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Ketamine

Big Latest Findings Of Diet and Depression

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Diet and Depression

Sugar as the culprit:  If you’re suffering from depression, you might want to drop soda from your diet. It does give you a momentary high because it increases the dopamine in your brain.

Dopamine, a neurotransmitter gives you feelings of satisfaction and pleasure. But drinking sugar-sweetened beverages have been known to increase the risk of depression.

This applies to all sugary foods and not just soda. Too much intake of sugar increases the glucose in the blood. It may manifest as blurred vision, dizziness, irritability, and depressive symptoms.

Refined sugar as well as carbohydrates have these effects if taken excessively. Yes, this means you also have to cut down on your favorite pasta and chocolates, too. These foods have little nutrients and drain up the body’s B vitamins, which are mood enhancers.

Moreover, sugar also affects chromium, another mood regulator that maintains your blood sugar level. In a nutshell, many studies suggest that added sugars may induce “depressogenic effects”.

Reis and associates noted that excessive intake of sugars causes dopamine malfunction and oxidative stress. It also results in insulin resistance and the formation of advanced glycation end-products.

These are the reasons why you should avoid sweets if you have treatment-resistant depression (TRD). If you have questions about ketamine IV infusion therapy for TRD, you may contact the Injection and Infusion Clinic of ABQ.

The certified ketamine clinicians have done more than 2,000 infusion therapies since 2017. Now before we get into the ketamine diet, let’s take a closer look. In this article, we will deep dive into the following:

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The Link Between Inflammation and Depression

Depression is a mood disorder and not an inflammatory condition. Inflammation however increases depression and other mental disorders such as anxiety, bipolar, and schizophrenia. 


A study conducted by Timberlake and Dwivedi explains that unfolded protein response (UPR) is the body’s cellular reaction to stress. It has been directly linked to inflammatory cytokine production and toll-like receptor or TLR. 


TLR expression is the body’s immune response to bacteria, viruses, and trauma. In their study, TLRs have been shown to rise in depression. This established the link between inflammation and depression.

In another study, researchers found out that inflammation contributed to causing some forms of fatigue and depression. They explained that antidepressants reduce inflammation.


However, people with higher levels of inflammation were predicted to be less responsive to treatments. These people responded more to therapies that targeted immune pathways. This was deemed effective in treating their depression and fatigue.

Although a more recent study points out covariates play a role in the equation. Covariates are dependent variables such as age, sex, body mass index, and exercise. This includes lifestyle habits and a history of smoking, drinking, or chronic illnesses.


The researchers reveal that associations between depressive symptoms and inflammatory markers decreased when covariates were adjusted.


Further studies have to be conducted to further contribute to the growing evidence that links inflammation to depression. This brings us to the next topic.


How is inflammation linked to sugar, since sugar is the culprit of intensifying depression?

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The Link Between Inflammation and Sugar

Participants in a study fasted overnight. On the following day, they ate three meals which contained 50 grams of carbohydrates such as pasta and white bread.


This may help explain the relationship between carbohydrates, their effect on blood-sugar levels, and the potential for chronic diseases. The results of the study show that high-glycemic diets, which causes blood sugar to rise, aggravated inflammatory process in lean and healthy young adults.


A related study determined a potential link between inflammatory disease and glycemic index. A study ran for over 13 years among 1,245 men and 1,490 women aged 49 and above. 


The researchers administered a food-frequency questionnaire throughout the study. They later noted that 86 men and 84 women died due to inflammatory disease. According to another researcher with the same idea, a high carbohydrate diet may promote inflammation in people with depression.


Elevated inflammation in the body is thus associated with the consumption of too many refined carbohydrates and sugars. This also results in insulin resistance and eventually weight gain or obesity.

Why is Sugar Addictive?

Why is sugar addictive in the first place? It has been revealed that sugar or intense sweetness is more addictive than cocaine. The researchers speculated that the compulsive wanting for sugar is caused by innate high sensitivity to the taste of sweets. 


Tastants are chemicals in the saliva that stimulates taste and makes you want to eat. The stimulation of these tastants due to sugar-rich foods generates a feel-good reward signal to the brain. Thus, the body craves more as the body gets satisfied.

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The Link Between Sugar and Depression

Hence, as you eat more sweets, the more you crave it. This high sugar intake results in inflammation. And inflammation is linked to depression.


People who ate sweets were discovered to be more likely to suffer from depression compared to those who ate whole foods (Akbaralay et al., 2009). It’s not just sweets.


The diet consists of high-fat dairy products, fried foods, processed meats and foods, and refined grains. By whole foods, we mean fruits, vegetables, and fish. These were safer and did not show symptoms of depression among people who ate them.


In a large-scale study, researchers got the same results. Researchers assessed 23,245 people using random effects regression from a Whitehall II study. People were asked about their diet and mood using food frequency and validated questionnaires, respectively.


The researchers found out that sweet foods and beverages or sugar intake increased the incidence of mood disorders in men (Knüppel, et al., 2017). Sugar consumption was 2 to 3 times higher than the recommended intake.


The researchers further revealed that policies could support the prevention of depression by encouraging the reduction of sugar intake.


This echoes a more recent study that saturated fats and added sugars were somehow related to higher anxiety among 1,128 older adults living in Greece. 


The researchers recommended the promotion of healthy dietary habits to reduce the incidence of anxiety in older adults. 

How Significant is Your Diet?

SMILE. It’s the name of a controlled-trial that investigated the impact of dietary changes on people with major depression. Researchers assessed 166 participants in 12 weeks.


The results reveal that dietary improvement may be effective as a treatment strategy in the management of mental disorders. This brings us to the topic of the appropriate food or proper diet for depression.

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Ketamine Diet

There is no ideal diet for people undergoing ketamine IV infusion. Let’s just say the “ketamine diet” may prevent aggravating your TRD symptoms.


A study reviewed 20 scientific articles and identified eating habits as beneficial for people with depression (Ljungbeng, et al., 2020).


These are the consumption of fish and various fatty acids and avoidance of processed foods. The researchers also included the intake of an anti-inflammatory diet, magnesium, and folic acid. 


Another group of researchers also found out that the Mediterranean diet along with vegetables, fruits, and fish have been linked to a lower risk of depression. 


While Western diets that are high in fats and sugary beverages have been linked to an increased risk of depression. They also noted antioxidants such as green tea can be good for you.


Are you having problems with your medications or procedures? The researchers suggest a healthy diet and proper nutrition as an alternative therapy. 

Special Dietary Tips for People Having Ketamine Infusion Therapy

To prevent depression, a study identified five key dietary components:

  • Stick with “traditional” diets like Japanese, Mediterranean, and Norwegian
  • Eat plenty of fruits, legumes, nuts, seeds, vegetables, and whole grains, which are high in selenium
  • Consume foods rich in omega-3 polyunsaturated fatty acids
  • Pick wholesome nutritious foods or plant-based over unhealthy foods or those that are processed
  • Limit eating fast foods, bakery goodies, and sweets


A study suggests taking Vitamin D. Vitamin D may alleviate depressive symptoms. It also improves your long-term health and general well-being. Many clinicians actually call Vitamin D a ‘brain hormone’. 


Almost all people need to supplement Vitamin D to achieve optimal levels. Our modern lifestyle of working indoors, wearing sunscreen, and showering all decrease our Vitamin D levels.


Another study suggests stop eating foods with refined and saturated fats that affect brain function and worsens depressive symptoms (Fernandes et al., 2017).


If you are already getting ketamine IV infusion, avoid grapefruit because it increases plasma drug concentration.


In 2017, a study reveals that St. John’s Wort is as effective as selective serotonin reuptake inhibitors (SSRIs) for people with mild to moderate depression.


But, refrain from ingesting this herb because it is known to breakdown ketamine, which decreases the efficacy. Drinking alcoholic beverages or taking illicit drugs are also disallowed.

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The Story

The complex interlinking of inflammation, sugar, and ketamine shows the dynamic prevention and management or therapy for TRD.

Based on the studies, diet, eating habits, and nutrition play an important role in its prevention.

Share this information to help others. Let them know how poor eating habits and nutritional deficiencies can worsen depressive symptoms. Give us a call at the Injection and Infusion Clinic of ABQ505 455 4300.


Send us your feedback or talk to us about your ketamine therapy. You may visit us in Albuquerque. We serve the Greater Albuquerque Area, Santa Fe, Rio Rancho, Tijeras, Edgewood, Los Lunas, and other surrounding areas. 

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Ketamine

How A Holistic Approach May Help Overcome Severe Depression

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Holistic Approaches to Severe Depression

Have you heard of Cognitive Behavior Therapy (CBT), Ketamine Assisted Psychotherapy (KAP), or Ketamine Psychedelic Psychotherapy (KPP)?

Whether you are currently getting ketamine infusions or just thinking about them, it is important to think about other techniques that can enhance your experience and results. There have been studies conducted about interventions that could enhance your healing experience.

These are other therapies that go well with your ketamine therapy. CBT, KAP, or KPP concentrate on your psychological state as you go through the psychedelic sensation during your ketamine IV infusion therapy.

We recommend a mental health professional who will supervise and guide you on these activities. Relaxation and breathing techniques, too, are also used during depression therapy.

