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Frequently Asked Questions: Redefining Depression With The Assistance Of Ketamine Therapy.

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Hello again. This is Susan from myketaminestory.com. I am once again addressing questions and concerns regarding Ketamine therapies for treating mood disorders and pain. I am writing a four part series answering questions about Ketamine use, based on my experience with Ketamine therapy over the past 2.5 years, for The Injection & Infusion Clinic of ABQ. This is the third post in my Q & A series.

My first blog, Ketamine: Addressing Questions & Concerns focused on my early experience with Ketamine Infusions. In part two of the series, Addressing Questions & Concerns About Ketamine Therapy for Treatment Resistant Depression I addressed questions and concerns about Intramuscular Ketamine verses Ketamine Infusion therapy. Today I plan to be a bit more random. I have had emails with several questions and themes recently. I want to address as many inquiries as I can and decided to approach this current series in a more hopscotch fashion.

I will preface this series of questions with an obvious disclaimer. I am answering all the questions posed in this blog, as well as the two previously mentioned, based on personal experience with Ketamine treatments and my own continued readings. I want to advocate the use of Ketamine for Treatment Resistant Depression because of my results from the therapy. I want to share my success and how I have benefited from the new form of treatment.

It has been through my Ketamine advocacy that people have approached me via email with questions and concerns. I have been fortunate enough to have providers reach out to me asking me about my results and my writings. It is because of these inquiries I am rarely at a loss for writing material. I have appreciated the interest and encouragements. I have enjoyed the offers to write about my story for other websites. I have. I am human. These interactions have not all been pleasant. I am always shocked by how insensitive “professional” people can be. What is even more baffling is the fact they are reaching out to me. Odd. They clearly seem to forget that I am a patient writing and not a doctor or other provider. I am flabbergasted at times. I could share numerous incidents that would surely puzzle the best conversationalist. The demands and expectations have been insane. I will briefly state that I can not simply be purchased and added to your business expenses. I am a human sharing personal experience. Please be respectful.

I need to add a special thank you as a side note. I have been known as a woman that expresses her feelings regularly. If I am overcome with strong emotions, I share them. I work incredibly hard on focusing on positive action and thoughts. If I am impressed or treated well I will make a point of saying thank you for your kindness. I am appreciative to Jason Duprat with The Injection & Infusion Clinic of ABQ for constantly being sensitive of my story and feelings. He repeatedly treats me with respect and honor. Jason allows me to feel comfortable and valued. We work with each other professionally with a twist of mutual fondness I think. I am grateful that his Ketamine clinic strives to bring more affordable infusions. I would love to see more Ketamine centers following his example. It really benefits everyone. If a center is willing to lower prices, then this massively successful therapy could be offered to more individuals suffering with Treatment Resistant Depression (TRD). Think about it. If you charge 500 and, say for example, only 10 people can afford treatment from your clinic each month making your total income 5,000. Now, for sake of easy math, think about charging 200 dollars per session. You can now service and provide hope to numerous of my fellow sufferers. Let’s follow this logic to the end. At 200 dollars per treatment you might book 30 or 40 clients per month giving you 6,000-8,000 in profits. You also get a bonus…. a full heart.

I admire Ketamine providers that understand the desperate need for Ketamine therapy for depression, but clearly care more about patient long term care. It is crucial to keep in mind that the majority of your client base will need to return repeatedly for booster/maintenance Ketamine thus also increasing your bottom line. Remember the 10 patients I mentioned in my first example? They will definitely find it even more financially stressful if not completely unrealistic to return for follow up care. My guess is maybe 1 out of 10 could manage the compounding cost of routine boosters of Ketamine therapy. Insurance companies do not currently cover the charge of Ketamine treatments. The numbers add up.

I once again digress.

I have had friends question my motives for writing for Ketamine clinics, and the motives of the providers requesting my help. To be completely honest, I have to say that I have no issue using keywords and letting the readers know about a specific Ketamine Clinic by name. It benefits everyone involved. However, I am very selective. I ask a ton of questions. I want to inform. I also am not a fool and I realize it is easier to spread your message when you have help. I admit that there are specific answers I am looking for when approached to write about Ketamine for sites other than my own. It means asking tough questions. I need to know the motives, the whys, behind the offer. I want to know how people act and react to my questions. I investigate. I approach each center as a patient and an advocate. I want to build a genuine relationship with my reader. I am writing on a very personal subject matter. A relationship built on trust and honesty is important to me. I also want and see the importance in establishing a relationship with Ketamine providers. We are all important and valuable. We can spread the news about Ketamine and give hope back to those in darkness.

Advocacy is a new adventure for me.

I wasn’t expecting to go on that rant. I apologize. It has been on my mind a lot recently. I do not want to be a bought and paid for direct advert. I definitely don’t want to appear insincere in my writings. Ketamine has offered me life. I want to educate and possibly offer change to those that don’t think their lives will ever improve.

My words, my language, and self expression mean so much to me. Please don’t script my feelings. I want to inform the public. I have my story and my style. If you really want to share my passion to educate the world on the benefits of Ketamine for depression then I suggest not editing my words to serve your hidden agenda. I did not approach you. Please remember that when you are slaughtering my message and find yourself shocked when I opt not to work with your Ketamine facility. I am advocating Ketamine for Treatment Resistant Depression. I am pretty confident that is why you contacted me. Yes? Readers are intelligent after all. They will recognize bullshit. I would.

Ketamine has and continues to breathe life into me. I started my personal website in January of 2017. I wanted to share and advocate the use of Ketamine to treat depression. It has been through my writings I have discovered how truly powerful words can be. In the recent months those words have been reaching more fellow sufferers. It is thrilling to know that more professionals are reaching out to learn more about Ketamine therapy, too. I have learned that I have value when I share and educate. Many times I am consciously aware that my writings are only me ruminating and desperately trying to make connections so I can heal. The idea that I may actually be helping others; that is fascinating and exciting.

I am immensely grateful to have The Injection & Infusion Clinic of ABQ as a platform to educate. They definitely have met all my personal standards for a Ketamine provider. Their Albuquerque, New Mexico Ketamine center is one of the lowest costing Ketamine providers in the nation. The also passed my “must offer” quiz by informing me that they will be offering Intramuscular Ketamine shots to clients at a reduced cost, for those that can’t afford the infusion boosters/maintenance programs. Oh, if I ever relocate!

I will be announcing another exciting development on myketaminestory.com website later this week. I also have a board full of blog topics to discuss and ponder. I am feeling creative and looking forward to writing several articles this month.

Okay, surprisingly I was finally capable of wrapping up that tirade on proper etiquette when asking a blogger for personal writing content for their Ketamine business.

Onward, to the latest question and answer blog; part three in this four part Q & A series. I hope you find it helpful.

What is Ketamine?

My life-preserver! It really is. Ketamine is basically an anesthetic drug that blocks pain. It was first developed in the 1960’s and was used to operate on soldiers during the Vietnam War. In the past, Ketamine, has also been used as an animal tranquilizer. However, in more recent years, Ketamine has been a common theme in nightclubs and parties because of the “hallucination” element users have repeatedly enjoyed.

What do you mean by “hallucination” element?

Well, in addition to dulling pain, Ketamine has been known to allow users to feel like they’re detached from their own body. This sensation is often written and explained as a dissociative effect. These feelings are often associated with a variety of drugs known as hallucinogens. This class of drugs are frequently known to distort perceptions of sight and sound. It produces feelings of detachment from the environment, mind, and self. The reason this can even occur is because the drug is reducing or blocking signals to the conscious mind from other parts of the brain. This out-of-body experience has made it a popular club or party drug, and is commonly called “Special K.”

How is Ketamine given?

If you have done any research on the subject you will probably get this answer; Ketamine is given as an infusion. An IV line is put in place and directly delivers the Ketamine into your vein. The needle is typically placed in your arm or hand. It is reported that this method is the quickest route for the medicine to get to the brain.

You may have also read that most people start with about six doses over a period of 2 weeks, and then they sign up to get booster Infusions once every 3 to 5 weeks.

The facts have alluded to the idea that you may need to continue treatments for a year or more to see long-term results. My experience has proven to me that long term use is absolutely necessary to continue to fight this demon, to recover and lead a productive life.

I agree with these findings, to a point.

Research online misses the fact that Ketamine is also now being given in many other forms. As many of you know, I started out with 6 Infusions and transitioned to IM Ketamine. I get Intramuscular Ketamine shots every two weeks. I do not see this regimen changing any time soon.

I have also used nasal Ketamine spray in an emergency situation. I keep a bottle on hand in case my symptoms show their hateful presence before my next appointment. I appreciate having this option even if I am notoriously known for consistently complaining about this delivery method. I admit that I still find the value of it, and if some horrific event took my beloved doctor away I wouldn’t hesitate to count on the glories of this spray if it meant I could be free of depression for days. I am truly grateful that is not my situation.

