Ketamine has been safely used for over 60 years as an anesthetic medication and is considered an essential medication by the World Health Organization. During an infusion, you will be receiving a sub-anesthetic or very small dose delivered in a slow and controlled manner through an infusion pump. This amount of medication will not cause you to lose consciousness, and you will be able to speak with the provider anytime you wish. Side effects are rare, generally mild, and limited to the day of the infusion. The most common would be a slight increase in blood pressure or heart rate. If you are predisposed to nausea, you may be more likely to experience it during your infusion. We can provide medication to prevent nausea prior to the infusion. Your vital signs will be continuously monitored for an additional degree of safety. A Certified Registered Nurse Anesthetist will be available at all times.
Delivering ketamine intravenously (through an IV) is considered the gold standard, and this approach is backed by considerable evidence. We highly recommend this method. However, if you have a strong preference for receiving ketamine via another route, there are alternatives, and the risks and benefits will be discussed on a case-by-case basis.
For mood disorders, you must have a documented diagnosis from a healthcare provider that includes the following:
- Post-Traumatic Stress Disorder (PTSD)
- Suicidal Ideation
- Bipolar Disorder
- Obsessive Compulsive Disorder (OCD)
For chronic pain conditions, you must have a documented diagnosis from a healthcare provider that includes the following:
- Complex Regional Pain Syndrome (CRPS)
- Reflex Sympathetic Dystrophy (RSD)
- Neuropathic pain
- Cancer pain syndromes
- Phantom limb pain
- Chronic Migraines
- Trigeminal neuralgia
- Other chronic pain syndromes
Ketamine is not a first-line option, so you must have received previous treatment. Ketamine therapy is designed to be used as one component of a multimodal approach to addressing your health needs. Although many patients are able to eliminate or decrease the use of other medications, we do not recommend making any changes to your medication regimen initially. Any adjustments should be made with your prescribing provider in a safe and controlled manner.
Most patients can safely receive ketamine therapy. There are a few medical conditions that might require treatment prior to beginning therapy or stop you from receiving this treatment. A few examples are uncontrolled hypertension, active substance abuse, pregnancy or unstable cardiac disease.
A thorough review of your medical history will be conducted prior to receiving ketamine therapy to ensure you are a suitable candidate.
At this time, IV ketamine therapy is typically not covered by insurance. We have been seeing a gradual shift as some insurers are providing at least partial coverage. We are hopeful that the treatment will be more universally covered in the near future. Upon request, we will generate a superbill that you can submit for reimbursement. We recommend calling your insurance company in advance to verify possible benefits or reimbursement.
For mood disorders, we recommend a series of six infusions to be given within 2-6 weeks. We will work with you and your referring provider to determine the effectiveness of the treatment. This can be highly subjective and largely based on how you feel and your response to questionnaires designed to track your progress. After the initial series, most patients gradually space the infusions apart for weeks to months or longer.
For chronic pain disorders, the schedule is much more variable, depending on your exact condition. Most patients begin with one or two infusions to gauge how effective the treatment is. We will work with you to design a treatment plan for your specific needs.
You must have a referral from a licensed healthcare provider that is authorized to diagnose your condition.
There are no exceptions to this rule.
We will also request a detailed medical history. Ketamine therapy is not deemed as an appropriate first-line treatment at this time. You will need to have an initial consultation which is free of charge to discuss your medical history and expectations for ketamine therapy and associated risks and benefits.
IV ketamine therapy has been shown to be effective in approximately 70% of patients when used appropriately. However, it is possible that you will not find the treatment beneficial. The vast majority of patients will know within two or three sessions if it is worth pursuing further.
After checking in, you will be given a private room with a comfortable recliner. You will be asked to fill out a brief survey that will be used to track your results over time. You will then be given a private room with a comfortable recliner. A small-gauge IV will be inserted, and the infusion will be initiated. The infusion contains a sub-anesthetic dose of ketamine delivered in a precisely controlled manner. You will be awake and aware at all times. Although ketamine therapy is extremely safe, your vital signs will be monitored continuously, and the provider will be readily available at all times. Most patients report feeling relaxed, and some have a slight floaty feeling. If anything is unpleasant or overwhelming, the infusion will be paused, decreased, or stopped entirely depending upon the situation; but this is very rare. You can expect to relax for an additional 30 minutes after the infusion is complete to ensure you are comfortable and safe. During your initial consultation, we will discuss in more detail how to prepare as well as rules regarding transportation and eating prior to your infusion.