A study narrates a report of a nurse’s experience with a patient who’s suffering from depression and chronic pain. The nursing care implemented relaxation, music, and biofeedback techniques.

Relaxation techniques included meditation and abdominal breathing. The sessions ran for 45 minutes to an hour.

The nurse observed that the patient was motivated, active, and aware of the psychosomatic symptoms. The patient also gained self-control and had a marked improvement in resolving problems.

There’s a simple breathing technique though you can do on your own before and during your ketamine IV infusion therapy. This can be coupled with mindfulness meditation (MM).

BEFORE your Ketamine IV Infusion Therapy

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It’s best to arrive at least 15 minutes before your therapy so you can settle down. The goal is to be in a grounded state with a calm and open mind.

This will prepare you for whatever you will go through during your ketamine infusion. You can achieve this through the 4:7:8 breathing technique to reduce your anxiety. This is also used in MM, which will be discussed later.

Dr. Andrew Weil developed the 4-7-8 breathing technique. He is the founder and director of the University of Arizona Center for Integrative Medicine. You focus on the following deep and rhythmic breathing pattern as you perform the technique.

  • Exhale to empty your lungs
  • Breathe through your nose for 4 seconds
  • Hold your breath for 7 seconds
  • Exhale through your mouth with pursed lips (whooshing or whooping sound) for 8 seconds
  • Do this set 4 times

You will have time for this at the Injection and Infusion Clinic of ABQ. We start your IV and get you settled into your comfortable chair. We then prepare your infusion, giving you an opportunity to settle in and mentally prepare for your ketamine infusion

DURING your Ketamine IV Infusion therapy

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Breath normally and just let go. Practice mindfulness by being aware of your thoughts, feelings, and bodily sensations in the present moment to achieve calmness. Focus your attention on the sound of your breathing. Accept any sensation you may feel during the ketamine infusion. Receive the experience without expectation or judgment.

10 Benefits of Mindful Meditation (MM)

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Sharpens your mental function

Boosts your immune system

Increases your energy level

Strengthens your resilience

Aids your body in managing pain

Induces relaxation

Regulates your mood

Reduces your stress and anxiety

Induces relaxation

Improves the quality of your sleep

Promotes better relationship with others

The National Center for Complementary and Integrative Health and the National Institutes of Health endorse meditation and mindfulness for general well-being.

Moreover, the Canadian Agency for Drugs and Technologies in Health (CADTH) recommends mindfulness intervention to decrease the recurrence of depression.

CADTH further extends this practice during the treatment phase of people who are at risk of relapse. And it also applies to people with major depression who are at the second-line therapy or maintenance phase.

MM with Mindfulness-Based Cognitive Therapy (MBCT): A study revealed that therapeutic change or “coming to terms” can be achieved through MM’s concept of “living in the moment”.

The researchers noted how MM skills had a vital role in the development of change. This continued practice offered support to MBCT in reducing the relapse of people with mood disorders.

MM as effective as non-mindful physical exercises for depression: Researchers surveyed five electronic databases that tested this idea. It turned out that both MM and non-mindful physical exercises were effective in reducing depression on a short- and long-term basis.

They suggested a larger sample size and well-controlled studies since they only came up with 12 randomized control trials.

Mindfulness interventions stabilize attention and improve mental ability: A review of related literature from electronic databases was performed by researchers. They found out that meditation-inspired interventions presented a promising solution in preventing and rehabilitating cognitive problems.

The researchers also suggested the creation of neuropsychological tools with seven attitudinal foundations of mindfulness practice. This was originally promoted by Jon Kabat-Zinn. This will serve as a guide to people in coping with their psychiatric issues. This includes depression among others.

MM for depression, anxiety, and spiritual well-being: Twenty-eight Japanese patients undergoing cancer treatment participated in a study.

The MM activities included breathing and yoga. They were trained in these techniques in the first session and they did the rest of the sessions in their homes.

They answered a preintervention questionnaire, then after two weeks, they answered a postintervention questionnaire. The questions were about depression and anxiety.

The results reveal that MM may be an effective therapy for anxiety and depression in Japanese cancer patients. They further said that spiritual well-being was linked to depression, anxiety, pain, and growth.

3 Ways to Practice Mindful Meditation

It can be a stand-alone therapy that is effective for depression and other mood disorders. There are three ways you can practice MM. You may perform it under the tutelage of an expert, do-it-yourself (DIY) with an instruction guide, or with the aid of a video or smartphone application.

1. You may practice mindfulness with a meditation guru, therapist, or life coach who will guide you through it.

A good reference is the “7 Attitudinal Foundations of Mindfulness.” Jon Kabat-Zin wrote about this in a book, entitled “Full Catastrophe Living.” Just to give you an idea, the eight attitudes are the following:

  • Acceptance
  • Non-judging
  • Beginner’s Mind
  • Trust
  • Non-striving
  • Letting go
  • Patience
  • Self-compassion

2. Do-It-Yourself

Here’s a simple way of starting your mindfulness meditation practice. You can perform this during your ketamine IV infusion therapy with the modification of your sitting position.

Or you can do it at home in between your ketamine IV infusion therapy sessions. It can be anywhere during your work breaks or any time of the day. In performing MM, the key is to focus on your breathing.

  • Sit down comfortably on a stable chair, bench, cushion or mat on the floor, or firm bed.
  • Observe the position of your legs. You may cross your legs while seated on the floor. If you’re seated on a chair or bed, place your foot firmly on the floor at a 45-degree angle.
  • Your head and shoulders are relaxed with your back straight following the natural curve of your spine.
  • Let your arms rest on your sides, parallel to your body.
  • Slightly lower your chin and gaze downward. You don’t have to close your eyes. If your eyes are open, let it be and see whatever appears before you.
  • Relax and just breathe. Focus your attention on the feel and sound of your breathing. Be aware of the sensations in your body.
  • Be there at the moment. Breathe in and breathe out. If your mind wanders, let it be. But let your attention go back to the rhythm of your breathing.
  • Practice the pause. If you need to reposition yourself, do so.
  • Go back to breathing even at times you may experience distractions from your environment or your mind. Be free from expectations and judgments.
  • Slowly emerge from your mindfulness meditation as you open your eyes to your environment.

3. If you’re tech-savvy and into gadgets, you may opt for a smartphone application.

A 12-minute smartphone-based mindful breathing technique is currently being studied. The researchers want to find out if it affects the heart rate of students with depression, anxiety, and chronic pain.

The random controlled study aims to evaluate the psychological and physical effects of the MM application. The study has yet to be completed by the end of 2020.

The researchers are hoping that through this study, MM training tools delivered through applications and web platforms will be developed to benefit people with depression, anxiety, and chronic pain.


There are a lot of mindfulness videos online. There’s a cool compilation of these at the David S. Rosenthal Center for Wellness and Health Promotion, Harvard University Health Services you may want to check out.

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A holistic approach to your severe/TRD

A holistic approach in treating severe/TRD can incorporate 4-7-8 breathing technique and MM in the routine. Both practices have been shown as safe and effective therapeutic adjuncts to major depressive disorder. These can go well with your ketamine IV infusion therapy. Both practices help you cope with your TRD symptoms in-between ketamine sessions, too. 

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For more information about Ketamine IV Infusion therapy, you may visit or call our friendly and caring staff at 505 455 4300 in the Injection and Infusion Clinic of ABQ serving Albuquerque, Santa Fe, Rio Rancho, Tijeras, Edgewood.

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Ketamine

What Can Happen After Your Ketamine Infusion Therapy?

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Ketamine Infusion Therapy

Ketamine infusion therapy has become one of the most popular and promising adjunct therapies today. It has been discovered in studies that it is effective in addressing issues related to treatment-resistant depression, substance abuse, chronic pain, and post-traumatic stress disorder - among others.

The Injection and Infusion Clinic of ABQ is one of the most outstanding clinics offering expert management in terms of ketamine infusion therapy. Its highly experienced team of healthcare providers are more than willing to assist every patient who wishes to achieve a better quality of life and mental health through ketamine infusions.

After all, if we get to have more than a glimmer of hope in the battle against depression, why should we forego the chance? Depression is not an easy foe, but it is not unbeatable either.

The good news is, Ketamine has already helped a lot of individuals with depression, and it continues to do so despite not being FDA-approved yet for this purpose.

Ketamine is used primarily as an anesthetic drug, however its action as an NMDA antagonist makes it a potential medication against depression - more so in individuals with treatment-resistant depression.


Depression, if measured in terms of total years wasted due to incapacity, is accordingly the leading cause of disability globally.1 It has a broad spectrum of symptoms, and the diagnosis is as challenging as finding a cure.

The complexity of the disease coupled with difficulty in diagnosis, and failures of many clinical trials – serve as a huge obstacle to many clinicians.

Depression does not look the same in everyone – it affects individuals in a multitude of ways, resulting in different manifestations of the illness.

However, the ultimate challenge in treating depression, and most psychiatric problems, is that there is never one such thing as a “boxed management” for everyone.

Every person has a unique story and a unique experience that had ultimately predisposed him or her towards developing such a condition. Even though we already have a lot of treatment options available for these psychiatric disorders, there will never be a “one-size-fits-all” treatment in the world of psychiatry (or even in medicine, for that matter).