There are also pharmacies making Ketamine torches otherwise known as Ketamine lozenges to help patients between their boosters or to extend their maintenance time frame to help reduce costs. I have not yet tried lozenges. I may switch from the spray to torches in the future. However, I am super comfortable with my treatment plan and can’t see convincing my doctor to prescribe the lozenges over the nasal spray. Plus, the lozenges would double my monthly cost because my compounding pharmacy charges more to make lozenges.

How much does nasal Ketamine spray and/or Ketamine lozenges cost?

The cost for the nasal spray ranges between 65-125 a month. My Ketamine spray cost is 65 dollars. The Ketamine lozenges, in my area, cost 125 dollars a month. I had and have to consider my total costs for my maintenance care. This, I imagine, will be the case most of the people seeking help from mood disorders with the use of Ketamine will discover for themselves and adjust.

How does Ketamine work?

Researchers don’t know exactly how Ketamine works to treat depression, but they have some ideas. Unlike antidepressants, which work by shifting the balance of brain chemicals like serotonin and dopamine, Ketamine is thought to change the way brain cells communicate with each other.

Ketamine blocks a type of receptor in the brain, known as NMDA, thought to play a role in depression. Recent studies find that Ketamine can have long-lasting effects on depression, even though the drug only stays in the body a short time.

Ketamine also acts on other brain receptors very similar to those opioid receptors, which affect pain and depression.

I, personally, accept this but I want to expound on the subject. I am planning to write a blog in the coming weeks on this topic. It is my understanding over the years that depression was linked to chemical imbalances in the brain and that was the cause of all my misery. I am now rethinking my beliefs.

The more I read about inflammation and diseases makes me convinced that depression is caused by inflammation and not an imbalance of chemicals.

I truly believe that the Ketamine reduces the swelling in my mind and on some levels my body. The Ketamine reduces the inflammation in all the damaged areas of the mind and it is, in my opinion, because of this reduction phenomenon that normal brain flow begins and repairs can be made. As I stated, I will be addressing this remarkable belief in my next blog.

How well does Ketamine work?

It works remarkably well for me. I can be in a really bad place emotionally before my Ketamine therapy and a few hours later I am motivated and willing to take on all the challenges life keeps insisting on throwing my way. Unlike traditional antidepressants, which can take weeks or longer to take effect, Ketamine starts working within a few hours. Personally, I can go into a session feeling extremely suicidal and discouraged only to find myself leaving my doctor’s office pondering how I could have felt so desperate only moments ago.

In the past, I can vividly remember, I had an active suicide plan in place as I walked into the building to get my Ketamine Infusion. Depression hurts. It kills everything. It makes believing in possibilities nonexistent. I am a fighter. I push back. I question. I think of myself as pretty open minded and self aware. However, I am still, after over two and half years of routine Ketamine therapy, incredibly amazed that I can walk out of my doctor’s office shaking my head that only a short time ago suicide felt like the best and only solution to this insidious disease that constantly takes ownership of me.

It is frustrating and immensely discouraging to continuously battle for mind control. I know that for people who are suicidal, this rapid effect can be lifesaving. It constantly pulls me away from the edge.

Ketamine is also helping people who haven’t found relief from other more traditional depression treatments. I am one prime example on the benefits this drug, Ketamine, is providing.

My personal experiences have been similar to many individuals that find themselves wanting to try this new treatment for depression. I am no different from others that have been to several psychiatrists, therapist, cognitive modification behaviorists, and have tried half a dozen, to a dozen or more, medication cocktails without success.

It is sadly noted that many people with Major Depressive Disorder have attempted suicide and again I am not unique. I have scars on the outside and even more on the inside. Suicide has always felt like a valid and logical solution to me and I found myself attempting plan after plan mainly craving relief.

I write now, and I get so sad thinking back on those decades of darkness and self loathing. The depression can sometimes still lead my mind to suicidal idealizations. It is uncomfortable. I trust that the Ketamine will win the battle for me, but thoughts can be powerful and habitual. I keep my doctor informed.

What do you notice about your mood after receiving a Ketamine Infusion?

I have been reading that most patients are reporting a lightening of their mood with Ketamine treatments. They feel that the dread they have been carrying for years begins to lift. If there was anxiety before, all of a sudden there is less anxiety. It’s also not uncommon for people to feel like Ketamine allows them to get out of bed and face their obstacles for the first time ever. I can concur. This has been my experience too.

What are the “side effects” of Ketamine therapy?

I laugh at this question. In my mind there are no side effects. What effects the Ketamine causes during the infusion time are not, in my mind, a side effect. It is the medication working. It is Ketamine showing you that mind and body are one and at the same time they are separate. I will explain.

I would say about 7-9 minutes after getting IV Ketamine, I often experienced “dissociative” effects. These sensations were very similar to what I imagine a spiritual awakening would be like. Many people have reported having an out-of-body experience while under the effects of Ketamine. These feeling subside as the drug wears off. It is roughly about 45 minutes where you will probably feel slightly off. I felt fairly “loopy” at times. Textures in the wall, door or clothing appeared to pop; like a 3D movie without the need for the trashy glasses. Things may look and sound a little bit different than they usually do for you.

Colors appeared very vibrant to me. Some people have mentioned that things might look blurred. I feel my eyesight sharpens with Ketamine. I had this amazing peaceful sensation and awareness. I was observing myself without that familiar harsh judgmental mind I detest.

In the beginning, I did have the unusual experience of looking down at my body and not really seeing it. I made a remark to my husband that I will never forget. I glanced nervously at him and shyly smiled and exclaimed, “Where is my body? I can’t see my feet or hands. I am feeling like a fish in a huge aquarium.” I was laughing at the silliness of my thoughts and observations. My hubby reassured me that I was still sitting in my chair; all of me. The next moment I glimpsed down and giggled and shouted, hey there my feet are!

The feeling lasts for about an hour after the IV, and then it should wear off, while the drug’s benefits continue.

The drug can possibly cause a spike in blood pressure and heart rate in the short term. I imagine that for most people, that’s probably not a huge problem. It was never an issue for me. It is something to be aware of.

Doctors don’t know much about the long-term effects of Ketamine because they haven’t been able to study it over long periods of time. However, more and more sufferers are finding relief with the assistance of Ketamine therapy.

There have been studies that are carelessly reporting that they have linked regular Ketamine use to memory issues and other problems related to thinking. I can state with confidence that after more than 2.5 years of Ketamine given to me regularly, every two weeks, I have not had any memory issues. However, I did lose months and months of memories with ECT treatments.

I am speaking with a genuine heart. I have had no side effects worthy of mentioning. I will comment again that in the beginning I had issues with nausea. I could have easily requested an anti-nausea medication but I tend to be a purist about all medications I take now. I honestly feel it is a small price to pay for multiple symptom free days.

The memory loss that has been a concern and reported as a potential reason to never offer Ketamine widely to the public doesn’t seem to be the case with the doses being used to treat depression. Yet, those against the use of Ketamine for Treatment Resistant Depression insist on claiming that it does.

Doctors also worry that the drug might lead to abuse, but this hasn’t been proven either. I have an addictive personality and have a history of becoming obsessed and massively addicted with a number of coping clutches in the past. For example, I am a recovering alcoholic and had been sober for over ten years when I started Ketamine therapy. So, yes, I did worry about addiction. I admit that I did fret about my tolerance level and whether over time I would grow intolerant or need more Ketamine to achieve the same results. My history has made me cynical. I worried unnecessarily. I have never craved Ketamine physically like I did with alcohol or other devices I used to manage my depression and anxiety over the years. I admit that I have heard myself say, “I am in critical need of Ketamine. I want it right now; fast. Please!” I have no doubt in my mind that desire and need is all about wanting to be symptom free again and not an actual feeling that would lead to abuse.

If the Ketamine is administered accurately, I feel the relief for 8-10 days and then I find that my illness creeps back in and takes over again. The return of my depression and anxiety can begins slowly at first. I notice it is harder to correct my thoughts or redirect them. I lose all patience with myself. Decisions become impossible to make. Frustrations and anger. I appreciate the slow build. It is when I go to bed feeling great, and I awake the next morning afraid to leave my house and quickly my resolution drives me straight to suicidal thoughts and plans.

