can ensure your treatment is well received, and so we can answer any questions you may have. Most residual side effects only last for the first 2 hours following administration, but we still ask that you not drive or operate heavy machinery for 24-hours post-infusion.
On the day of your ketamine infusion, it is important to maintain a special diet to reduce the chances of developing any nausea from the treatment. Typically, this means avoiding acidic juices and other similar foods that may irritate your GI tract. We ask that
you not eat 6 hours prior to your infusion. You may drink WATER up to 2 hours prior to your infusion.
For Ketamine infusions we ask that you bring someone to drive you home, as you will not be allowed to be discharged from the facility by yourself. Your driver does not have to stay for the infusion, but they must be available to pick you up when you are ready for discharge.
Still have questions, contact us.