KETAMINE TREATMENT
WHAT IS KETAMINE?
You probably know Ketamine as an old street drug called “Special K,” a tranquilizer, or a hallucinogen. While this might be true for someone misusing or abusing this medication, it can also be an amazing treatment for people with a wide array of mental health disorders. It is now approved by the FDA for use in children and adults for anesthesia and as a pain reliever during medical procedures. When administered in a low-dose infusion, ketamine is a medication that may provide relief of symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder. Ketamine’s use for treatment of depression or other mental illnesses is off-label. Off-label use of medications is legal and very common. In fact, about one in five prescriptions written in the US today is off-label.
WHY SHOULD I CONSIDER KETAMINE AS AN OPTION FOR ME?
Depression is the leading cause of disability around the world and suicide accounts for roughly 46,000 deaths per year in the United States, which is about 1 death every 11 minutes. Between 2000 and 2018, the rates of suicide in our country went up by about 30%, and in recent years mental illness has been a topic of discussion in many American homes. While more traditional routes of treatment include using oral medications called Selective Serotonin Reuptake Inhibitors or SSRIs (Prozac, Zoloft, Lexapro, etc…) which work by increasing the amount of Serotonin in your brain, Ketamine is believed to work by actually repairing damage done to the brain caused by cortisol and other long-term stress hormones, which build up proteins in the brain over time. Ketamine is a very fast acting and effective treatment for depression and other mental health issues and is therefore considered to be a potentially lifesaving option.
Along with being an effective treatment for depression, Ketamine has also shown significant promise in treating the following other mental health disorders:
· Anxiety
· Post-Traumatic Stress Disorder (PTSD)
· Obsessive Compulsive Disorder (OCD)
· Seasonal Affective Disorder (SAD)
· Post-Partum Depression
· Suicidality
Ketamine is a relatively safe and versatile medication. Being able to provide treatment in either intravenous, intramuscular, or nasal forms, we are able to help a wide array of clients to meet their needs, both clinically and financially.
WHAT SHOULD I EXPECT?
The most common and most effective treatment is given via IV infusion. If you opt for this form of treatment, an IV catheter will be inserted into a vein of your hand or arm and a ketamine fluid will be dripped into the vein. During the infusion your level of sedation, blood pressure, heart rate, oxygen concentration, heart rhythm and respirations will be monitored. After the treatment, you will need time to recover in the office and may take some sips of fluid during the recovery period. For depression, current research recommends that you receive 6 treatments over about two weeks as the primary treatment episode. Additional maintenance treatments may or may not be suggested, occurring about once a month or less frequently as recommended by your infusion provider.
For IM injections, you will be in our office for a much shorter amount of time. An injection of Ketamine will be administered in one of your deltoid muscles (in the upper arm) and you will be asked to stay in the office for a short resting period (10-15 minutes).
For Esketamine (or Spravato), you will have to be in our office for 2 hours. 2 or 3 separate doses of Esketamine will be administered via a nasal spray at the beginning of your appointment, and you will be continually monitored throughout the 2-hour time period. For your convenience, we do offer a TV in our Spravato Suite to help pass the time, but clients are encouraged to bring their own form of entertainment (tablet, phone, music) to make their treatment as pleasant as possible.
For any of these treatment options, the patient will not be allowed to drive for a period of 24 hours, so a designated driver will need to check in with the front desk at the beginning of each visit. If you do not have a driver, we will be unable to perform your treatment for that day.
WHAT ARE THE POSSIBLE SIDE EFFECTS OF KETAMINE?
Possible side effects may include and are not limited to:
● fast or irregular heart beats
● increased saliva or thirst
● increased or decreased blood pressure
● lack of appetite
● vivid dreams
● headaches
● confusion
● metallic taste
● irritation or excitement
● constipation
● floating sensation (“out-of-body”)
● blurry or double vision
● twitching, muscle jerks, and muscle tension
● confusion
● urinary frequency
● nausea or vomiting
● memory changes
Rare side effects of ketamine are:
● allergic reactions
● hallucinations
● pain at site of injection
● euphoria
● increase in pressure inside the eye
● involuntary eye movements
● inflammation in the bladder
● low mood or suicidal thoughts
● respiratory complications
Side effects of receiving an IV are:
● mild discomfort at the site of placement
● infiltration
● bruising
● infection
HOW DO I SCHEDULE TREATMENT?
To schedule treatment, you will need to be seen for an evaluation by one of our Psychiatrists / Psychiatric APRNs. This appointment, which can be billed to insurance, will include a detailed medical and psychiatric history to make sure Ketamine is right for you. After your evaluation, if you qualify for treatment, we will get you scheduled for your initial series of 6 infusions. Once this is completed, you will talk with your provider about maintenance dosing and how frequently you should be infused. Each patient’s treatment plan is unique and tailored to their individual needs.
To get started, call our office at 501-506-1587 to talk with our front desk about any questions you may have and to get scheduled for your initial evaluation.
PATIENT RESOURCES / LINKS
(Medical News Today) What 83 studies say about ketamine and mental health -
https://www.medicalnewstoday.com/articles/what-83-studies-say-about-ketamine-and-mental-health
(Harvard Health Publishing) Ketamine for major depression: New tool, new questions –
(JAMA Psychiatry) A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders –
(LINK)
(Indian Journal of Psychiatry) Efficacy of ketamine therapy in the treatment of depression –
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6767816/
Susan Gayhart – blogger and actual ketamine patient