It doesn’t make sense to me. I was fine when I went to bed. Why, oh why? What happened? The OCD thinking takes the wheel and drives my every action. It is days like these that I am forever grateful for Ketamine. I know these emotions and fears are temporary. I also know I have the Ketamine spray for days like these and that helps pacify me. I don’t ever really feel the need to abuse the nasal spray either. I feel and have found for myself that If you are feeling symptom free from that nightmare you thought only suicide could cure, you probably won’t be sticking around the house getting high. You will be out there living the life you were meant to. Having said that, I do understand the risks and concerns. Ketamine is no different to me than Benzodiazepines and Opiates. Doctors write a Xanax script without blinking and trust me I worry more about the abuse with anti-anxiety medications than I ever will with Ketamine.

How much does it cost?

The price can vary based on the doctor and location. Generally, each IV costs $400 to $800.

As of 2017, Insurance companies often don’t cover the cost of treatments. I am aware that Kaiser Permanente has recently started testing a Ketamine program.

There are also more and more centers opening every few months. I have located several offices, such as The Injection & Infusion Clinic, offering Ketamine Infusions for as low as $299 per infusion. I suggest doing your homework.

I would also consider IM Ketamine shots or Nasal Ketamine spray which are both typically more cost efficient.

In conclusion, If you know of anyone suffering with treatment resistant depression, like I do, let them know that Ketamine therapy may be an option worth looking into. It has been and continues to offer me relief from my symptoms. If you or someone you know are considering Ketamine infusion therapy, please visit www.infusionclinicabq.com for low cost ketamine infusion and injection options. If you are not in the Albuquerque, New Mexico area I also suggest approaching a local professional and start educating them on the benefits of Ketamine. It doesn’t hurt to ask for what you need.

You can also visit my Ketamine provider list to find a provider in your area which is located here and on my personal website.

Join me again next month, when I address more questions about Ketamine Infusions and Intramuscular Ketamine in the final blog of my Q & A series. I plan to share my thoughts and experiences about how diet effects mood and possibly Ketamine. I will revisit any unanswered questions about the different delivery methods, the effects of Ketamine, Ketamine Advocacy, and concerns over what I have been reading during my research and studies on the drug. I appreciate all the interest and inquiries. I really do. Thank you for reaching out. I hope others will find hope with Ketamine. I will continue to advocate… Ketamine for Treatment Resistant Depression and Anxiety Disorders. It continues to work its “magic” for me every two weeks.

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Pondering Concerns & Questions: The Benefits Of Ketamine For Treatment Resistant Depression

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Hello again. This is Susan from myketaminestory.com. I am once again addressing questions and concerns regarding Ketamine therapies for treating mood disorders and pain. I am writing a four part series answering questions about Ketamine use, based on my experience with Ketamine therapy over the past 2.5 years, for The Injection & Infusion Clinic of ABQ. This is the fourth and final post in my Q & A series.

My first blog, Ketamine: Addressing Questions & Concerns focused on my early experience with Ketamine Infusions. In part two of the series, Addressing Questions & Concerns About Ketamine Therapy for Treatment Resistant Depression I addressed questions and concerns about Intramuscular Ketamine verses Ketamine Infusion therapy. In my last blog, Frequently Asked Questions: Redefining Depression With The Assistance Of Ketamine Therapy, I was a bit more random. I had emails with several questions and themes and I addressed as many inquiries as I could. In my final question and answer dialogue I want to discuss research, clinical studies, and the need for changes to occur within our insurance companies and federal government so that maybe one day Ketamine will not be so difficult to afford or obtain from any qualified professional.

I will preface this series of questions with an obvious disclaimer. I am answering all the questions posed in this blog, as well as the three previously mentioned, based on personal experience with Ketamine treatments and my own continued readings. I want to advocate the use of Ketamine for Treatment Resistant Depression because of my results from the therapy. I am sharing my success and how I have benefited from Ketamine, the new form of treatment for depression.

Let’s jump right into this frustrating topic.

How long have researchers been studying the positive effects Ketamine has on mood disorders?

I am not completely sure. I think I read that in 2000, researchers started studying Ketamine as a treatment for depression. I personally was not aware of Ketamine as a medication used for Treatment Resistant Depression until 2015. I would have loved to have known about Ketamine a decade ago, but I am constantly reminded in my recovery to be grateful that my husband discovered it when he did.

It was over those 15 years that the studies and research have led us to discover that Ketamine improves the mood and does so much faster than traditional antidepressant drugs.

The clinical studies were demonstrating that not only was Ketamine reducing depression symptoms, it was also working for individuals that had exhausted all other options because traditional methods, such as ECT and antidepressant cocktails, had failed over and over again. That has been my experience; my story.

What uses have been found for Ketamine through 2017?

Ketamine has only been FDA-approved as an anesthetic for surgery and diagnostic procedures. That status has not really changed over the last few years, as some might expect, given the fact Ketamine has been featured in medical journals and news magazines.

In 2017, Ketamine is now being successfully used to treat depression, suicidal thoughts, anxiety, OCD, post traumatic stress disorder (PTSD), other mood disorders, and nerve-related pain.

So, is Ketamine FDA-approved to treat depression?

No. There is no money in it. It is a very expensive process and the drug companies won’t make any money off the drug if it is reclassified.

However, on a positive note, Ketamine is now being recognized by the American Psychiatric Association as a valid treatment for depression. The reason this is a good outcome is it has been beneficial for those providers already using Ketamine therapy to broaden their client base. I also find it helpful in advocating the use of Ketamine for Treatment Resistant Depression and Anxiety for those suffering, as well as new interest in providing this incredible therapy to more people.

Could you explain why Ketamine isn’t FDA-approved to treat depression?

I will attempt to explain what I understand about the process. In order to approve any new drug, the FDA needs evidence that it works effectively and it doesn’t cause any major harm. Typically, they determine their decision based on evidence from clinical trials involving hundreds or thousands of people.

Most of the clinical studies that have been done using Ketamine so far have been small; 25 to 50 people.

The reason larger research programs on Ketamine haven’t been done in the past is mainly because these type of clinical studies can cost millions of dollars to orchestrate.

The main issue has been that Ketamine is a generic drug. Pharmaceutical companies can’t patent it again and earn their money back from the clinical trials needed to reclassify the drug to include treating mood disorders.

However, companies are developing other drugs based on Ketamine. This is both a positive and a negative in my opinion. The main complication will be creating a pill that is so like Ketamine and continues to have no side effects. Every antidepressant I was ever on had horrific side effects. Pure Ketamine, as it is now, has no side effects. Let me correct that statement by clarifying that after 2.5 plus years of Ketamine use I have yet to show signs of any health concerns. That has never been my experience in the past, with other medications; ever. Before Ketamine, I was a frequent visitor to my family doctor due to illnesses and side effects. What is even worse, I have been in my share of emergency rooms far too many times to remember because of the medications I was prescribed for my depression and anxiety. I will never forget the pain and fear I felt when one medication cocktail had so many side effects that I was no longer capable of urinating! Seriously. It took several attempts to figure out which medication was the culprit. Once again leaving me all the more miserable and suicidal. No wonder I was initially skeptical when my husband mentioned Ketamine to me for the first time.

In August 2016, the FDA put the drug Esketamine on a fast track to approval by designating it as a breakthrough therapy. Esketamine, which is given as a nasal spray, is being tested in phase III clinical trials. Another drug that acts on NMDA receptors called Rapastinel (GLYX-13) also received breakthrough therapy status in early 2016.

My primary fear is what big pharma will unnecessarily add to their new creation when attempting to reproduce the results of Ketamine, which is already being made perfectly and inexpensively without any lasting side effects.

What should people consider before they try Ketamine?

I think the only worry I had when I made the appointments for my 6 Infusions in 2015 was actually a double sided fear. What if Ketamine doesn’t work for me? And the flip side of that obsessive thought was the painful terror I felt at the thought, what if Ketamine helps me and I can’t afford to continue the treatments. I was convinced it would lead me straight to my death if it didn’t work, but what if it is effective will I ever survive without it?

What would life without depression and anxiety even look like? I was pretty twisted by all my thoughts leading up to my trip to New Jersey for my six infusions.

I never believed Ketamine was a miracle cure. Never. It didn’t seem possible that after more than four decades of profound depression and anxiety six treatments could kick that evil. I knew that if Ketamine was helpful, I was going to need to find a provider closer to my home and for an affordable rate for me. I worried this would not be realistic because in 2015 options were limited. So, because of this panic I felt in the beginning, I might suggest looking into follow up care to reduce the anxiety if that is an issue for you, like it was for me.

Do you think that Ketamine therapy is a miracle cure for depression?

No. I feel Ketamine is a tool. It gives you the ability to do the work you need to do. You may have been trying repeatedly to improve your mood and situation wanting only to accomplish wellness and over the years you have failed. I feel Ketamine assists my recovery. I can see progress. When I utilize the cognitive behavior therapy (CBT) tools, I genuinely feel I am learning and improving now.

