Information for Patients

From the literature and published studies, Ketamine may help with Major Depressive Disorder (MDD), Treatment-Resistant Depression (TRD), Bipolar Depression (Types I and II), Postpartum Depression, Posttraumatic Stress Disorder (PTSD), Severe Anxiety, Obsessive-Compulsive Disorder (OCD), Fibromyalgia, Severe Migraines, Chronic Regional Pain Syndrome, Chronic Neuropathic Pain.

Ketamine Infusion Therapy is most helpful for those patients suffering treatment-resistant depression, i.e., patients who have tried at least two traditional anti-depressants (tricyclics, SSRIs, SNRIs, MAOIs) without adequate improvement and/or undesirable side-effects.

Ketamine has been proven to reduce the symptoms of severe, even suicidal treatment-resistant depression for up to 75% of patients. Furthermore, ketamine acts very rapidly, often within hours, as opposed to several weeks with conventional anti-depressants. Ketamine Infusion Therapy is NOT for those suffering temporary or situational depression caused by environmental factors, grief, relationship problems, etc.

National Institutes of Health researchers found that a single, low-dose ketamine infusion was relatively free of side effects for patients with treatment-resistant depression.

From the same study by NIH – Out of 120 possible side effects evaluated, 34 were found to be significantly associated with the treatment. Eight occurred in at least half of the participants: feeling strange, weird, or bizarre; feeling spacey; feeling woozy/loopy; dissociation; floating; visual distortions; difficulty speaking; and numbness. None persisted for more than four hours. No drug-related serious adverse events, cravings, propensity for recreational use, or significant cognitive or memory deficits were seen during a three-month follow-up.

The traditional medications prescribed for depression are either not fast-acting enough or effective enough. Ketamine is an effective alternative for some patients. It works differently from an SSRI such as Lexapro or Zoloft.  The classical “shorthand” explanation for how SSRIs work is the “chemical imbalance” theory -There is a deficit of serotonin, and SSRIs increase serotonin levels. That was never really true.

Depression is linked to the build-up of proteins in the brain—ketamine can repair damage to the brain that are the result of long-term stress hormones. The body’s response to stress spills cortisol and other hormones in the brain and damages it in the process. Ketamine is thought to have much more rapid effects on increasing brain plasticity.

Most medications do not need to be stopped prior to treatment with Ketamine.

Benzodiazepines and Lamictal (lamotrigine) have both been shown to partially inhibit the effectiveness of the infusion. Patients taking these medications should, if possible, avoid these medications for 12 hours before their infusion, and should wait 6 hours after their infusion before resuming them. If you are taking relatively large dosages of benzodiazepines, to maximize your potential for a successful response to Ketamine therapy you may need to work in advance with your prescribing physician to taper your dose down.

• Active substance abuse — alcohol, cannabis, non-prescribed medications (Urine toxicology screening prior to the initiation of treatment to prevent the risk of precipitated mania may be ordered by an anesthesiologist).
• History of psychosis, History of increased intracranial pressure, pregnancy (current), uncontrolled hypertension or/and  Acute or unstable cardiovascular disease.
• A previous negative response to ketamine.

Ketamine has approval by the FDA for a surgical level of anesthesia. Medical uses outside of the operating room are considered “off-label,” but allowed when deemed medically appropriate by a medical doctor.

It has been estimated that over 20% of all prescriptions in the United States are “off-label.” Indeed, many academic medical centers, including Yale University, the University of California in San Diego, the Mayo Clinic, and the Cleveland Clinic, have all begun offering ketamine treatments off-label for severe depression.

Ketamine infusion therapy is not a service typically reimbursed by insurance companies. As the treatment gains acceptance, we hope this situation changes. However, depending upon your individual medical insurance plan, some portion of the treatment may be eligible for partial reimbursement. We will provide you, on request, with the paperwork to submit to your insurance company in the event they offer reimbursement for the treatments.

The screening cost is $200 and includes a psychological assessment, a psychological interview with a counselor (if needed), a medical history review by an anesthesiologist, and an evaluation after infusions. This cost will cover evaluation after infusion too.

The cost for each individual Depression treatment is $375. The cost for each individual Chronic Pain treatment is $875.

We accept cash, check, and credit card.

We will provide a superbill to any of our patients who request one so that they can submit a claim for insurance reimbursement.

Please continue to see your health provider during and after the ketamine treatment. We are providing consultant care for you and your providers.

No.

You may have heard of Ketamine as a party drug under other names such as Special K, Kit Kat, or Vitamin K. However, the dose used for the treatment of depression is much smaller than the dosages used in illicit settings, and it has been found that at these very low doses, in a medical setting, there is virtually no potential for addiction or abuse. In fact, low-dose Ketamine infusion therapy can be helpful for patients struggling to recover from addiction to alcohol or drugs.