Frequently Asked Questions About Ketamine
Ketamine was first synthesized in 1962 by a chemistry professor at Wayne State University. It is a fast-acting, quickly metabolized, non-opioid anesthetic. It has been used in and out of the hospital for safe, effective pain relief for decades and is the most common anesthetic used in third-world countries. For these reasons, The World Health Organization (WHO) has deemed it an essential medication.
In the United States, ketamine is routinely administered (in much higher doses) by civilian and military paramedics, emergency room physicians, and anesthesiologists for acute pain relief and anesthesia. In the past two decades, researchers and medical providers have discovered that ketamine can treat both emotional pain and physical pain. It has been proven to quickly (days to weeks) reduce symptoms associated with depression, anxiety, and PTSD, facilitating psychotherapeutic support and improving quality of life. Ketamine therapy has also shown benefit with some chronic neurological pain conditions, including migraine and complex regional pain syndrome.
Ketamine acts at many different sites in the brain. Although its mechanisms are not fully understood, current thinking supports the actions of ketamine on the surface of certain brain cells as responsible for its rapid and prolonged effects (reduction in depressive symptoms). Ketamine is an N-methyl D-aspartate (NMDA) receptor blocker. Blocking this receptor allows for the regulation of glutamate, an abundant neurotransmitter responsible for several central nervous system functions. Effects of ketamine on other brain cells lead to increased levels of brain-derived neurotrophic factor (BDNF) and mammalian target of rapamycin (m-TOR), both elements involved in neural plasticity.
Since glutamate is so prevalent within the central nervous system, it is not surprising that investigations into origins and progression associated with certain neurological pain conditions have implicated it as a likely culprit. Receptors responding to glutamate are believed to play a role in the development and proliferation of migraine headaches, complex regional pain syndrome, and fibromyalgia. As such, ketamine therapy is a reasonable treatment consideration and has shown encouraging results.
Research has shown that repeated or prolonged exposure to stress (physical or emotional pain, fear, trauma) damages the connections between brain cells. Ketamine has been proven to help repair those damaged connections.
Simply put, ketamine repairs and enhances neural connectivity in the brain, leading to rapid and prolonged symptom resolution. In addition to treating physical pain, it treats the emotional pain associated with traumatic experiences or memories, allowing patients to comfortably address the underlying pathology, internal and external stressors as well as feelings of being overwhelmed. For example, patients with major depression or obsessive-compulsive disorder, tend to have thoughts that occur in repetitive patterns (chatter, negative thoughts, perseveration, or anxious thoughts). Ketamine gives us a tool to reset the internal conversation, essentially breaking the cyclical patterns associated with relapse.
IV Ketamine – $450
Intramuscular Ketamine – $400
Our goal is to provide an individualized plan to specifically address each patient’s needs. Therefore, the following is intended as a general guideline and will depend on the patient’s specific condition, circumstance, and response to treatment.
Currently, insurance companies do not widely cover ketamine infusions. However, as coverage options evolve, our patients report receiving some reimbursement back and we are happy to assist your efforts to request reimbursement from your insurance provider. Our service includes a method for submitting your superbill electronically.
You may not have anything to eat four (4) hours prior to your infusion appointment or have anything to drink two (2) hours prior to the infusion appointment. You may not eat or drink two (2) hours prior to an oral ketamine appointment.
No. Although ketamine is metabolized rapidly, thinking may be impaired for up to 24 hours after an infusion. For your safety, we require that you have a driver confirmed BEFORE starting the infusion. For the next 24 hours after your infusion, we advise refraining from strenuous activity, watching small children, operating machinery, or entering into legal contracts.
No. Continue to take all your medications, including medications for pain or mood disorders. Although you may experience a decreased need for these medications after ketamine infusion, you must work with your prescribing physician to wean off these medications appropriately. It is important not to stop any medication abruptly, as it can cause serious withdrawal symptoms.
The goal of psychotherapy in conjunction with ketamine is symptom reduction and the development of lifelong strategies that minimize the possibility of relapse.
Ketamine repairs and enhances neural connectivity in the brain, leading to rapid and prolonged symptom resolution. It treats the emotional pain associated with traumatic experiences or memories, allowing patients to comfortably address the underlying pathology.
Ketamine helps diminish the discomforting feelings that inhibit patients from understanding or effectively caring for their fears, emotional discomforts and pain. Learning and implementing strategies to address the underlying issues with psychotherapy can reduce the need for continued treatment or medications.