There should be some emphasis that Ketamine isn’t a quick fix. Although it can have a rapid positive effect, I don’t think enough information is given about the possibility of having to return after the first six infusions for a booster in order to continue to thrive from the benefits of Ketamine on your depression and anxiety.

People are getting the idea that Ketamine is a miracle cure. This is upsetting to me. I believe only a few people are fortunate enough to get one dose and then have their depression go away. I don’t think this is an accurate portrayal of Ketamine. It is likely that even after the six recommended infusions most will need follow up care.

The initial effects of the drug on depression can fade quickly; within 1 to 3 days. Most people need to get repeat treatments over many months or years to see long-term improvements. This has been my story.

I feel adding mindfulness training and constantly utilizing cognitive behavioral therapy tools might help the Ketamine antidepressant effects last longer. It has worked for me many, many times over the past couple years.

I am suffering with Depression and want to try Ketamine. Where can I get Ketamine?

You can get it at a Ketamine clinic. There are more than one hundred clinics around the country now, but the drug can also be administered by a medical doctor, registered nurse, nurse practitioners and physicians assistants just to name a few.

I recommend speaking to a family doctor or trusted practitioner about Ketamine and its benefits. Advocate for your health and mental well being. It will not hurt to ask for what you need. It may be frustrating trying to educate professionals, but it never stops me. This drug is changing lives and you may just find that empathetic provider willing to learn and assist you.

Ketamine is also given experimentally in clinical trials. I suggest googling Ketamine studies or clinical trails on Ketamine for TRD or mood disorders.

I have been generating a Ketamine Providers and Locations list and I update it regularly. The list can be found here and on my personal website. This list may help you find a clinic in your city or state.

In conclusion, If you know of anyone suffering with treatment resistant depression, like I do, let them know that Ketamine therapy may be an option worth looking into. It has been and continues to offer me relief from my symptoms. If you or someone you know are considering Ketamine infusion therapy, please visit www.infusionclinicabq.com for low cost ketamine infusion and injection options. If you are not in the Albuquerque, New Mexico area I also suggest approaching a local professional and start educating them on the benefits of Ketamine. Again, it doesn’t hurt to ask for what you need. ​

Join me again next month, when I plan to share my thoughts and experiences about how diet affects mood and possibly Ketamine therapy. I appreciate all the interest and inquiries. I really do. Thank you for reaching out. I hope others will find hope with Ketamine. I will continue to advocate Ketamine for Treatment Resistant Depression and Anxiety Disorders. It continues to work its “magic” for me every two weeks.

#Ketamineshot #albuqerqueketamine #abqketamineclinic #newdepressiontreatment #IMKetamine #abqketamine #CognitiveBehavioralTherapy #ketaminedepression #newmexico #albuquerque #newtreatmentfordepression #theinfusionclinicofabq #theinjectionclinicofabq #whatisketaminelike #infusionclinicabq #ketamineanddepression #KetamineProviderLocationsList #Ketaminelocations #KatamineProviders #ketaminetherapy #TreatmentResistantDepression #FDA #Clinicalstudies #ClinicalTrails #Ketamineresearch #Ketaminestudies #Ketamine #ketamineinfusions #myketaminestorycom #theinjectionandinfusionclinicofalbuquerque #Ketamineclinics #ketamineforPTSD #theinjectionandinfusionclinicofabq #ketaminetreatment #ketamineprocess #CBT #PTSD #ECT #ketaminefordepression #ketaminenewmexico #KetamineAdvocate #depression #intramuscularKetamine #Electroconvulsivetherapy #ketamineforpain

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Ketamine: discover a new treatment

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Hello. This is Susan from myketaminestory.com. I am a blogger that suffers with Treatment Resistant Depression (TRD), Anxiety and Obsessive Compulsive Disorder (OCD). I was introduced to Ketamine for TRD in January 2015. I am forever grateful that I was. I spent the first two years focused on my recovery. I now have an excellent treatment plan in place but that does not clear me from obstacles or pitfalls. I journal regularly. I educate and advocate for Ketamine Therapy to help treat depression. I write for The Injection & Infusion Clinic of ABQ, entirely based on my experience with Ketamine therapy over the past 2.5 years,

This blog is a work in progress. My desire is to educate both the general public as well as physicians on the use of Ketamine for treating chronic clinical depression. I was diagnosed with clinical depression and generalized anxiety disorder at the age of 18. I spent nearly 30 years after that searching for treatment to pull me from the depths of suicidal depression, daily panic attacks, insomnia and agoraphobia. I have spent countless times in psych hospitals, often for long periods. I have been prescribed practically every antidepressant on the market at one time in my life. The side effects alone have horror stories that could easily fill an entire 700 page novel. I have felt so desperate to escape the hell I was constantly living in that I tried ECT (electroconvulsive therapy, otherwise known as shock therapy). I believe that after a couple decades of seeking out treatments and several different varieties of therapy to no avail I truly began to believe that maybe it was “all in my head”. However, I could never wrap my mind around that because I was sincerely convinced that I would never willingly choose the world I was suffocating in daily.

Fast forward to 2015, I am once again deep in the pit of depression. I see no hope. I am done fighting. I have attempted to take my life so many times that I can’t recall a number; suicidal depression is always calling your name. January 2015, my light went out. I honestly had no fight left in me. Those of you that suffer know exactly what I mean. Trust me when I say treatment resistant depression is exhausting. I felt like I was fighting an evil so big, dark and all encompassing I couldn’t breathe. I was done. It was my most serious attempt. I left a note that no action should be taken. I apologized, but I could only pray that one day they would know and understand that I loved them and stuck around so, so long for them. The pain, hopelessness and the lack of successful treatment drove me to actions, that unfortunately many understand while others will never get it; to those individuals please be grateful you are so blatantly unaware of the world we were unknowingly and unwillingly sucked into. My last attempt was a serious one. I was so frustrated and angry when I was unsuccessful. My therapist and husband went into research mode and both were equally excited about this new treatment they found for treatment resistant depression: Ketamine infusions. The only problem was that it was a new treatment and insurance won’t cover the cost. I know for many, including myself, the cost of mental health puts a financial burden on the family. We didn’t have extra money to invest in an unknown expensive treatment. I was so angry. Why do we have to put a monetary value on what we are worth? I was at the end. I knew with everything in me I would keep trying to take my life until I was successful because the life I was living was no life at all. My husband and therapist realized I was unreachable. They kept pushing me to give it a try. We used our entire income tax return and traveled to New Jersey (we live in Virginia and at the time there were no clinics or facilities providing Ketamine infusions there) to the Ketamine Treatment Center of Princeton.

https://www.youtube.com/embed/uTOZSUPNVlU

It took everything in me to stay alive until we received our tax refund and could travel to the treatment center. It was the longest five weeks of my life. It was filled with doubt that Ketamine infusions could even help me and that driving desire to end my life. In the end, I had 6 infusion treatments over a two week period. And I am thrilled to admit it changed the direction of my life. I was fortunate enough to learn that a doctor in Charlottesville, Va was willing to start trying intramuscular Ketamine shots. When I returned home to Virginia I was feeling rather strange, but in a hopeful positive manner. When I was asked what it was like I could only compare it to an individual that has been deaf all their life and they undergo cochlear implants. I imagine once they wake from surgery everything in their world is shifted, new, scary and a little shocking. I felt like I was experiencing life from the shoreline instead of under the vast powerful ocean waters. My life, it has not been the same. I have discovered me. It is still a lot of personal growth work and I struggle, but Ketamine has allowed me to see clearly. It gives me the ability to do the work because it pulls me up and out of the debilitating depression. I get Ketamine shots every two weeks now. I want to share my experiences, educate, possibly change a flawed belief system, as well as force insurance companies to pay for the cost of treatment. And trust me, the cost is a fraction of the cost of hospitalizations and traditional methods of treatment. In my blog I plan to document my Ketamine treatments, the effects, how it is changing my life, educate others suffering with treatment resistant depression, discuss changing insurance policies to include Ketamine treatments and if I am effective in my writings I am really hoping to open the eyes of psychiatrist, physicians, and nurse practitioners alike.

In conclusion, If you know of anyone suffering with treatment resistant depression, like I do, let them know that Ketamine therapy may be an option worth looking into. It has been and continues to offer me relief from my symptoms. If you or someone you know are considering Ketamine infusion therapy, please visit www.infusionclinicabq.com for low cost ketamine infusion and injection options. If you are not in the Albuquerque, New Mexico area I also suggest approaching a local professional and start educating them on the benefits of Ketamine. Again, it doesn’t hurt to ask for what you need. ​

I have been generating a Ketamine Providers and Locations list and I update it regularly. The list can be found here and on my personal website. This list may help you find a clinic in your city or state.