Doctors can go only as far as creating tenets of management protocols mostly involving selective serotonin reuptake inhibitors (SSRIs) coupled with psychotherapy. Some cases require employing brain stimulation therapies as well.

But since every person is different, there will always be a possibility of a treatment failure. In fact, most medical practitioners are faced with the challenge of how to avoid treatment failures in any kind of therapy.

Depression is already a crippling, debilitating condition – treatment resistant depression (TRD), on another note, can be twice as paralyzing and agonizing, and frustrating.

And surprisingly, 10-20% of individuals diagnosed with depression, meet the criteria for TRD.

People who are living with treatment resistant depression have often lost quite a great deal of hope that they can recover from the illness. And yet, ketamine infusions have proven to be very promising in addressing TRD.

It is fast-acting, has proven to be effective in most patients, and even researchers are continually studying it due to the promise that it offers.


However, despite overwhelmingly testimonials from patients, there are indeed reports of ketamine infusions not living up to expectation, especially among the elderly.

Yes, these things can happen. Treatment failure happens. In both TRD patients and non-TRD patients.

One research study discovered that failure to respond to ketamine infusion therapy was common in people who had late-onset depression. It was hypothesized that aging significantly changes the sensitivity to ketamine hence the occurrence of more intense side-effects in the elderly patients than those in younger patients.


It was further postulated that N-methyl-D-aspartate (NMDA) receptors appear to be significantly affected compared to glutamate receptors as individuals age, resulting in an overall decline in its number and functionality.


And since ketamine works as an NMDA antagonist, it explains the lack of efficacy towards the geriatric population due to either of two things: (1) lack of NMDA receptors (probably due to degenerative changes), or (2) structural changes in the existing NMDA receptors rendering it nonfunctional.


Another study further disclosed that in the geriatric population, there was a documented inability to maintain an antidepressant response after a range of eight to 22 maintenance infusions.

Although the study emphasized that there were only mild, transient, adverse effects noted, the population in the study specifically failed to show a sustained response towards the ketamine maintenance infusions.

These treatment failures are not enough to dismiss the highly documented myriad of positive responses of patients towards ketamine infusions. There are more studies documenting the efficacy of ketamine infusions in addressing treatment-resistant depression than studies documenting failure of response to therapy. 


Ketamine infusions are a promising solution for treatment-resistant depression and its rapid onset of action continues to spark interest among medical practitioners to know more about all of its mechanisms of action.

To date, there are only two known pathways accounting for the effects of ketamine resulting in rapid onset of action against depression and suicidal ideation.


Researchers believe there must be more pathways responsible for its effect. Continuing studies, ongoing positive feedback from these studies, and multiple success stories have cemented ketamine’s place in the medical world as part of a therapeutic plan for people with treatment-resistant depression.

To avoid unnecessary anxiety and worry whether to process with ketamine infusions or not (even when you are already advised by your physician to consider the therapy), here are a few things to consider:

Ketamine is not a simple fix for all your depressive symptoms, despite how promising most patient testimonials are.

Always remember that results for every patient vary: every patient is, after all, unique, and hence responses are also unique. The therapy must be viewed as something collective – the sum of all the parts – in order to fully realize what it has to offer.

Although a lot of patients report the absence of depressive symptoms right after the first ketamine infusion session, this might not be the same case with yours.

Follow your own personal therapeutic management plan given by your health provider, and be honest and cooperative enough to comply with all the monitoring and follow-up sessions that they encourage.

Ketamine Infusion therapy is not the primary choice of therapy for patients with depression.

First and foremost – ketamine is an adjunct to treatment, an aid, a support mechanism on top of currently prescribed therapy. It is not a standalone cure to your depression.

Second, ketamine infusions are given as an alternative to patients who have refractory depression – patients who have not responded to initial modes of therapy such as antidepressants, psychosocial counseling sessions, and even electroconvulsive therapy.

It is vitally important to recognize that these other modes of management exist, and they are prioritized before a patient is advised to receive ketamine infusion therapy.

There are studies showing that ketamine infusions have a very robust effect, and full remission was noted specifically in TRD patients in just one to two hours.4\ Therefore, patients with TRD should be the main target of therapy for ketamine infusions, as compared to non-TRD patients.

Ketamine infusions can have a significant impact on your budget, so be prepared.

There is a big possibility that your health insurance does not cover ketamine IV infusions. If covered, coverage and reimbursement may vary from company to company.

Also, most patients require four to six infusions over a period of two to three weeks as part of the initial therapy, depending on the severity of your condition.

The number of maintenance therapy sessions and the dosing will depend on your response, so make sure you comply with all the monitoring questionnaires and follow-ups recommended by the clinicians at The Injection and Infusion Clinic of ABQ.

Make sure you choose a Ketamine clinic that gives you assurance and peace of mind.

Clinics are not all equal. Many clinics are new and not yet well-established.

Many clinics are only open part-time.Go for a clinic that is open most days, has already established its name and protocols in terms of ketamine IV infusions and look up reviews online.

The Injection and Infusion Clinic of ABQ is proud to offer infusion therapy four days per week. It also has full-time staff working Mon-Fri.

Ongoing ketamine infusion therapy research.

This explains the numerous ongoing research studies and case studies for ketamine infusions, especially regarding the long-term effects of ketamine infusions among different populations.

The lack of sufficient data on the specific subject might be the only thing hindering the full approval of ketamine for the treatment of depression.

Patient cooperation makes a big difference.

Always be honest with yourself, even though it can be challenging at times for a patient with depression. At the first sign of treatment failure, inform the staff at the clinic.

In the same manner, if you have experienced improvement in your symptoms, notify us as well. Also be sure to keep your mental health provider updated. We recommend against discontinuing other antidepressants, but lower doses are often effective.

Our thousands of infusions and over three years of experience has taught us that discontinuing other medications too soon, often leads to a relapse. This type of experience is one of the many reasons you want an experienced clinic.

Be open about any symptom that might be bothering you. Comply with the questionnaires and follow-ups. The acknowledgement of your role in the solution of your problem is one of the many ways to keep your head above the water.

Not only does it help your clinic assess whether they are on the right track or not, it also makes you feel good about yourself.

You can write down in a journal your thoughts while having your sessions; reviewing it from time to time can give you a glimpse of how you are doing as a patient.

We also recommend this because journaling at your best, helps you journey back on your dark days.

The Injection & Infusion Clinic of ABQ

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It is incredibly important that ketamine infusions be viewed by its mechanism of action as a neuroregenerative agent, or as something that is continuously improving connections within the brain. Viewing it as such will spare patients from the expectation of getting a “quick fix” just by having a single infusion.

Understanding it from that perspective enables the patient to acknowledge that recovery is a collaborative effort. Ketamine infusions serve as an adjunct therapy. And that healing takes time, and timelines vary from patient to patient.

Treatment failure can happen. But maybe, it is just part of the battle that needs to be won. A battle that many have overcome.

And while fighting this battle against depression, make sure you or your loved one is given the best care. Book an appointment with The Injection and Infusion Clinic of ABQ, now. 

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Ketamine

FAQs on Ketamine Infusions: What You Need to Know

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FAQs on Ketamine Infusions

What’s the last resort when other antidepressants don’t work for severe depression?

Ketamine intravenous (IV) infusion is a breakthrough therapy for people with severe or treatment-resistant depression (TRD). TRD is a condition where at least two adequate antidepressant treatments didn’t work.

Ketamine infusion is fast-acting and safe. A single low dose infusion can have long term effects of up to 15 days. It’s also effective for people with TRD who exhibit symptoms of suicidal ideation.

Depression is one of the most common psychiatric disorders in the world. It affects people of all communities. If left untreated, depressive symptoms can become chronic and disabling. It hinders a person from doing day to day tasks efficiently.

A variety of medicines and psychosocial therapies are available to ease symptoms of depression. But treatment resistance was noted in about one-third of people who fail to achieve full recovery. Thus, there’s ketamine infusion therapy for TRD.

The Injection and Infusion Clinic of ABQ offers Ketamine infusions for a better quality of life. If you qualify for IV ketamine therapy, or you are considering ketamine IV infusions, here are some frequently answered questions (FAQs) that we have for you:

What is Ketamine?

Ketamine is a glutamate N-methyl-d-aspartate (NMDA) receptor antagonist mainly used in the field of anesthesiology. It works by blocking sensory perception in the patient and has been approved for use in anesthesia since the 1970s.

What are the uses of Ketamine?

Ketamine was originally used in veterinary medicine and for pediatric sedation. Aside from pain management, Ketamine has been noted to have bronchodilator effects (studied in the management of asthma exacerbations in children) and observed to be useful in cases of status epilepticus.

The classification of ketamine as a dissociative agent makes it very effective as an analgesic Ketamine has been widely used to provide analgesia in burn dressing changes, during excision and grafting and for sedation, and even in prehospital or battlefield settings where resources are limited. It has been used off-label in the management of chronic pain and neuropathic pain.

Is Ketamine safe?

Yes. Ketamine has been used for more than 50 years as a potent analgesic with a safe anesthetic profile. Administering it in the right doses does not affect the airway reflexes nor does cause respiratory depression, making it a preferred drug for pediatric analgesia. It also does not lower blood pressure like most anesthetics.

