Ketamine is a medication that has been used since 1970 as an anesthetic and is a rapid-acting, extremely effective intervention to address treatment-resistant depression and suicidal ideation. 

Ketamine works by modulating the glutamate system in the brain. It increases synaptic plasticity and connectivity, which are believed to play a key role in its rapid antidepressant effects. 

At AwakeningsKC, we administer ketamine intranasally through a nasal spray device. The treatment is administered at our office under the supervision of a medical professional. The dosage and frequency vary based on patient needs and response to treatment.  

When ketamine is administered intranasally, it can provide rapid relief within hours, unlike traditional medications, which can take weeks. Intranasal administration is also considered more convenient since patients do not have to receive an IV.   

Spravato® (esketamine) is an FDA-approved medication containing a derivative of ketamine, which is covered by most insurances for the treatment of treatment-resistant depression and suicidal ideation.

Spravato® only comes in two fixed doses: 56 mg and 84 mg. Intranasal ketamine offers more individualized dosing and flexibility to treat other conditions like PTSD, anxiety, and chronic pain. Studies indicate ketamine might offer better overall response and remission rates for depression compared to esketamine, though both are effective treatments.

Choosing between ketamine and Spravato® depends on various factors, including individual patient needs, treatment history, and financial considerations. Consult with our team of professionals to determine the most suitable approach. 

Ketamine treatments are offered on Mondays, Wednesdays, and Fridays at 10 AM, 12 PM, and 2 PM. Patients will do treatments 1-2x per week; the frequency will be determined by your treatment team. 

Depending on your dosage, patients will complete 6-8 treatments. Once complete, you will meet with your provider to evaluate your progress and discuss the next steps. 

Ketamine is not FDA-approved for mental health and is considered an “off-label” treatment. 

We believe in making ketamine therapy available to anyone who needs it. Our admissions team will gladly discuss any and all payment options you have. 

Patients are required to be at the office for a total of 2 hours from administration. During this time, our team will monitor your blood pressure and response to the medication. 

Generally, ketamine is well-tolerated. Common side effects include nausea, dizziness, dissociation, and increased blood pressure. 

Patients with the following may not be able to receive ketamine: uncontrolled blood pressure, active mania, active psychosis, schizophrenia, significant cardiac history, clinically significant substance abuse, current pregnancy, recent ocular surgery, intracranial pathology, and history of aneurysm, epilepsy or stroke. 

The medication is sent to a local pharmacy, and the patient is responsible for picking it up or coordinating shipment to their home. The patient is responsible for bringing the medication to the clinic, where it will be stored for the duration of the treatment. The medication seal must be intact/untampered with for the patient to receive treatment. 

• Fasting Protocol: Patients should not eat solid food for 4 hours prior to your scheduled appointment. Patients may have clear liquids such as water, clear broth, apple juice, tea, or black decaf coffee up to 2 hours before their appointment. 
• Transportation: Due to the dissociative nature of ketamine, patients are prohibited from driving, operating machinery, or doing anything which requires them to be fully alert following the ketamine treatment. Patients should not participate in these activities until after a full night’s rest. All ketamine patients are required to have a driver, so patients should arrange transportation before their treatment.
• Medication: Very few medications have interactions with ketamine. Some medications may need to be held prior to your ketamine treatment and resumed after. These may include benzodiazepines (i.e., Xanax, Ativan, Klonopin), stimulants (Adderall, Vyvanse, Ritalin), and lamotrigine (Lamictal). All patients should consult with their doctor before starting ketamine to see if they need to alter their medication regimen on the day of the treatment.