Join me again later in the month, when I plan to share my thoughts and experiences about how diet affects mood and possibly Ketamine therapy. I want to send out a special thank you to everyone, from my fellow sufferers to those that love us, that continue to connect with me. I appreciate all the interest and inquiries. I really do. Thank you for reaching out. I hope others will find hope with Ketamine. I will continue to advocate Ketamine for Treatment Resistant Depression and Anxiety Disorders. It continues to work its “magic” for me every two weeks.

Originally posted on myketaminestory.com

#Ketaminestudies #Clinicalstudies #FDA #Ketamineresearch #Ketamineshot #albuqerqueketamine #abqketamineclinic #newdepressiontreatment #IMKetamine #abqketamine #abq #CognitiveBehavioralTherapy #CBT #albuqerqueketamineclinic #abqketaminecliniccom #ketaminedepression #newmexico #albuquerque #theinfusionclinicofabq #newtreatmentfordepression #theinjectionclinicofabq #whatisketaminelike #infusionclinicabq #ketamineanddepression #KetamineProviderLocationsList #albuquerqueketamineclinic #Ketaminelocations #KatamineProviders #ketaminealbuqerque #TreatmentResistantDepression #myketaminestorycom #ketamineinfusions #ketaminetherapy #theinjectionandinfusionclinicofalbuquerque #albuquerqueketamine #ketaminealbuquerque #Ketamineclinics #ketamineforPTSD #theinjectionandinfusionclinicofabq #ECT #PTSD #ketamineprocess #ketaminefordepression #ClinicalTrails #ketaminenewmexico #ketaminetreatment #CertifiedRegisteredNurseAnesthetist #ketaminecenters #Ketamine #abqketamineclinic #ketamineinjection #wwwmyketaminestorycomresourcesprovider #abqketamine #ketamineinfusion #abqketamineclinic #KetamineAdvocate #wwwmyketaminestorycom #depression #intramuscularKetamine #Electroconvulsivetherapy #ketamine #ketamineforpain

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Ketamine Therapy And Diet: Insights on Inflammation And Depression

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Hello and welcome. It is Susan from myketaminestory.com.

As a brief summary, I write about my experiences and journey with Ketamine Therapy on my personal website, The Injection and Infusion Clinic of Albuquerque, and also for The Boise Ketamine Clinic. I have a long history with treatment resistant depression and anxiety disorders. My personal mental health care resume includes numerous failed medication cocktails, ECT, Cognitive Behavior Therapy, Talk Therapy and hospitalizations. I admit I understand how all of these treatments could potentially help, but they never did for me. It was a little over two and half years ago that I was introduced to Ketamine for depression. I am alive today because of a drug that is raising many questions and concerns from the professional world.

My question, as I am forever questioning, is which came first: inflammation or depression? If I control the foods I eat, can I reduce my symptoms of depression? Does my depression cause excess inflammation? How does it work? I don’t know. I am investigating.

I have made many observations.

I want to know. I need to know. I am still digging and searching for control of this illness. Does diet plays a part in how efficient Ketamine treatments are? Yes. Fact? I am not sure yet. I am a guinea pig in my own research. I am beginning to think inflammation is key. I wonder, can I help or hinder my Ketamine treatments by eating anti-inflammatory foods? Does eating foods that cause inflammation bring on feelings of depression? If I eliminate these food from my diet will the Ketamine therapy last longer for me? Do I have more inflammation than the normal individual? Is that why I have Treatment Resistant Depression? Is that why Ketamine works for me? Is it why no anti-depressants or other psychiatric medications have benefited me? Does inflammation bring the onset of depression? Does depression lead the body to resist and swell?

I examine.

I think there is a connection.

I will continue my study for years. This is what I know based on personal experience and journaling.

I must honestly state that I have been putting this blog off. I just realized as I sat down to write that the main reason I don’t want to write on the subject of diet and Ketamine and how they work together to combat the symptoms of depression is because as soon as I type my discoveries, I can no longer pretend that I am not aware of the relationship.

I am fully aware.

I resent having to rigidly control and often times restrict so many part of my life because of this silent killer.

I use food for emotional comfort.

Am I not allowed to enjoy anything?

I stay focused for months at a time. I compile and avoid foods that cause inflammation. I am feeling amazing.

I hit a bump in the road. Stress.

Self sabotage?

I have spent the last couple of years paying attention to how sugar contributes to my depression. I have eliminated sugar from my diet for periods of time and noted my anxiety and depression levels. My husband has said for decades that sugar exacerbates my depression. I didn’t want to hear this. I have had to give up so much already due to this horrific illness. I strive for acceptance. I work at appreciating the aspects of this disease I can realistically control and modify. I am art in progress. That is what I tell myself.

I want to be kind to myself. I know I am my worst enemy and critic. We all beat ourselves up for not meeting expectations or goals we set for ourselves. I understand that. I know I am not special or unique in the way I attempt to be a better version of myself. The problem is when I knowingly participate in a behaviors I know will compromise my recovery and health. It is difficult not to splurge when I feel weak. It is even more of a struggle for me not to celebrate successes with my old unhealthy reward systems.

Once I write this, it will be my responsibility to follow my own advice.

Okay, I have dragged my feet long enough. Please understand these are my experiences and opinions and they are based on personal exoerience. I am a patient. I am making every effort to take back my life and heal.

I think the major discovery that I have made over the past year is that sugar is evil. I laugh. It really plays a significant role in my moods. I deny this fact all the time. It is times when I really want a Reese’s Peanut Butter Cup that I lie to myself about my findings.

Why do I think that sugar influences the depressive symptoms?

I am now becoming convinced that inflammation is the major culprit in causing Treatment Resistant Depression. I believe swelling in the body during infections wakes depression up and thus compromises our drive to fight back mentally as well. I think this is an accurate assessment I have made since becoming a Ketamine therapy patient and taking notes. I feel that the reason Ketamine is so successful in treating depression is its ability to reduce inflammation. That, of course, allows for growth and regenerates new cells; healthy new connections.

Old habits are hard to break.

An interesting side note to mention is when it occurred to me that sugar is the nemesis to my getting well. Depression is best friends with sugar. Think about it. When you feel sad, tired, or angry what do you reach for? Is it comfort foods? Is it a candy bar? A sugary treat? My guess is we all grab that unhealthy option when we feel we desire it because life is too hard on us. What is mind-blowing to me is that when I started to feel better and free of my depressive symptoms because of my treatments with Ketamine, I started to crave sugar! I would get my IM Ketamine shot and feel amazing for days. It was around day four or five after my Ketamine therapy that I found myself obsessed with wanting chocolates or cookies. Why? I feel great.

Why?

My conclusion to why Ketamine may cause me to believe that I am in a deep need of sugar has two parts. I believe the reason my body craves sugar after Ketamine is partly due to my desperate need to break old patterns and begin learning better coping strategies. I need to make better choices. I feel wonderful so I totally desire to treat myself to this cupcake, right? Oh, the lies we tell ourselves. I want to believe I should be rewarded, but isn’t eating supposed to be about fueling our bodies? My face has a look of disgust right now. I am calling myself out. I must accept responsibility. I don’t want to. I want to not think. I want to eat whatever my heart desires. I earned this……

What did we earn?

If we know specific foods disrupt our body and mind in a negative manner, wouldn’t we avoid those items?

I would hope so. However, that has not been my experience. We love to lie to ourselves. We are masters of persuasion. We tell ourselves whatever is needed to justify our actions. I am guilty. I kid myself each and every time I eat sweets. I know sugar causes inflammation. I am fully aware that I absolutely believe that inflammation is at the root of my depression. Why would I willingly subject myself to the risk of a depressive episode by inhaling a bag of M & M’s? I lie to myself. I manipulate myself. I fantasize that not even sugar can take away the uplift Ketamine provides me with. I uncovered time and again how false statements seem absolutely credible when we stop thinking our decisions don’t have consequences.

Lastly, I admit that feeling anything besides depressed is very new to me. It feels foreign. It feels very uncertain and uncomfortable at unpredictable times. I am afraid to trust in these new emotions and experiences. Do I desire to be happy? Do I know how to live a life without the darkness? I feel like an alien in a whole different way. I worry. When will I lose this sense of well being?

Anxiety.

It is confusing to process all the insights and information available to me. Depression blocks. Ketamine opens all the pathways and reduces the areas that are blocked by depression; aka inflammation.