How does Ketamine work in patients with depression?

In simple terms, depression results from imbalances in communication systems in the brain. Ketamine works bystimulating growth of neurons within the brain, allowing the different systems to communicate effectively with one another.

Biochemically, ketamine is a non-competitive, glutamate N-methyl-d-aspartate (NMDA) receptor antagonist. NMDA-receptor antagonism is linked to the potentiation of glutamate transmission at α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors and increased brain-derived neurotrophic factor (BDNF) levels, which are associated with antidepressant properties.

It has been speculated though, that there are still other mechanisms that remain to be discovered regarding ketamine and TRD - such that studies are still being conducted further to hopefully uncover the exact mechanism responsible for the strong and sustained effect of ketamine infusions against depression.

New Ketamine Patients!

First-time patients must book a Pre-Ketamine Consult prior to your first infusion. This consult reviews your history and determines whether Ketamine is an appropriate treatment option.  Referrals are not required*, but you must be established with a mental health or primary care provider prior to starting treatment.

What medications interfere or interact with Ketamine?

Ketamine is very safe, but fortunately the drug interactions are only a few. Ketamine is noted to have synergistic effects on some drugs and may decrease the effectiveness of other drugs.

People who are suffering from substance abuse or alcohol abuse are often prescribed benzodiazepines – which are known to decrease the effectiveness of ketamine. Specific examples of benzodiazepines are Ativan, Klonopin, and Xanax.

Medical practitioners prescribe these drugs for anxiety, muscle spasms, and sleep disorders. However, benzodiazepines can delay and decrease the effects of ketamine if used in conjunction.

On another note, people with epilepsy and bipolar disorders are often prescribed lamotrigine. Lamotrigine 150 mg or higher doses for bipolar disorder and seizures decreases the effectiveness of ketamine. Hence, lamotrigine decreases glutamate while ketamine increases it.

Lithium stabilizes the mood of people with bipolar disorder. Unlike benzodiazepine and lamotrigine, lithium enhances the antidepressant effects of ketamine.

Should I stop taking my prescribed medications once on Ketamine therapy?

No. You should continue taking your medications as prescribed by your psychiatrist or mental health provider. After your consultation, we will guide on which medications may need to be adjusted and you can report these recommendations to your mental health provider.

If I have other medical conditions, can I still get ketamine infusion?

People diagnosed with psychosis are not allowed to undergo ketamine IV infusion. Ketamine may increase the possibility of dissociative episodes which may aggravate the symptoms of people with psychiatric disorders.

Some medical conditions like arrhythmias make ketamine unsafe. Untreated glaucoma and untreated high blood pressure, must be corrected prior to starting ketamine infusions.

If in doubt, schedule a free consult with one of our practitioners and they will guide you based on your individual circumstances.

Ketamine for Depression

Clinically-proven Depression treatment! The symptoms of Depression can place a massive burden on a patient and their family. Ketamine infusions offer hope for a major reduction in your depression symptoms.

What are the current routes of administration of Ketamine?

Aside from intravenous infusions, there are other routes of ketamine administration. These are intramuscular, nasal, oral, rectal, subcutaneous, and sublingual administrations.

The most rapid method to deliver Ketamine is through the intravenous route. This also helps effectively regulate the delivery of the drug in its proper dose. Ketamine IV infusions have the fastest onset and recovery. They are also easiest to adjust the dose/rate throughout the infusion.

Ketamine can also be given intramuscularly, however, higher doses are required as compared to IV infusions and the procedure can cause localized bruising at the IM site. The intramuscular route is well studied largely through its role and application in pediatric sedation, where intravenous access is usually difficult.8

The most recent route of administration is through the intranasal route, which is the route of choice for esketamine, its enantiomer, in the treatment of TRD.

What should I expect during my Ketamine IV Infusion session?

Upon arrival at the clinic, you will be asked to do some standard paperwork and you will be set up on Mood Monitor, a tool that allows the clinic to monitor changes before and after each infusion.

After processing payment, you are then ushered to the back of the clinic to start IV therapy. Once done, the nurse addresses your concerns, and you are then ushered back to your infusion chair. Once you are settled comfortably, you will be set-up on the monitors and your ketamine infusion will be initiated. Please do not be afraid to raise any concern to the staff , especially your expectations on what you will be going through on your first session.

During the infusion, most patients are noted to dissociate. This is entirely normal, and the staff will be there to monitor and guide you throughout the process. You will feel dreamy or light after several minutes, a mood that some call a “reflective state”. Please do not hesitate to call the staff’s attention once you feel uncomfortable during your infusion. Once the infusion is complete, you will be given time to rest and recover for 30 minutes. In the absence of any untoward effects, your IV line is then removed, and you will be discharged.

The day following your infusion, expect to receive a questionnaire from Mood Monitor. Kindly complete the questionnaire as this is extremely important to monitor your response to the infusion.

So, there you go! It will be so easy, and you can breeze your way through it! For a more detailed description, check out this video below so you can have an idea what to expect during your first ketamine infusion appointment at The Injection and Infusion Clinic of ABQ.

What are the possible side effects after getting Ketamine infusions?

Patients often report feeling “strange or loopy” within minutes of the start of the ketamine infusion, and resolves within two hours. There were also reports involving minor and temporary effects such as nausea, vomiting, dizziness, double-vision, drowsiness, restlessness, and confusion.

When this happens, kindly call the attention of the staff assigned to you to assist you with your needs. Other than that, there were no serious drug-related adverse effects noted, no reports for dependency and tendency for recreational use, no significant cognitive or memory deficits noted within a three-month period of monitoring and follow-up.

Thus, the best way to get your Ketamine IV infusion is through a professional clinic where you can be monitored by a healthcare professional, and you are given the right dose for your therapy. The Injection and Infusion Clinic of ABQ assures you that you are monitored well and given the safe dose, hence quality of care is not compromised.

Ketamine for Postpartum Depression

Postpartum depression affects up to 15% of mothers. The negative effects on child development are well-established. THANKFULLY, there is now a FAST-ACTING option.

Ketamine is also known as a club drug. Can frequent Ketamine infusion sessions get me addicted to Ketamine?

Ketamine as a recreational drug was first reported in the 1970s. “K-hole”, “Super K”, or “kai-jai” are some of the terms associated with ketamine. The misuse of ketamine as a club drug increased at the turn of the century.

As a therapeutic substance, you will be unlikely to get addicted to it since the dosage and frequency of infusion is controlled at low and specific doses. Moreover, chances of addiction are nil unless you are self-medicating. 

Ketamine is FDA-approved (for anesthesia) but is used off-label for depression. What does this mean?

No. You should continue taking your medications as prescribed by your psychiatrist or mental health provider. After your consultation, we will guide on which medications may need to be adjusted and you can report these recommendations to your mental health provider.

How long will each ketamine IV infusion session last?

The standard regimen followed at The Injection and Infusion Clinic of ABQ is six infusions spread over two to three weeks. Adjustments are made based on individual response.

Though randomized controlled studies have documented responses even on the first day of infusion. Our experience in the clinic is that most patients have a response by the fourth infusion.

When this occurs, remaining infusions are then spaced out a bit longer (e.g. instead of the 5th infusion occurring in two-three days, we postpone it to five or even seven days). Take note however that the number of sessions for each patient are extremely variable and is based on patient response and preference.

Please do not forget to complete Mood Monitor so we can help you get the optimal management plan for your condition here at The Injection and Infusion Clinic of ABQ. We are highly committed to give you the best experience in our clinic.

Ketamine for Post-Traumatic Stress Disorder (PTSD)

Studies has shown that a single 45-minute Ketamine Infusion can produce rapid reductions in PTSD symptoms as measured by the Clinician-Administered PTSD Scale to increase the duration of effect a series of 6 infusions.

How long will each Ketamine IV Infusion session last?

Ketamine infusions for mental health are administered over forty minutes. The approximate recovery time is about thirty minutes (this is on a case to case basis – some patients take longer time to recover). All in all, most patients can expect to spend almost two hours in the clinic from the start to the end of the infusion session.

Do I need to bring someone with me to my sessions?

You can come on your own. And most of our patients prefer this. However, you may bring someone to sit with you. Since we encourage “letting go” during a ketamine infusion, we have observed that having a friend or family member can interfere with that process.

You are not advised to drive right after a session for safety reasons. You need to plan for your ride prior to the start of your ketamine session. Most of our patients have us call their ride once they enter recovery. Uber or Lyft is also allowed. Kindly inform the staff of your after-recovery plan before the start of the session.

Can I eat prior to a Ketamine IV infusion session?

You will be advised to not eat six hours before your scheduled therapy. Nausea and vomiting happens in about 50% of patients during and after the therapy. You can however drink clear liquids up to two hours before the session. If nausea or vomiting happens, you will be given Ondansetron (Zofran) IV as needed. Ondansetron is also given prophylactically if a particular patient is known to experience nausea.

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Schedule a FREE Ketamine Consult now!

Your comfort is our utmost priority at The Injection and Infusion Clinic of ABQ. We hope this helped. If you are ready to start or if you have questions, schedule a free consult with The Injection and Infusion Clinic of ABQ.

