Ketamine stimulates the development of new receptors and synapses in the brain by interfering with and rebalancing the glutamatergic system to stimulate new synaptic connections. Ketamine works as an NMDA receptor antagonist and an AMPA receptor stimulator.

Ketamine was first used (and still is) as general anesthetic agent. It has been approved to used in the hospitals for the past five decades and has a proven record of safety. Recently, it is being used to treat depression (also PTSD and neuropathic pain) via an IV injection of small doses of ketamine.

Ketamine works by quickly increasing the activity of the neurotransmitter glutamate in the frontal cortex of the brain which allows new synapses to form in the same area. The speediness of ketamine in producing an antidepressant effect occurs because this drug bypasses the traditional serotonin route and goes directly to activating glutamate. This is very different from traditional antidepressants, which first increase the activity of serotonin in multiple different areas of the brain, and then ultimately affect glutamate. This process usually takes two to four weeks to take effect, while ketamine yields an almost immediate effect.

Yes. The benzodiazepines as listed below will interfere with the treatment:

• Klonopin
• Xanax
• Ativan
• Valium

If you are taking any of the above mentioned at the dose above 100mg per day, you may be asked to skip a dose 24-48 hours before the start of your infusion and wait until 6 hours after before resuming your benzodiazepine.

In addition, there are currently three other medications, which are known to significantly interfere or block the response to ketamine, and these include:

• Lamotrigine (Lamictal)
• Risperidone (Pisperdal)
• Olanzapine (Zyprexa)

They are “relative contraindications” to therapy and may need to be reduced to discontinued prior to treatment.

Not yet. 

There are dozens of studies done by researchers from prestigious medical centers and The National Institute of Mental Health for over the past two decades. They have proved ketamine’s safety and efficacy in treating major depressive disorders and suicide ideation. Yet, without very large controlled studies generally required by the FDA to get approval for any psychiatric drug, approval has been delayed. Meanwhile, ketamine is being used as “off label,” as is true with many other medications prescribed by physicians.

Yes.

You will need to have someone who can drive you home after the infusion. However, they do not have to stay with you during the infusion. It is highly recommended you to not drive a vehicle, operate heavy/dangerous machinery, sign any contracts, or partake in other potentially risky activities until the following morning.

A total of 6 sessions over six weeks (once a week).

That will maximize the effectiveness of Ketamine infusion therapy. Thereafter, patients can choose to do a maintenance therapy where they return once a month for first year after 6 infusions course. The second year of maintenance would be 1 infusion for every 6 weeks.

40 minutes to an hour

The length of the infusion will be about 40 minutes and you can have a little bit of extra time before discharge.

No.

Ketamine has been proven safe in humans over five decades in and out of hospitals as surgical anesthesia and trauma management. Those patients experience longer exposures and at much higher doses than those used to treat severe depression. Although ketamine has been abused recreationally in high doses as a club drug, but there is no evidence that ketamine is addictive

In fact, ketamine infusion have been found to be remarkably effective in preventing withdrawal symptoms and medication craving. There is current research which indicates that ketamine may be used to combat alcohol, heroin and cocaine addiction.

You cannot eat solid food for 6 hours prior to your scheduled appointment.

However, you may have clear liquids such as water, clear broth, apple juice or clear tea/coffee (no milk or leaves) up to 2 hours before your appointment.

The answer varies from person to person.

Some patients feel the change within an hour of their first infusion. Some can take a day or up to the 2nd infusion to feel the change. Others gradually see the improvements throughout their 6 infusions.

Most patients experience a mild dissociation or inner reflective experience that is tolerated well.

No.

Ketamine infusion therapy is, perhaps, the most exciting and successful new treatment for severe depression. It has been proven effective in most cases, and is available to you and your loved ones. Patients with debilitating severe depression with constant thought of self harm can not afford to wait.

No.

Other antidepressant medications do not interfere with ketamine’s mechanism of action.

It is $450 per infusion. The total of 6 treatments would be $2700.