As much as I have wanted to be symptom free from my mental illnesses, I am also finding it provokes massive amounts of doubt and insecurities. My ego attacks. It wants status quo. The ego rules the game if you let it. I demand control. Susan’s Ego bites back. I like to think that I am bright and self aware. My Ego blindly slaps me when I am overconfident. I am constantly being brought back to reality when I mindlessly partner up and play the self importance role my Ego loves. I bring the Ego into the conversation because it is the second reason I believe I crave sugar when I am symptom free of my depression. It is self sabotage. There is a strong possibility that at the core of my being I truly don’t believe I desire to be content and mentally at peace. I catch my thoughts and I say to myself, of course I deserve to be happy and enjoy life; everyone does. However, if that were absolutely the case, why do I make poor choices. I know what sugar has done to me in the past. Ketamine won’t change how my body processes sugar. Sugar is liquid depression.

The Ego doesn’t want me to be healthy because it is at risk if I do gain the power to silence it. It is after my Ketamine therapy and I am feeling fantastic and confident mentally that the Ego loses ground and control. I believe my cravings are sparked by my Ego’s desire to stay top boss of my being. It is my opinion that we are playing tug of war. The Ego thinks we are playing king of the mountain. Confusing. I want to work together. Not going to happen is my guess. The Ego is tricky. It knows you better than anyone. That makes twisting the facts and perceptions of the world a breeze for the game master.

Ketamine offer insights on many levels if you pay attention. It continues to aid me in questioning. I want to understand. I throw out my ruminations in hopes of obtaining clearer views of myself and the world around me. I may be wrong. I may ascertain more definitive facts later and adjust. I am not used to adjusting. I want to change what my idea of myself is. These beliefs limit me. I am aware. I am clueless.

In short, I need to avoid sugar to keep my happy state of mind. Easy? No. It is a challenge. Every single day it is a final exam I have the question and answers to, but my mind freezes and I fail to select the correct answer. I am average. Our society is addicted to food and I am no different. I use food to feed the emptiness and confusion I feel.

I will say that sugar is my top priority for elimination. An absolute must.

Studies show a link between sugar and depression. In fact, some blame sugar for the onset of depression. The Link Between Sugar And Depression: What You Should Know, speculates that there is a cause and effect relationship between sugar and depression. I agree. I take it a step future by hypothesizing that the reason there is a connection between sugar and depression is solely because of the inflammation sugar produces in the body and mind.

I will switch gears now and touch briefly on my experiences with an animal free diet. In the past few years I have been experimenting with my diet and mood. I have been Vegan in the past. And I must say my goal is to eat a Vegan diet 90% of the time. I love cottage cheese, and I struggle to cut it out of my life once I indulge. I have noticed that I feel physically worse when I introduce dairy back into my life. I have been Vegetarian on and off for decades.. I strive to be Vegan. It is in my best interest. When I first began Ketamine I was motivated to make changes in every aspect of my life. I overwhelmed myself with these expectations of change and progress. I am determined that if I can figure out the triggers that cause me excess inflammation, I can personally reduce my depressive episodes. I have found nothing supporting this, mind you, but I am investigating. I can honestly admit that eating a Vegan diet made me feel lighter and healthier. I also love knowing that I am not contributing to the harm or death of animals, so spiritually I feel stronger being a Vegan.

Recently, in the past week or so, I decided to eat meat again. I want to test whether my animal free lifestyle was affecting my depression and sleep. Was I lacking iron? Was my body missing nutrients? It has been about ten days that I have been eating meat again. And I feel like I can state that I wasn’t missing anything. I don’t feel like I have increased my energy level any. I feel substantially more uncomfortable physically. I will be returning to a Vegetarian diet shortly. Personally, for me, Veganism is my preference. I tried to implement as many anti inflammatory foods into my diet as possible. I want to be known for following my own advice and plan to return to a vegan meal plan for my New Year’s resolution. Finger crossed and lips sealed. I know that was lame. Sorry.

I am always examining my relationship with food and how it relates to my mental illness. If I discover anything interesting I will be sure to address those finding in future blogs.

There is something to the saying, you are what you eat! I want to know where the life satisfaction tree grows. How about you?

If you are interested in educating yourself on Ketamine therapy for Treatment Resistant Depression, check out the four-part series I wrote answering questions about Ketamine use, based on my experience with Ketamine therapy over the past 2.5 years, for The Injection & Infusion Clinic of ABQ.

My first blog, Ketamine: Addressing Questions & Concerns focused on my early experience with Ketamine Infusions.

In part two of the series, Addressing Questions & Concerns About Ketamine Therapy for Treatment Resistant Depression I addressed questions and concerns about Intramuscular Ketamine verses Ketamine Infusion therapy.

In my third blog, Frequently Asked Questions: Redefining Depression With The Assistance Of Ketamine Therapy, I was a bit more random. I had emails with several questions and themes, and I addressed as many inquiries as I could.

In my final question and answer dialogue, Pondering Concerns & Questions: The Benefits Of Ketamine For Treatment Resistant Depression, I discussed research, clinical studies, and the need for changes to occur within our insurance companies and federal government so that maybe one day Ketamine will not be so difficult to afford or obtain, from any qualified professional.

I hope these personal blogs from a patient that suffered for over four decades with treatment resistant depression will be helpful in convincing you why Ketamine could help you. Also, if you would like to become a provider of Ketamine Therapy try enrolling in The Ketamine Academy’s online Ketamine Infusion Therapy training course; it is an excellent decision. The Ketamine Academy online program will surely benefit you and the mental health community.

In conclusion, If you know of anyone suffering with treatment resistant depression, like I do, let them know that Ketamine therapy may be an option worth looking into. It has been and continues to offer me relief from my symptoms. If you, or someone you know, are considering Ketamine infusion therapy, please visit Jason Duprat’s Ketamine clinic at www.infusionclinicabq.com for low cost ketamine infusion and injection options. If you are not in the Albuquerque, New Mexico area I also suggest approaching a local professional and start educating them on the benefits of Ketamine. Again, it doesn’t hurt to ask for what you need. ​

I have been generating a Ketamine Providers and Locations list and I update it regularly. The provider list can be found here and on my personal website. This list may help you find a clinic in your city or state.

Feel free to visit The Ketamine Academy to enroll in your dream today. If you are fascinated, but not yet ready to commit, I recommend the free trial to help you determine whether you want to invest in yourself and in this is new online ketamine infusion training course. Just think, if you enrolled in The Ketamine Academy your new clinic could easily be added to my directory for the grand opening!

#ketamineforpain #ketamine #Electroconvulsivetherapy #intramuscularKetamine #depression #KetamineAdvocate #wwwmyketaminestorycom #ketamineinfusion #abqketamine #abqketamineclinic #ketamineinjection #abqketamineclinic #wwwmyketaminestorycomresourcesprovider #Ketamine #ketaminecenters #ketaminenewmexico #ketaminetreatment #ClinicalTrails #ketaminefordepression #ketamineprocess #PTSD #ECT #theinjectionandinfusionclinicofabq #Ketamineclinics #ketaminealbuquerque #albuquerqueketamine #theinjectionandinfusionclinicofalbuquerque #ketamineinfusions #ketaminetherapy #TreatmentResistantDepression #myketaminestorycom #ketaminealbuqerque #KatamineProviders #Ketaminelocations #albuquerqueketamineclinic #KetamineProviderLocationsList #ketamineanddepression #infusionclinicabq #whatisketaminelike #albuquerque #ketaminedepression #newmexico #abqketaminecliniccom #albuqerqueketamineclinic #theinfusionclinicofabq #CBT #abq #IMKetamine #abqketamine #albuqerqueketamine #TRD #Ketamineshot #Ketamineresearch #Academy #ProviderTraining #abqketamineclinic #Ketaminestudies #Ketaminecourse #Clinicalstudies #CertifiedRegisteredNurseAnesthetist #ketamineprovidercourse #Ketaminetraining #neuropathic #theinjectionclinicofabq #newtreatmentfordepression #clinicsetup #newdepressiontreatment #CognitiveBehavioralTherapy #neuropathicpainconditions #FDA #neuropathicpain #ketamineforPTSD #KetamineAcademy

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Crohn’s Disease, Ulcerative Colitis, And the Sweet Relief of IV Nutritional Therapy

IV Nutrional therapy

The plush skin of youth, more energy than they know what to do with, and better resilience when flu season rolls around? That may sound like nothing more than a lovely little fantasy for your Crohn’s Disease and Ulcerative Colitis patients, but it doesn’t have to.

Don’t worry. We’re not talking about some magic elixir, or the mysterious Fountain of Youth. We aren’t even going to suggest one more obscure home remedy to add to the long list of concoctions the internet has already peddled and pushed at patients with gut issues trying to find relief wherever they can.

If you’re looking for the best balance to prescribing treatments for your Ulcerative Colitis or Crohn’s Disease patient, better health is possible for them through incorporating IV nutritional therapy into their treatment plan.