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Ketamine

20 Amazing Facts You’d Love to Know About Ketamine for Depression

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Ketamine in History

Ketamine has been used for years now as a therapeutic substance for Treatment-Resistant Depression (TRD). 

The National Institute of Mental Health reported an estimated 11 million US adults suffered at least one major depressive episode in 2017 alone. Depression is real and it won’t go away on its own. 


Pharmaceutical companies have developed antidepressants and medical procedures over the years. Medicines though react differently with each person. Some get relief from their symptoms, while others do not.


In this article, we will share with you:

10 Historical Facts About Ketamine

  • 1956: The pharmaceutical company Parke-Davis in Detroit, Michigan, USA synthesized phencyclidine (PCP) as a general anesthetic (Maddox et al., 2013). Its trade name Sernyl was a powerful anesthesia. Its production was later discontinued due to its many side effects.
  • 1962: The original form of ketamine or CI-581 was synthesized as a short half-life derivative of PCP or (R, S)-ketamine (Domino, 2010)
  • 1964: Dr. Edward Domino and Dr. Guenter Corssen performed the first study of (R, S)-ketamine in humans. They studied the anesthetic effects of CI-581 on healthy volunteer-prisoners. The prisoners reported feeling disconnected from their bodies. They felt as if they were floating. Later, Ketamine was dubbed as a dissociative anesthetic because of this sensation.
  • 1965: Ketamine was confirmed as an effective anesthetic and analgesic (Domino et al, 29165)
  • 1970: The U.S. FDA approved ketamine as an anesthetic and analgesic. It was used as a field anesthetic by Vietnam soldiers during the US-Vietnam war. During this decade, studies explored the properties and anesthetic and analgesic effects of ketamine for therapeutic purposes (Tyler et al., 2017)
  • 1978: Starting in 1978 and onwards, ketamine became a Class III substance of the US Controlled Substances Act.
  • 1983: Ketamine was confirmed as an N-Methyl-D-aspartate receptor (NMDAR) antagonist (Anis et al., 1983). NMDAR antagonists are used as anesthetics for animals and humans. It causes a trance-like state. A study pointed out that ketamine had pain relief and sedation properties.
  • 1985: The World Health Organization included ketamine as a safe intravenous anesthetic in the Model List of Essential Medicines
  • 2000: Researchers conducted the first double-blind placebo control study of (R, S)-ketamine as an anti-depressant. It showed rapid-acting and sustained anti-depressant effects in a patient suffering from major depressive disorder (Berman et al., 2000)
  • 2019: The U.S. FDA and European Commission approved (S)-ketamine nasal spray for TRD

Ketamine 101: What It Is, Best Uses and Applications

How exactly does Ketamine work? What are these mental health disorders and how can ketamine administration help? Get to know Ketamine better!

10 Myths on Ketamine Busted

Myth 1: Treatment-Resistant Depression (TRD) is a hopeless case

There are various therapies for TRD. Mental health clinicians prescribe antidepressant medications for TRD. These medications are divided into groups or classes.

These are selective serotonin reuptake inhibitors or SSRIs, serotonin-norepinephrine reuptake inhibitors or SNRIs, norepinephrine, and dopamine reuptake inhibitors, tetracycline antidepressants, tricyclic antidepressants, and monoamine oxidase inhibitors.

You may be prescribed a medication in one of these classes. If it doesn’t work, you may be given another medication from a different class. If this still doesn’t work you will be given a combination of medications from other classes.

Your mental health clinician can also recommend a combination of an antidepressant with a different kind of medication. This is called augmentation therapy. These medications are lithium, antipsychotics, and dopamine.

Other than medications, Cognitive Behavioral Therapy (CBT) has been studied as an effective adjunct to medications. The Mayo Clinic also listed psychotherapy, dialectic behavioral therapy, and psychodynamic treatment to name a few (Mayo Clinic, n.d.). Medical procedures are also an option.

These are vagus nerve stimulation (VNS), electroconvulsive therapy (ECT), and repetitive transcranial magnetic stimulation (rTMS). Ketamine intravenous infusion therapy has become the last resort when medications and procedures fail. Why is this so? Read Myth no. 2 for answers.

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Myth 2: Ketamine doesn’t work for TRD since it’s just an anesthetic

Yes, Ketamine is an anesthetic and pain reliever. It’s an off-label drug for TRD. Ketamine is made up of two enantiomers or a pair of molecules These are R- and S-ketamine.

A study found out that both enantiomers showed rapid and long-lasting effects. R-ketamine appeared to be potent and safe relative to S-ketamine because it exhibited no psychomimetic side effects.

Spravato is an S-ketamine nasal spray that was recently approved by the FDA for TRD. Ketamine used for infusion is an off-label use of racemic ketamine, meaning it has both the left and right isomer of the drug. There have been a lot of studies conducted on the efficacy and safety of ketamine IV infusion therapy.

It has been shown that ketamine had rapid antidepressant effects even for ultra-resistant depressed people. Researchers found out ketamine is safe and well-tolerated.

It is effective as a maintenance therapy, too. Researchers revealed that repeated once-a-week infusions of ketamine had cumulative and continued antidepressant effects.

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Myth 3: Ketamine is a horse tranquilizer not suitable for people.

Veterinarians sedated horses and other animals with ketamine. It goes way back to the 1960s. It’s also suitable for people since for so many years, it has been used as an anesthesia and pain reliever.

For animals, veterinarians may inject higher doses to reach a desired effect. Horses are infused with 2.2 mg ketamine/kg bodyweight.

Ketamine infusion for people with TRD comes in small doses at 0.5 mg ketamine/kg body weight.

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Myth 4: Ketamine is just a party drug

In the 70s, ketamine became popular as a club drug in Europe and the US due to its psychedelic or euphoric effects (Wolff, 2016). One of its popular street names is “K”.

In large doses, users of ketamine abusers reported a sensation of falling into a deep and dark hole. Ketamine as a recreational drug is illegal. It is considered a regulated drug by the Drug Enforcement Agency.

Its medical use is legal. The government allows ketamine therapy for TRD under the strict supervision of certified healthcare professionals.

Ketamine is given to people with an appropriate controlled dosage in a healthcare facility, such as the Injection and Infusion Clinic of ABQ. Its ketamine-certified staff has administered more than 2,000 Ketamine infusions since 2017. 

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Myth 5: Ketamine mixed with alcohol produces better results

Ketamine with alcohol does NOT maximize the desired effect. Mixing ketamine and alcohol is dangerous. A study showed that combining ketamine and alcohol may result in over-intoxication.

The potential overdose can lead to memory loss, coma, and even death. The combination of both substances causes impairment of your motor coordination and reflexes. This can lead to minor to serious injuries.

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Myth 6: Ketamine makes you crazy or psychotic!

FALSE. Ketamine will not make you crazy or psychotic unless you have a pre-existing psychiatric disorder. This is why people with psychiatric disorders are not allowed to undergo ketamine therapy.

Because there is a possibility that ketamine may aggravate the present mental disorder. In typical circumstances, it may induce momentary hallucinations that are within safe limits and reversible.

Healthy participants in a study reported hearing voices and music as hallucinations at a moderate dosage. These visual and auditory perceptions are temporary and don’t persist after the therapy. No valid basis has been reported about ketamine as a cause of mental illness.

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Myth 7: Ketamine leads to addiction

Any drug has the potential for addiction, not just ketamine. The key here is responsible usage. According to the United Nations Office of Drugs and Crime in 2014, PCP derivatives or new psychoactive substance such as ketamine misuse is only at 1%.

Ketamine creates feelings of calm and detachment. It becomes pleasurable for some people to the extent of seeking a repeat experience.

This makes it a potential for psychological dependence or abuse. This happens at higher doses, which is unlikely in a medical setting or under a controlled environment.

Addiction can exist if you take ketamine without medical supervision, which is illicit. Ketamine does NOT cause physical dependence, like opiates or benzodiazepines.

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Myth 8: Ketamine is for adults only

Adults 18 years and above have undergone ketamine IV infusion therapy. They have been subjects of many studies that resulted in positive outcomes. There’s only a little information about the efficacy of ketamine to adolescents with TRD. But these are promising.

There’s a study conducted among 12-18 teenagers with TRD who were administered six doses of 0.5 mg/kg of ketamine. Ketamine infusions were tolerated with fleeting dissociative symptoms.

The researchers concluded that ketamine may have a potential role in treating adolescents with TRD. They recommended further studies would be helpful to validate the dosage and long-term effects.

A more recent pilot study used ketamine to see if there are any behavioral or neural changes among adolescents with TRD. And to find out if these changes are related to the improvement of symptoms.

The study reveals that behavioral and neural findings were related to clinical improvement in adolescents with TRD.

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Myth 9: Ketamine should not be used since there’s Electroconvulsive Therapy (ECT)

According to Dr. Amit Anand, Electroconvulsive Therapy (ECT) has been considered as one of the best therapies for TRD.

Across the Life Span program in Cleveland Clinic, Ohio. He is the head of an ongoing study to compare ECT and ketamine in treating major depression among people who have not responded to antidepressant medications.

ECT is known to cause memory loss. This is not a side effect of ketamine, making it a more attractive option to many patients suffering from TRD.

