KETAMINE INFUSION THERAPY

Ketamine is a safe, fast-acting anesthetic with a wonderful variety of applications to treat mental health and chronic pain. It was first synthesized in 1963 as a rapid anesthetic that supported the cardiopulmonary system and had a reduced recovery period, limiting the possibility and severity of adverse side-effects. It was so safe that it became known as a “buddy drug” during the Vietnam War since non-medical personnel could administer it on the battlefield.

In 1970, ketamine’s antidepressant properties were discovered, leading to a cascade of positive studies published on its treatment of unipolar depression. Further studies have shown its efficacy for the treatment of PTSD, OCD, Bipolar Depression, Severe Anxiety, Fibromyalgia, Complex Regional Pain Syndrome, and other pain syndromes.

Approximately 70% of patients experience a significant reduction in symptoms – many during their first infusion. Now, Ketamine is widely used by psychiatrists and anesthesiologists to heal mood disorders, eliminate suicidal ideations, and alleviate chronic pain.

Ketamine works by increasing synaptogenesis and neuroplasticity, regulating glutamate, and decreasing inflammation.

Increases Synaptogenesis

Synaptogenesis is the formation of new synapses between neurons in the nervous system.

Increases Neuroplasticity

Neuroplasticity is the ability of the brain to form and reorganize synaptic connections, especially in response to new information, new experiences, or following an injury.

Regulates Glutamate

Glutamate is the primary fuel source for the central nervous system. 

Decreases Inflammation

Inflammation is part of the body’s immune response, which serves as a defense system against infections. 

A Little Bit About Your Brain 

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The human brain is made up of about 100 billion nerve cells, or neurons, that “talk” to each other through thread-like fibers (long transmission cables – axons, and short twiggy fibers – dendrites). Each neuron makes between one thousand to ten thousand points of contact, called synapses, with other neurons. Synapses allow information to be exchanged between neurons.

Our experiences reshape and modify our brains by strengthening and weakening synapses that link neurons together. For example, when the pattern “event B always happens after event A” is constantly being reinforced, the synapses between the neurons that represent A and neurons that represent B get strengthened. On the other hand, if A and B stop having any meaningful relationship with each other, the neurons that represent A and B will shut down their mutual connections to reflect this new reality.

Moreover, emotionally-charged experiences form stronger connections. Both positive and negative impressions have the potential to strengthen their path in the brain.

Our brains engage in neuroplasticity when we learn through repetition, creating new patterns, habits, and beliefs. On the flipside, we can lose a skill or belief when we don’t practice it often enough to keep the connections strong and active.

When positive connections atrophy and negative patterns and behaviors are reinforced, people often feel stuck in their depression with no hope for a way out.

The good news is that our brains are constantly re-shaping themselves, and, much like muscles, even the weakest positive connections can be strengthened with focused attention and repetition. Through therapy and positive psychology, you can learn new information and adopt new ways of looking at events in your life.

Harness the Power of Neuroplasticity With Ketamine

Ketamine helps you rewire your neural connections rapidly and safely by beginning a process leading to increased production of brain-derived neurotrophic factor (BDNF) – a protein that increases neuroplasticity and synaptogenesis. It creates a perfect foundation for your work with a therapist.

Ketamine for Mood Disorders

People affected with mood disorders frequently feel significantly better after receiving ketamine infusions. This is not because it tricks you into thinking you feel better. Ketamine helps repair the damage in the central nervous system caused by an incompetent NMDA receptor.

Ketamine, however, is not a cure for chronic disorders. Whatever caused the problem in the first place may still exist. Therefore, we work with you to find and heal the root cause and address your long-term needs. Ketamine infusions can be an amazing bridge to healing that quickly decreases symptoms.

Once Ketamine has kick-started the healing process in the central nervous system, you can achieve rapid progress in processing emotional trauma, introducing and learning new ways of thinking, and redirecting your energy towards positive momentum for your life.

Ketamine for Pain Conditions

During your infusion, ketamine works in your nervous system to help break cycles of chronic pain caused by nerve damage and faulty communication. Ketamine also has potent anti-inflammatory properties and increases circulation in the body, reducing joint pain brought on by swelling.