A Good Kind of Cheating

Healthy diet options that make perfect sense to someone with a normal digestive tract can be the downfall of your patients. So, according to the direction you’ve given them, your patients have learned, adapted and grown towards eating habits that work better for them. Unfortunately, that means they’ve had to cut corners in obtaining ‘balance’ in this whole ‘well-balanced diet’ business.

IV nutritional therapy can help fill some of the nutritional gaps that result from a more selective diet, and can help keep a more vulnerable body healthy and strong.

Perhaps one of your patients as hit a wall in their health, and even the thought of eating a full meal makes them feel exhausted. It happens. IV nutritional therapy is a wonderful way to help their body pick back up and keep going strong whenever they’re dealing with a dreaded flair-up, especially when digestion or nutritional balance are more severely out of step.

Supplements That Get To the Source

If your patients are taking your best advices, they’ve been taking vitamin supplements regularly and haven’t skimped on sticking to such a routine. If your patients are your average busy human beings, they’ve more likely been forgetting this step in their routines altogether.

Which poses a problem, as you know that your Crohn’s and Ulcerative Colitis patients naturally struggle to absorb the full range of nutrients from anything that they eat. It’s the nature of the beast, especially when enduring the joys of a “flare up” season. As a result, malnutrition can be a natural and common side effect—even when their eating habits are clean as a whistle.

IV nutritional therapy being administered intravenously means that there’s no barrier between the body and those nutrients that it needs. Your patients get to give their gut a rest, but still get the goods their body needs successfully into their system.

IV Treatment Over Steroid Shots or Oral Medicine

As a medical professional, you know that there’s a time limit on the effectiveness of treatment options. It’s expected that oral drug treatments for Ulcerative Colitis and Crohn’s will only work well for a season, and then patients need to transition to something else.

Self-administered steroid shots are one alternative to oral drugs—but not everyone does well with sticking themselves with a needle on a regular basis.

Remicade is also an alternative option. This drug is administered intravenously, and has shown success in treating ulcerative colitis and Crohn’s disease, as well as rheumatoid arthritis, psoriatic arthritis, psoriasis, and ankylosing spondylitis. It’s a good option for if your patient is in a place where their gut really isn’t effectively taking in the medicines your taking.

Some patients would prefer not to go to a hospital every time they receive this drug, though. Instead, it’s as simple as having them schedule regular appointments with a local IV therapy clinic. Your patients can get those needed medical Remicade IV infusions in a much more relaxed and low-stress setting.

Ulcerative Colitis and Crohn’s patients who are recovering from illness, overcoming a “flare up,” are pregnant or wish to become pregnant, or are trying to improve their overall health could all benefit from IV nutritional therapy. As a responsible medical professional, it’s beneficial to consider if and when IV nutritional therapy is the right choice for providing the most balanced care for your patients.

It’s important to always emphasize your patients consult with you first before beginning their IV therapy treatments, and also to highlight that such treatments are never meant to be a substitute for pursuing a healthy and well-balanced diet alongside of receiving treatment.

Consider how IV nutritional therapy can help best meet the needs of your Crohn’s disease and Ulcerative Colitis patients.

 

Screenshot 288

The plush skin of youth, more energy than they know what to do with, and better resilience when flu season rolls around? That may sound like nothing more than a lovely little fantasy for your Crohn’s Disease and Ulcerative Colitis patients, but it doesn’t have to.

Don’t worry. We’re not talking about some magic elixir, or the mysterious Fountain of Youth. We aren’t even going to suggest one more obscure home remedy to add to the long list of concoctions the internet has already peddled and pushed at patients with gut issues trying to find relief wherever they can.

If you’re looking for the best balance to prescribing treatments for your Ulcerative Colitis or Crohn’s Disease patient, better health is possible for them through incorporating IV nutritional therapy into their treatment plan.

A Good Kind of Cheating

Healthy diet options that make perfect sense to someone with a normal digestive tract can be the downfall of your patients. So, according to the direction you’ve given them, your patients have learned, adapted and grown towards eating habits that work better for them. Unfortunately, that means they’ve had to cut corners in obtaining ‘balance’ in this whole ‘well-balanced diet’ business.

IV nutritional therapy can help fill some of the nutritional gaps that result from a more selective diet, and can help keep a more vulnerable body healthy and strong.

Perhaps one of your patients as hit a wall in their health, and even the thought of eating a full meal makes them feel exhausted. It happens. IV nutritional therapy is a wonderful way to help their body pick back up and keep going strong whenever they’re dealing with a dreaded flair-up, especially when digestion or nutritional balance are more severely out of step.

Supplements That Get To the Source

If your patients are taking your best advices, they’ve been taking vitamin supplements regularly and haven’t skimped on sticking to such a routine. If your patients are your average busy human beings, they’ve more likely been forgetting this step in their routines altogether.

Which poses a problem, as you know that your Crohn’s and Ulcerative Colitis patients naturally struggle to absorb the full range of nutrients from anything that they eat. It’s the nature of the beast, especially when enduring the joys of a “flare up” season. As a result, malnutrition can be a natural and common side effect—even when their eating habits are clean as a whistle.

IV nutritional therapy being administered intravenously means that there’s no barrier between the body and those nutrients that it needs. Your patients get to give their gut a rest, but still get the goods their body needs successfully into their system.

IV Treatment Over Steroid Shots or Oral Medicine

As a medical professional, you know that there’s a time limit on the effectiveness of treatment options. It’s expected that oral drug treatments for Ulcerative Colitis and Crohn’s will only work well for a season, and then patients need to transition to something else.

Self-administered steroid shots are one alternative to oral drugs—but not everyone does well with sticking themselves with a needle on a regular basis.

Remicade is also an alternative option. This drug is administered intravenously, and has shown success in treating ulcerative colitis and Crohn’s disease, as well as rheumatoid arthritis, psoriatic arthritis, psoriasis, and ankylosing spondylitis. It’s a good option for if your patient is in a place where their gut really isn’t effectively taking in the medicines your taking.

Some patients would prefer not to go to a hospital every time they receive this drug, though. Instead, it’s as simple as having them schedule regular appointments with a local IV therapy clinic. Your patients can get those needed medical Remicade IV infusions in a much more relaxed and low-stress setting.

Ulcerative Colitis and Crohn’s patients who are recovering from illness, overcoming a “flare up,” are pregnant or wish to become pregnant, or are trying to improve their overall health could all benefit from IV nutritional therapy. As a responsible medical professional, it’s beneficial to consider if and when IV nutritional therapy is the right choice for providing the most balanced care for your patients.

It’s important to always emphasize your patients consult with you first before beginning their IV therapy treatments, and also to highlight that such treatments are never meant to be a substitute for pursuing a healthy and well-balanced diet alongside of receiving treatment.

Consider how IV nutritional therapy can help best meet the needs of your Crohn’s disease and Ulcerative Colitis patients.

A Side Note For Medical Professionals:

If you are a medical professional interested in learning more about providing IV nutritional therapy to your patients we have created an internationally renowned online course that will teach you exactly how to safely prescribe and administer IV nutritional therapy.

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     $899.00

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Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder (PMDD), a severe mood disorder, is characterized by mental health and physical symptoms in the week before the onset of menstruation and affects millions of women worldwide[i]. It is a much more intense form of PMS.

Emotional and mood related symptoms include:

  • Mood swings, tearfulness, sensitivity to rejection

  • Irritability or anger

  • Marked depressed mood, hopelessness, self-depreciating thoughts

  • Anxiety or tension

  • Loss of interest in usual activities

  • Lack of energy

  • Changes in appetite

  • Changes in sleep

Physical symptoms include:

  • Breast tenderness

  • Breast swelling

  • Bloating

  • Water retention

Most women experience the greatest severity of symptoms from 3-4 days prior to onset of period to up to 3 days’ post-period onset. Symptoms are absent in the post-menstrual week.

Why do some women get this disorder? The etiology is still unclear. Many experts believe it is a combination of genetic factors, stress, and the hormonal fluctuation that lead to most of the symptoms.
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What Hormonal Fluctuations?

Estrogen exerts potent effects on the brain and is involved in regulating mood, cognition, sleep, eating, and other aspects of behavior. The fluctuations of this hormone during the menstrual cycle, especially during the luteal phase (after ovulation through onset of period) when the levels steadily decline, could be a key factor in the etiology of PMDD[ii].

Estrogen has many beneficial traits such as:

  • Increasing serotonin and number of serotonin receptors in the brain

  • Modifying the production and effects of endorphins- the ‘happy’ hormones

  • Protecting nerves from damage, and possibly stimulating nerve growth

Right after ovulation, your progesterone levels acutely increase and then suddenly fall with menstruation.Research shows that chronic progesterone exposure followed by rapid withdrawal may be another one of the key factors in the etiology of PMDD[iii].