Ketamine for TRD has been acknowledged and is an accepted healthcare practice. Each therapy has its pros and cons.

The fact is, individuals react differently to medicines and procedures. The best therapy for one may not be the best for another. 

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Myth 10: Ketamine is a stand-alone therapy for TRD

Not really. A study of 16 participants with TRD showed that Cognitive Behavioral Therapy (CBT) may bolster ketamine’s antidepressant effects.

CBT is a psychological method deemed effective for depression and other mood and substance dependency disorders. It may be combined with ketamine IV infusion therapy. Its goal is to change thinking patterns through various strategies.

It enables a person to recognize biases and rethink them in a more rationally. It allows the person to use problem-solving skills in difficult situations and learn ways of boosting one’s confidence.

CBT is performed by a certified therapist just like ketamine is administered by a certified clinician.

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Want to Know More About Ketamine Infusion?

At the Injection and Infusion Clinic of ABQ, we have noted that patients have the best outcomes with regular boosters AND at least one other medication. Since ketamine is so different than SSRIs or SNRIs, this makes sense that two classes of medication would have synergistic effects.


Visit us or give us a call at 505-445-4300. Our certified ketamine clinicians are happy to answer your questions. 

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Ketamine

Ketamine 101: What It Is, Best Uses and Applications

ketamine injection and infusion clinic of abq

What is Ketamine?

Ketamine was first introduced in the 1960s as an anesthetic. Known to produce dissociative general anesthesia, it is commonly used in surgical and obstetric procedures


As ketamine does not compromise the functions of the heart and lungs, it is widely used in the field of critical care and pain medicine.

Besides it’s use in treating medical patients, it is also sought out for it’s psychedelic effects. Users who take ketamine at low doses experience hallucinations, sedation and an “out of body experience”.


Those who are familiar with ketamine recreationally may also know it as “Special K”, “Cat Vallium” & “Super Acid”. Consequently, people who take ketamine in high doses are prone to develop bladder problems, loss of consciousness and schizophrenia-like symptoms. The recreational use of ketamine, does not negate its medical usefulness.

How exactly does Ketamine work?

Studies show that ketamine works by binding to multiple receptors in the brain. One of these includes its ability to bind to opioid receptors, which provide pain relief.

Ketamine also has an affinity for the NMDA receptor, where it functions as an antagonist. The excitatory neurotransmitter glutamate primarily binds to the NMDA receptor, which plays a role in stress management.

Ketamine also binds to the AMPA receptor - a part of the glutamate neurotransmission which sends signals between nerve cells. It is unclear how ketamine provides antidepressant effects in addition to its anesthetic and pain relief properties.


Researchers postulate that it may be due to its ability to bind to many different receptors and affect many parts of the body. Imaging studies of the brain show that ketamine administration increases activity in the anterior cingulate cortex and signaling in the prefrontal cortex. These outcomes are correlated to ketamine’s rapid antidepressant properties.

Ketamine has proven itself to be a valuable drug in the field of medicine. It’s use as an anesthetic agent and pain relief medication make it valuable in many various medical fields. In the past decade, studies consistently highlight its role in the treatment of mental health disorders.

What are these mental health disorders and how can ketamine administration help?

Ketamine for Depression

Depression is characterized by the following symptoms:

  • A persistent loss of interest 
  • Depressed mood with sleep disturbances
  • Fatigue
  • Feelings of worthlessness
  • Guilt
  • Suicidal ideation (thoughts)

According to the National Institute of Mental Health (2019), in 2017, a major depressive episode affected approximately 17.3 million adults in the US.

Only 65% of these people received professional medical treatment, while 35% did not receive any treatment at all. As the exact mechanisms of major depressive disorder are unknown, current available treatments are limited in its efficacy.

Treatment-resistant depression is also increasing in incidence. In a clinical trial involving more than 2000 patients with depression, researchers monitored the symptoms and medication intake of participants for 6 weeks. The prevalence of patients with treatment-resistant depression was found to total 55%.

Earlier studies have also shown promising results from IV infusion of ketamine. Patients with major depression were injected with 0.5mg/kg of ketamine, which resulted in significant improvement after only 3 days.

The patients reported improvement in the two most prevalent symptoms of depression: loss of interest in activities and depressive mood.

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Over the years, many studies have been conducted on the efficacy of ketamine as an antidepressant. In 2019, a single dose of IV ketamine was shown to improve severe depression and anxiety symptoms within 1 hour of administration.

This effect was sustained when followed by 5 more doses in the course of 2 weeks. After a month of administration, the overall severity of depression also decreased.

Researchers have also examined the effects of IV ketamine administration after childbirth. Postpartum depression - also known as “baby blues”, is characterized by feelings of emptiness, sadness and anxiety after pregnancy.

In one study, a group of mothers was given a low dose of IV ketamine after childbirth. The prevalence of postpartum blues and depression was lower compared to the group that did not receive any.

Perhaps the most significant effect of ketamine is its effect in suicidal ideation. Suicidal ideation is considered a psychiatric emergency, as there is currently no known medical treatment for it.

In a study involving more than 100 patients with treatment-resistant depression, one subanesthetic dose of ketamine was administered for 40 minutes.

After 3 hours, the participants answered several questionnaires assessing their depression severity and suicidal ideation. The group that received the ketamine infusion showed less tendency towards suicidal ideation.

Ketamine’s rapid and sustained properties have earned it the title of “miracle drug”. Despite its many benefits, it is important that patients do not attempt self-medication.

As it is a potential drug of abuse, administration requires the supervision of an experienced professional in a clinical setting.

For those that prefer to stay away from needles, the ideal therapy for depression also requires a multidisciplinary action involving a psychiatrist, in conjunction with other medications and cognitive behavioral therapy.

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Ketamine for Anxiety

Generalized Anxiety Disorder (GAD) is a common chronic disorder that affects the adult population. It is defined as persistent, uncontrollable worrying and anxiety that causes notable distress and impairment in daily functioning.

GAD affects all aspects of a person’s life - including their work and personal relationships. Standard treatment for GAD is a combination of cognitive behavior therapy and oral medications.

From initial studies that highlight the effects of ketamine for depression, researchers postulate that it may also benefit those with anxiety. This is due to the similarities in brain network activity for patients with depression and anxiety.

One study involved 12 patients with treatment-resistant generalized anxiety disorders. Subcutaneous ketamine at low doses was administered to these patients at weekly intervals.

After just an hour of administration, the patients reported a reduction in anxiety that persisted until the end of the week. There were no adverse effects for this group of patients.

Hence, the study concluded that ketamine can also be a potential medication for treatment-resistant anxiety disorders.

Another type of anxiety disorder ketamine can improve is Social Anxiety Disorder (SAD). SAD, or social phobia is characterized by uncontrolled fear of embarrassment, humiliation and scrutiny in public areas or situations.

This fear is so excessive that it can lead to significant impairment in daily functioning. Researchers estimate that approximately 3-7% of adults in the US suffer from Social Anxiety Disorder.

Many patients with social anxiety disorder do not respond well to the current available treatments for anxiety. In one trial involving 18 adults diagnosed with SAD, researchers administered IV ketamine at 0.5mg/kg for 40 minutes.

Compared to the control group, the social phobia and other anxiety-related symptoms of this group improved remarkably after 2 just weeks.
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Ketamine for PTSD

Post-traumatic stress disorder (PTSD) is a disabling and chronic condition that often manifests after a traumatic incident. People with PTSD  are prone to re-experiencing traumatic events, as well as possess avoidance and hyperarousal symptoms.

They can also exhibit combative and detachment symptoms when triggered by something related to the inciting event. PTSD often occurs concurrently with other psychiatric conditions such as depression, alcohol abuse and anxiety.

Given the proven effects of ketamine in treating anxiety and depression, the possibility that it can also be used to treat PTSD was explored. In one study, 30 US army veterans with PTSD were given six 1-hour ketamine infusions.

Their depressive and PTSD symptoms were assessed using validated questionnaires. From the questionnaire, researchers discovered that the score for both depression and PTSD symptoms decreased after the ketamine infusions.

They postulated that inducing a transpersonal dissociative experience alongside intravenous high-dose ketamine was what produced the desired effects. 

In another study involving patients with both PTSD and major depressive disorder, researchers administered 6 ketamine infusions at 0.5mg/kg every Monday, Wednesday and Friday.

After 8 weeks, data showed a remission rate of 80% for PTSD and a 93.3% response for treatment-resistant depression. The effect for PTSD was found to have been sustained for more than a month, with no adverse effects or worsening of symptoms in the participants during the study.

As a result, researchers concluded that ketamine infusions administered in a clinical setting can be beneficial for patients with PTSD and treatment-resistant depression.

Even today, the exact role of ketamine in PTSD is an active field of study. As researchers continue to study the effects of ketamine, we may discover more information regarding the optimal dose, administration and indications of Ketamine for PTSD. 

Currently, the FDA approves the use of ketamine for the treatment of depression at a specific dose and route, under the supervision of a healthcare provider.

One aspect that is important is the method of ketamine administration. During clinical trials, researchers often used ketamine infusions or intravenous ketamine (inserting a needle into the vein). As you’ll soon discover, how ketamine is administered is just as important as what it is used for.