We administer low, controlled doses of ketamine through an IV infusion, and many patients find immediate relief from their chronic pain during their first infusion.

Re-Fuel Your Brain

Glutamate is the primary fuel source of the central nervous system. Mood disorders, in part, may be the result of our central nervous system (CNS) not having enough glutamate.

The N-Methyl-D-Aspartate (NMDA) receptor is like a dam for Glutamate. In mood disorders, the NMDA receptor may be dysfunctional and may remain open, allowing glutamate to flow freely in a very uncontrolled state. This decreases the amount of glutamate upstream the NMDA receptor. When glutamate levels decrease to a critical level the AMPA receptor stops functioning correctly. The AMPA receptor is responsible for neurogenesis (the formation of new nerve cells), neuroplasticity (the correct alignment of neurons), and controlling inflammation in the CNS. As the AMPA receptor frequently turns off, neurons begin shriveling up and dying off and inflammatory processes become rampant.

Ketamine is a medication that works to slow down or stop the NMDA receptor from allowing the uncontrolled flow of glutamate through it. Ketamine selectively blocks the NMDA receptor which allows the CNS to fill back up with glutamate. Low dose intravenous Ketamine infusions only block the NMDA receptor for up to 72 hours. Therefore, multiple ketamine infusions are necessary to keep the NMDA receptor blocked until enough glutamate exists in the CNS to jump-start the AMPA receptor.

When the AMPA receptor is functional, it produces Brain-Derived Neurotrophic Factor (BDNF), which stimulates synaptogenesis, and increases neuroplasticity. In essence: it builds new neurons, helps neurons communicate effectively, and decreases inflammation.

How It Feels

We administer controlled sub-anesthetic doses of ketamine through an IV in our restorative, spa-like clinics under constant medical supervision. Infusions range from one to several hours, depending on the diagnosis, and patients describe their experiences as relaxing and peaceful.

With Ketamine Infusion Therapy, most people experience a rapid reduction in depressive symptoms and are left with feelings of love, compassion, and peace.

A study published in the International Journal of Transpersonal Studies describes the state of mind people experience during and after the infusion as “Increased psychological clarity, feelings of being cleansed, increased confidence, feelings of happiness and well-being, state of inner peace, feelings of detachment, motivation to improve oneself, and strong feelings of empathy for everyone.”

These effects are usually most pronounced immediately after an infusion but can last weeks or even months after treatment.

How Ketamine Infusion Therapy Works: 

  • Patients sit in a comfortable reclining chair in a dedicated room of our spa-like clinics.
  • We administer sub-anesthetic dose of ketamine through an IV.
  • Most infusions last around an hour, and patients describe their experiences as relaxing and peaceful.
  • The national standard for treating mood disorders with ketamine infusions is for patients to complete six to ten infusions over the course of several weeks. With pain conditions, treatment recommendations vary per diagnosis and the severity of the problem, but many patients find immediate relief during their first infusion.

Maintenance Infusions: 

  • Approximately 15-20% of our clients that undergo ketamine infusion therapy require maintenance infusions.
  • This may range from once a month to once a year.
  • It is impossible to predict who will need additional infusions or how often they may be needed.

Response

Mood disorders: 

  • In our experience, 75% of clients experience significant reductions in symptoms.
  • 65% experience sustained improvement in symptoms and do not come back for maintenance infusions.

Pain disorders: 

  • Acute migraine response success averages at 75%.
  • For chronic migraine sufferers, the intensity, duration, and frequency are often decreased to the point where the client’s oral breakthrough medications are able to control the majority of future migraine headaches.

Immediate Relief from Suicidal Ideations

When people are suicidal, they tend to see only one way out of their current situation. With Ketamine’s ability to stimulate neurons, “light up” the old forgotten positive neural pathways, and rapidly create new ones, ketamine provides fast relief in emergency suicidal situations.

Suicidal ideations with a plan is a medical emergency that needs to be treated in the emergency room.  However, 14% of Americans have suicidal ideations which may need long-term supportive care.

If you are seeking treatment to resolve your suicidal ideations, contact us at 866-951-4325. If you have a plan to harm yourself, please call 911 or the suicide prevention hotline at 800-237-8255.

Research and Studies

  • Berman, R. M., Cappiello, A., Anand, A., Oren, D. A., Heninger, G. R., Charney, D. S., & Krystal, J. H. (2000). Antidepressant effects of ketamine in depressed patients. Biological Psychiatry, 47(4), 351-354. doi:10.1016/s0006-3223(99)00230-9. [PubMed]

  • Murrough, J. W., Perez, A. M., Pillemer, S., Stern, J., Parides, M. K., Rot, M. A., . . . Iosifescu, D. V. (2013). Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions in Treatment-Resistant Major Depression. Biological Psychiatry, 74(4), 250-256. doi:10.1016/j.biopsych.2012.06.022 [PubMed]

  • Shiroma, P. R., Johns, B., Kuskowski, M., Wels, J., Thuras, P., Albott, C. S., & Lim, K. O. (2014). Augmentation of response and remission to serial intravenous subanesthetic ketamine in treatment resistant depression. Journal of Affective Disorders, 155, 123-129. doi:10.1016/j.jad.2013.10.036 [PubMed]

  • Lapidus KA, Levitch CF, Perez AM, Brallier JW, Parides MK, Soleimani L, Feder A, Iosifescu DV, Charney DS, Murrough JW. 2014 A randomized controlled trial of intranasal ketamine in major depressive disorder. Biol Psychiatry. Dec 15;76(12):970-6. doi: 10.1016/j.biopsych.2014.03.026. Epub 2014 Apr 3 [PubMed]

  • Michael Thase, MDK Ryan Connolly, MD, Unipolar depression in adults: Management of highly resistant (refractory) depression. [UpToDate][NIH Public Access]

  • Mrazek DA, Hornberger JC, Altar CA, Degtiar I. A review of the clinical, economic, and societal burden of treatment-resistant depression: 1996-2013. 2014 Aug 1;65(8):977-87.  doi: 10.1176/appi. ps.201300059.  [Psychiatric Services free article] [PubMed]

FAQs

Low dose ketamine has minimal side-effects including nausea, slight headache, anxiety, slightly increased heart hate or blood pressure, and drowsiness.
Depending on your diagnosis, we typically recommend 6-10 treatments over 2-3 weeks to start. After that, subsequent treatments may be required on an as-needed basis.
Yes, we prescribe and administer both nasal and IV ketamine in our clinics. Spravato, the brand name of esketamine, is a nasal medication derived from ketamine that was FDA-approved on March 5, 2019. All of our clinics are certified to administer Spravato, however, we do not anticipate it being distributed by the manufacturer until the fall of 2019.
Many medicines like antibiotics, pain medicines, anesthetics along with Ketamine are used with both humans and animals.
Yes. Please review the FDA’s website  for more information.

The route of administration for medications is critical for how quickly and effectively they work.

When administered through an IV, ketamine’s bioavailability is 100%, meaning that your body can immediately access and use the medication. Through nasal administration, ketamine’s bioavailability decreases to 45% – less than half the bioavailability of IV ketamine!

IV administration is the gold standard for using ketamine to treat mood disorders and chronic pain. Nasal ketamine has its place and we may prescribe it for certain situations, but whenever possible, we prescribe IV ketamine.

Ketamine was created in 1963 and approved by the FDA in 1970. In order to approve a medication for a specific use, the FDA conducts trials to determine if it is safe and effective without significant side-effects. Once an older medication is approved it is very rare for drug companies to provide all the necessary information and research required to put the medication “on label” for specific conditions. Please review the FDA’s website for further information.
A nasal form of ketamine has been approved by the FDA on March 4th, 2019. However, it is our belief that the nasal route is significantly less effective than an IV route of administration. Ketamine infusions provide a consistent and reliable serum level that we can easily titrate to optimize safety and outcome. Many medical professionals believe nasal ketamine will not become a widely prescribed medication and will only be prescribed for use within a clinic.
Spravato is a drug that was FDA-approved for treatment-resistant depression on March 5, 2019. It is a derivative of ketamine. During the research and drug development process, scientists isolated one side of the ketamine molecule to create a new version of the drug. Spravato is administered in a certified clinic by a medical professional and patients are required to be monitored for two hours after receiving Spravato.

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