IV vs Oral Ketamine

Ketamine can be administered through an intravenous, intranasal, subcutaneous, or oral route.

One study explored the effects of oral ketamine, and it’s ability to exert it’s same rapid and sustained antidepressant properties. After collating several studies that used oral ketamine, researchers came to the following conclusion:

  1. The reduction in depressive symptoms manifested only after 2-6 weeks of taking oral ketamine, as compared to IV ketamine which only takes hours.
  2. Oral ketamine does not decrease suicidal ideations.
  3. Oral ketamine does not demonstrate improvement in treatment-resistant depression.

The authors of these studies claim that more relevant studies are needed for a robust conclusion. Omitting these claims, ketamine infusions are found to be more effective for treatment-resistant depression and reducing suicidal ideations, when compared to oral ketamine. 

Some authors also add that oral ketamine is not palatable. It also has a much higher incidence of nausea. This is due to peak plasma levels not being as high as IV administered ketamine, as it would have to undergo hepatic metabolism if taken orally.

Intranasal administration of ketamine can also pose several problems, as variations in the structure of the nasal cavity can affect the efficacy. Patients might also find it difficult to administer the medication themselves, which can affect the outcome.

Furthermore, because ketamine infusions are performed in a clinical setting, healthcare providers can monitor vital signs and respond as needed. This addresses complications immediately and allows the patient to focus on the experience.

Ketamine is regarded as a miracle drug in the field of healthcare. Studies have shown it to have a positive outcome on patients suffering from depression, anxiety, chronic pain, and PTSD. By binding to multiple receptors in the brain, ketamine’s effects are found to be long lasting and effective at treating mental health disorders.

The Injection and Infusion Clinic of ABQ can provide Ketamine infusions to patients!

Our team of clinicians are experienced in handling ketamine. We have completed over 2,000 infusions since 2017. We are active members of the American Society of Ketamine Physicians, Psychotherapists & Practitioners.

If you’re thinking about using ketamine for medical treatment, visit us here to learn more about ketamine infusions and how it can benefit your mental health.

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Ketamine

How to Fight Severe Depression with Ketamine Infusion

severe treatment resistant depression

I’ll get straight to the point. For you or anyone you know with Severe Depression or Treatment-Resistant Depression (TRD), ease your worry. IV Ketamine Infusion may be the right therapy for you.


Researchers reviewed 24 related studies about the effects of ketamine on TRD. To name a few, they gathered studies from PubMed, Medline, and ScienceDirect. The review confirmed the role of glutamate in ketamine’s fast antidepressant effects. 


The results showed notable improvement in the symptoms of depression. I’m sharing with you some of the experiences from 416 people, who participated in the various studies. These four stories come from the studies, which demonstrate
the rapid effect of low-dose ketamine.

Uplifting stories about IV Ketamine Infusion
from people suffering from Severe Depression

STORY 1

Three people with TRD were studied through naturalistic observation in a span of 12 months. They received repeated ketamine dosage of 0.5 mg/kg. The researchers rated the severity of their depressive symptoms with the Montgomery-Asberg Depression Rating Scale (MADRS).


The three people responded positively to the ketamine therapy. Based on their own responses though, they had to go through with their individual therapy. The study showed that low-dose ketamine had a therapeutic effect on people with TRD. The study’s method though did not use other approaches. There was no random sampling, blinding, or placebo control.

STORY 2

A 49-year old woman who had a six-year history of TRD. Researchers administered ketamine intravenous infusion to her. She had it once every one to two weeks or a total of 36 doses for 10 months. Her mood stabilized the researchers noted. The severity of her symptoms was nearly reduced to 50%, too.

STORY 3

Another set of researchers conducted a random control trial study of 73 people using intramuscular injections. The researchers grouped them into two. One was the ketamine group. The other was the active placebo group. The placebo group was injected with Midazolam, an anxiolytic. After 24 hours, the researchers assessed them using MADRS. The ketamine group showed greater improvement in the MADRS score than the Midazolam group. The researchers concluded ketamine IM exhibited fast antidepressant effects.

STORY 4

The study by Murrough and colleagues was likewise confirmed in another related review. This 2019 review showed promising results of ketamine as a non-competitive receptor antagonist (NMDA) or a selective serotonin reuptake inhibitor (SSRI). Ketamine had rapid antidepressant effects on people with TRD. This is based on the review of ketamine’s clinical efficacy and mechanism of action. The researchers noted that the effects of a single dose of ketamine lasted up to one week. Two weekly ketamine infusions lasted up to 15 days.

severe depression ketamine the injection and infusion clinic of abq

Encouraging effects of Ketamine on people with concurrent disorders

There are two other stories from studies that show ketamine’s efficacy. It has been established as a fast-acting antidepressant for TRD. And, it’s also therapeutic for people who are at the same time suffering from suicidal thoughts or battling substance dependence.

Suicidal ideation

10 people with TRD participated in a non-controlled study. For four weeks, they received IV Ketamine doses of 0.5 mg/kg. This was done in the morning in a well-controlled medical set-up. The researchers used the MADRS and Scale for Suicide Ideation for assessment. 


According to the researchers, all study subjects had a momentary increase in blood pressure. They also experienced changes in consciousness, while four of them experienced mild delusions or hallucinations. These are expected and resolved without intervention. The results of the study showed a decrease in the severity of depression after 40 minutes to 15 days.


Suicidal ideation also decreased until the seventh day. The researchers concluded that a rapid, single 0.5 mg dose of ketamine is effective in quickly lowering symptoms of TRD and suicidal thoughts.

Substance dependency

A 55-year old male patient with TRD received two ketamine infusions of 0.5 mg/kg. He was alcohol and benzodiazepine dependent as well. The researchers assessed him through the Hamilton Depression Rating Scale and the Beck Depression Inventory. The study ran for six weeks.


The results of the study revealed that on the seventh day, positive effects started to wane. But, a second infusion was effective. The researchers concluded that repeated ketamine produced positive effects on people with TRD who had a coexisting substance-use disorder.

How ketamine works as an antidepressant

Limitations of the Studies on Ketamine Infusion

The above-mentioned studies exhibited positive effects of ketamine on people with TRD. Most of the studies also commented they focused only on the short-term efficacy of Ketamine infusion. They recommended other researchers to examine the long-term effects of its use. 


Some of the researchers also suggested further investigation of the proper practice, dosage, and intervals of administration. There’s also the question of “How many ketamine infusions are you supposed to have?” And, “When do you stop?”

What is Ketamine?

You’ve read about the good effects of ketamine. Let’s now take a closer on what ketamine is and what it’s used for. Ketamine is a substance that has anesthetic and pain killing properties. Since the 1970s, the FDA gave a thumbs up to ketamine as an anesthetic. It’s usually injected into your body during operations. It’s also used during short-term diagnostic exams.

How Ketamine works as an Antidepressant

There’s no clear explanation of how it works. Ketamine though has to do with receptors in the brain called NMDA. In our brain, there are neurotransmitters called glutamate located between spaces of neurons. Ketamine works by increasing the amount of glutamate. Glutamate works with another receptor called AMPA.


Let’s stick with the acronym as the spelled-out word is hard to remember. As I was saying, AMPA is responsible for helping neurons talk to each other in synaptogenesis. This is the process of creating a new pathway that possibly affects the way we think and feel. Ketamine may work by decreasing signals involved in inflammation linked to mood disorders, such as depression.

Symptoms of TRD or Severe Depression

Thus, ketamine works as an antidepressant due to its mechanism of action in the brain. This applies to TRD, too, based on the stories I narrated earlier. But what is depression and how is it different from TRD? The National Institute of Mental Health (NIMH) describes the symptoms of depression. Some of these symptoms are associated with the following specific behaviors:

  • Excessive sleeping or the lack of it
  • Irritability or mood swings
  • Loss of interest in activities once enjoyed
  • Hopelessness or a feeling of doom
  • Extreme feeling of loneliness or isolation
  • Suicidal thoughts or thoughts about death or dying
  • Inability to perform self-care or activities of daily living

TRD be like…

  • Experts say that TRD occurs when a person isn’t responsive to two or more different kinds of antidepressants.
  • A person may not be able to tolerate the therapeutic doses of an antidepressant. This may be due to the serious side effects.
  • Symptoms may become worse as remedies don’t work. 

Traditional remedies for TRD

According to the World Health Organization (WHO), more than 264 million people suffer from depression globally. Moreover, WHO also mentioned that it contributes to the global burden of disease and causes disability worldwide.


Like depression, the remedy for TRD is prescription medications. Electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are also options. It’s still best to consult your primary health care provider on your antidepressant intervention options.

Prescription Medications for TRD: pros and cons

For prescription medications, you may choose from a wide array of antidepressants and SSRIs. There’s also serotonin-norepinephrine reuptake inhibitor (SNRI) and monoamine oxidase (MAO) inhibitors. Other medications can be added to your existing antidepressant. These are called combination or augmentation therapy. Taking a cocktail of medications poses side effects for you. Moreover, what might work best for a friend, may not work for you. So, taking antidepressants can be a form of trial and error.

ECT and TMS for TRD: pros and cons

It has been the usual practice to administer ECT or TMS for TRD. Both therapies come in a series of sessions that can go on for weeks or even months. The medical community considers ECT for TRD as the gold standard.


In ECT, controlled electric current courses through electrodes attached to your scalp. You’re under anesthesia when this is done. You won’t feel the surge of electricity. You won’t get shocked either. Your brain will experience brief seizures when current is applied. This hopefully relieves the symptoms of your severe depression.


There’s a possibility of improper administration and incorrect use of the ECT equipment. So, only trained healthcare providers perform this procedure. The side effects include memory loss, nausea, headaches, and muscle soreness. The risks of heart rhythm problems may occur if you have any heart problems.


On the other hand, TMS has an electromagnetic coil attached to your forehead. It emits a magnetic field with the same outcome as ECT. You lose consciousness or experience seizures. Unlike ECT, you don’t need to be sedated. Side effects during the procedure include anxiety, mild discomfort, and skin irritation at the coil’s site. You may also experience headaches or light- headedness after the procedure.

Downsides of Ketamine

Compared to medicines, ECT, and TMS...ketamine does fairly well, too. Like any other therapy, ketamine comes with side-effects. You may experience anxiety, increased blood pressure, confusion, dizziness, and nausea.


It’s a controlled drug because it has a potential for abuse. Reckless or unmonitored use of this can lead you to psychological dependence. Although, it is physically non-addictive. If you have any history of substance dependence or alcohol use, ketamine may not be a good fit for you.


The benefits of IV Ketamine Infusion may still outweigh the possible risks. It’s becoming an accepted rapid antidepressant therapy for TRD. As more research is being conducted, the efficacy of ketamine will be further investigated. Health insurance companies do not typically cover ketamine as a therapy for TRD.


The Injection and Infusion Clinic of ABQ provides superbills to anyone interested in submitting for insurance reimbursement. We see about 5% of our patients get partial-reimbursement.

How Ketamine is administered to the body

How Ketamine is administered to the Body

Ketamine for TRD is recommended when other antidepressant medications fail. It comes in two forms. There is ketamine IV infusion and S ketamine intranasal spray.

Ketamine IV Infusion

Ketamine is infused intravenously in your arm. None of it is wasted as it is delivered directly into your bloodstream. Ketamine IV infusion therapy usually takes 40 minutes as it is infused at a controlled rate. 


The dose is based on your weight, response and side effects. You may be given a dose of one to six infusions before it starts to kick in. One-time boosters are needed every 3-6 weeks. The time between boosters usually increases with time.

Esketamine

In March 2019, the FDA approved Spravato or esketamine / S ketamine as an antidepressant. This form of ketamine is only the left isomer or “half” of the intravenous ketamine.


Ketamine for infusion is called “racemic ketamine”. This means it has both the left and right isomers of the medications. These isomers are chemical mirror images of each other. Spravato is packaged as an intranasal spray.


A clinician supervises you for two hours after the nasal spray is administered. This observation period is an FDA requirement. For the first four weeks, your nostrils will be sprayed twice weekly. For the next four weeks, it will be administered once a week. It becomes bi-weekly in the succeeding weeks.


As a downside of the intranasal spray, you may have a sudden urge to sneeze, cough, or gag. It may drip out of your nose or throat, instead of heading to your brain as intended. Although your out of pocket cost may be less, the overall cost is significantly more than an infusion.

Second thoughts about Ketamine?

Ketamine IV infusion and intranasal spray have its pros and cons. They’re not the first-line remedies for TRD. Rather, they are the answer to remedies that have failed. What sets it apart from the traditional remedies is its fast-acting mechanism. Ketamine provides immediate relief, which other therapies cannot do. If you are still thinking about Ketamine for you, it’s recommended you consult with an experienced Ketamine clinician. 


The clinicians at The Injection and Infusion Clinic of ABQ have performed over 2,000 infusions since 2017 and all are ketamine certified. If you are looking for an experienced Infusion Clinic in Albuquerque, New Mexico give us a call at 505-445-4300

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Ketamine

What is Chronic Pain? Causes, Impacts, and Treatment Options

Chronic Pain: Causes & Treatment Options at Injection & Infusion Clinic of ABQ image

What is Chronic Pain?

Chronic pain is one of the most common reasons people seek medical help.
In 2016, the CDC conducted a survey on US citizens and discovered the following:

  • 50 million adults suffer from chronic pain
  • 19.6 million adults have high-impact chronic pain symptoms
  • Approximately 30% of patients report severe pain lasting for more than 6 months. 

When severe pain lasts for more than 3 months, it is known as high-impact chronic pain. This type of pain is commonly associated with disabilities that limit a patient’s daily activities

What exactly is chronic pain? What causes it and why should this be a concern?

Contrary to what most people believe, pain is not necessarily a bad thing. It is a signal that our body uses to communicate. Without it, we would never know if something was wrong.

For example, if you’ve ever touched a hot stove, be grateful that you felt pain. It’s your body's way of saving you from further injury. However, when pain lasts for more than 12 weeks, it becomes a concern.

Most tissue-related injuries heal within that timespan. Pain that continues to persists afterward, can signify a serious problem that should not be overlooked.

When it comes to cancer-related pain, there are two types: malignant and chronic. It is important to know the differences between these two types, as treatment differs depending on the situation. If you want to learn more about the effects of chronic pain and how to treat it, read on.

What is the burden of chronic pain?

It makes you less productive.
  • People that suffer from chronic pain often find their lives turned upside down. Many are unable to work and find themselves distracted by their pain. As a result, their productivity sharply declines and many are forced into early retirement.
It negatively affects your sleep.
  • Sleeping with a leg cramp is difficult. Multiply that pain exponentially, and it’s not hard to see why people with chronic pain have difficulty sleeping. Those with chronic pain often wake up tired, as their sleep quality is poor.

    Many people who suffer from chronic pain often complain about sleep disturbances. In the US, approximately 10% of people attribute insomnia to chronic pain. One survey in Australia revealed pain to be the number one reason behind poor quality of sleep. As well, people with chronic pain tend to take longer before falling asleep, have longer nighttime awakenings, and shorter durations of sleep.

    The science behind the link of chronic pain to sleep disturbance is complex and not yet completely understood. We do know that when our body experiences pain, it activates the stress-response system at the hypothalamus. It increases the levels of certain hormones that can make you more alert and awake.

    Science does not yet fully understand the link between chronic pain and sleep disturbances. However, we do know that when our body experiences pain, it activates the body’s stress-response system, also known as the hypothalamus. When the hypothalamus is activated, it triggers an increase of certain hormones in our bodies. These hormones are responsible for keeping us alert and awake, which spells disaster before bedtime.

    Serotonin is involved in pain modulation and pain transmission. Neurotransmitters like serotonin also play an important role in the pathophysiology of sleep disturbance.
  •  According to Johns Hopkins Medicine (2014), the release of serotonin into the spinal cord can make non-pain sensing nerve cells sensitive to pain. This results in an increase of “pain signals” that are perceived by the brain.

    Lastly, infections and inflammatory diseases involve the widespread release of cytokines like interleukin-1 and tumor necrosis factor. Both of these promote the perception of pain and affect the different stages of sleep.
Chronic Pain Injection and Infusion Clinic of ABQ
It costs you a lot of money.
  • Over-the-counter painkillers, doctor visits. as well as sick leaves from the office can be costly. If you add them all up, the total estimated socioeconomic burden of chronic pain amounts to billions of dollars a year.

    Researchers looked into the cost of chronic pain drugs that were prescribed for a year in the US. Overall, prescription medications for pain reached $17.8 billion a year.

    From 2000 to 2007, the total outpatient visits related to chronic pain was approximately 690 million times. From these visits, 29% of the patients had been taking at least 5 medications for their chronic pain.

    Compared to other drugs, analgesics and NSAIDs took up $1.9 billion, opioids took up $3.6 billion, while other adjuvant treatment for chronic pain took up $12.3 billion.

    Among these adjuvant treatments, the most common type was antirheumatics/immunologics which are often prescribed for forms of arthritis and other diseases of the joints. 
Chronic pain lowers the quality of your life. 
  • Chronic pain affects your sleep, your presence at work, your productivity, as well as your medical costs. It’s no surprise that from a holistic standpoint, it can also lower your quality of life.

    Quality of life can be defined by the way you view your position in life. This includes factors such as culture, expectations, and concerns. It encompasses not just your physical health but also your psychological and emotional state, the quality of your relationships and the features of your environment.

    The World Health Organization estimates the number of “chronic pain days” a year to be 22%. When added up, it results in 21.5 million days of chronic pain from patients.

    Chronic pain affects more than just the patient - the people around them can also be affected. People that suffer from chronic pain often feel they are a burden to their loved ones.

    For example, a family could be preparing for a vacation, only for one person’s arthritis to flare up and postpone the trip. Others may have difficulty walking independently, and rely on family members to take care of them.

    Additionally, a study done in Australia found that poor quality-of-life was associated with chronic pain and musculoskeletal disorders. Another study done in Europe supported these findings, as more than half of the respondents reported that they experienced constant pain.
It can make you prone to depression. 
  • Depression and chronic pain have more in common than you might believe. Clinical depression can manifest itself as chronic pain, and chronic pain can l