How is PMDD treated?

  1. First line of treatment for PMDD are Selective Serotonin Reuptake Inhibitors (SSRIs)[iv]. Unlike with other mood disorders, patient’s with PMDD experience rapid onset of action from SSRI (as opposed to the typical 2-3 week onset time)[v]. Therefore, people with PMDD benefit from intermittent dosing. Administering the medication only during the luteal phase, from the time of ovulation until menstruation onset alleviates many of the symptoms[vi].

  2. Hormonal therapy: Some women with PMDD respond well to oral contraceptive. In 2006, YAZ, an oral contraceptive, received US Food and Drug Administration (FDA) approval for the treatment of PMDD in women desiring oral contraception. Not all women respond to oral contraceptives and not all oral contraceptives improve symptoms. Please speak with your gynecologist regarding the best options for you.

  3. Psychotherapy: A study showed that cognitive-behavioral therapy, one type of psychotherapy, was associated with increased use of effective coping strategies and shift in perception of premenstrual symptoms[vii].

  4. Supplements: Calcium was shown to improve PMDD[viii] along with Vitamin B6[ix] and Magnesium[x].

Unfortunately, many women with PMDD do not respond to the traditional treatment options. PMDD can cause substantial signs of depression for days or even weeks every month and millions of women are forced to cope with a crippling condition that is very difficult to treat.

Recent research shows that Ketamine administered at the onset of PMDD may alleviate the treatment resistant symptoms.

Why Ketamine may be an option
Recent data shows that Ketamine actually activates estrogen receptors[xi].
Why is this important? As mentioned above, the declining levels of estrogen during the luteal phase may be a contributing factor to PMDD. By administering ketamine at the start of the luteal phase or when symptoms of PMDD become apparent, we may be able to effectively treat one of the big contributing factors.
The same study showed that Ketamine works with estrogen to increase glutamate levels.
What is glutamate? Glutamate is a neurotransmitter (chemicals that transmit signals in the brain) that may be uniquely central to the biology behind major depression. The lack of glutamate in certain regions of the brain has been strongly linked to depression[xii]. Ketamine has been shown to activate glutamate transmission in the brain and is thought to be a key mechanism in its anti-depressant effects[xiii]. Ketamine may have direct impact on mood and other signs of depression if administered at the onset of PMDD.

This is an exciting time as more information becomes available regarding the benefits of Ketamine. More research needs to be done to find definitive answers, but the data we have so far gives us hope that Ketamine may have a beneficial role in the treatment of PMDD.

Disclaimer: Dr. June Lee is the medical director of Optimum Ketamine Center. Optimum Ketamine Center website does not provide medical advice, diagnosis, or treatment. Dr. Lee’s blog is not intended for medical diagnosis or treatment. The information provided on this website is intended for general consumer understanding only. The information provided is not intended to be a substitute for professional medical advice. For medical advise or assistance, readers should consult their healthcare professional.


[i] Dennerstein L, Lehert P, Heinemann K. Epidemiology of premenstrual symptoms and disorders. Menopause Int. 2012;18:48–51. [PubMed]

[ii] Shanmugan S, Estrogen and the prefrontal cortex: towards a new understanding of estrogen’s effects on executive functions in the menopause transition. Epperson CNHum Brain Mapp. 2014 Mar; 35(3):847-65.

[iii] Smith SS, Ruderman Y, Frye C, Homanics G, Yuan M. Steroid withdrawal in the mouse results in anxiogenic effects of 3alpha, 5beta-THP: a possible model of premenstrual dysphoric disorder. Psychopharmacology (Berl) 2006;186:323–33.

[iv] ACOG: ACOG Practice Bulletin Premenstrual syndrome. Clinical management guidelines for obstetrician-gynecologists. Int J Obstet Gynecol. 2001;73:183-91.

[v] Steinberg EM, Cardosos GMP, Martinez PE, Rubinow DR Rapid response to fluoxetine in women with premenstrual dysphoric disorder. Depress Anxiety. 2012;29:531-40.

[vi] Freeman EW. Luteal phase administration of agents for the treatment of premenstrual dysphoric disorder. CNS Drugs. 2004;18:453-68.

[vii] Kleinstauber M Witthoft M. Cognitive-behavioral and pharmacological interventions for premenstrual syndrome or premenstrual dysphoric disorder: a met-analysis. J Clin Psychol Med Settings. 2012;19:308-19.

[viii] Thy-Jacobs S, Starkey P Calcium carbonate and the premenstrual syndrome effects on premenstrual and menstrual symptoms. Premenstrual syndrome study group. Am J Obstet Gynecol 1998; 179:444-52

[ix] Kleijnen J, Ter Riet G et al. Vitamin B6 in the treatment of the premenstrual syndrome- a review. Br J Obstet Gynaecol 1990;97:847-52.

[x] Khine K, Rosenstein DL et al. Magnesium retention and mood effects after intravenous infusion in premenstrual dysphoric disorder. Biol Psychiatry 2006;59:327-33.

[xi] Ho, Correia, Ingle Ketamine and ketamine metabolites as novel estrogen receptor ligands: Induction of cytochrome P450 and AMPA glutamate receptor gene expression. Biovhem Parmacol. 2018 June;152:279-292.

[xii] Murrough JW et al. Targeting glutamate signaling in depression: progress and prospects. Nat Rev Drug Discov. 2017;17:472-86

[xiii] Abeallah et al. The effects of ketamine on prefrontal glutamate neurotransmission in healthy and depressed subjects. Neurpsychopharmacology 2018. 43, 2154-2169

#infusion #premenstrul #premenstrualdysphoricdisorder #pms #PMDD #ketamine #ketamineinfusion #ketamineinfusions

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Ketamine Nasal Spray and Treatment Resistant Depression, Anxiety, PTSD and Chronic Pain

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A recent study found that a single dose of IV ketamine can have a quick antidepressant response in patients who have had difficulty treating their depression with other antidepressant medications. The antidepressant effects lasted about a week for the patients, and had fewer side effects than other forms of medical treatment.

This is great news for patients who have experienced treatment-resistant depression, anxiety, PTSD, or chronic pain and have been searching for a way to relieve their symptoms. Many antidepressant medications offer serious setbacks for patients, including taking a long time to start working and low rates of success. But ketamine offers new promise for people suffering from depression or other conditions, especially those who have had trouble finding a drug that worked for them.

“The discovery of ketamine and its unique mechanisms heralds a new era with tremendous promise for the development of novel, rapid, and efficacious antidepressant medications,” wrote Ronald S. Duman, a psychiatrist from Yale University who analyzed the study.

Nasal Spray Adds New Possibilities

Currently, a patient would receive an infusion of the drug from a provider via IV drip. However, one pharmaceutical company, Janssen, has reformulated a derivative of ketamine into a nasal spray form. The drug is molecularly different from ketamine and only contains the L isomer of ketamine.

According to some early trials, Janssen has reported their drug to be an effective antidepressant in nasal spray form. So far, researchers have found that esketamine (Spravato) is not significantly different from ketamine in terms of its effect on depression. But because it would be a patented drug, it offers a more lucrative option to pharmaceutical companies who would want to be able to recuperate the costs of clinical trials in studying its effectiveness and obtaining FDA approval.

Currently, compounded ketamine nasal spray (with both isomers) is available through a prescription. Compounded medications are FDA-approved drugs in other forms or doses.

Injected Ketamine Likely More Effective
The Injection and Infusion Clinic of ABQ is keeping its eye on esketamine as it makes its way to market. While Janssen and other pharmaceutical providers have high hopes for the new nasal spray, Spravato, it’s important to recognize that it is unlikely to be the cure-all that Janssen is promoting it to be. Janssen has not yet announced whether their esketamine nasal spray (Spravato) will be available for at-home administration or if it will be restricted to clinic-only settings. Ketamine and its derivatives are a controlled substance. As such, there are risks when taking it, especially when offered as a take-at-home medication.

Still, if you have treatment-resistant depression, anxiety, PTSD, or chronic pain that has responded to IV ketamine infusions, adding nasal spray could be part of a comprehensive treatment plan. Not all patients are eligible, nor is it recommended in all cases.

In the meantime, low-dose ketamine IV infusions are known to be extremely effective and safe. And while nasal spray likely has its place, it will unlikely be the cure-all Janssen has been promoting it to be.

For more information on this exciting new treatment for depression or to book an appointment, get in touch with us.

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Spravato Esketamine: What we know so far….

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FDA approved a new nasal spray medication for treatment-resistant depression called Spravato, trade name for Esketamine on March 5, 2019. We’ve had many inquiries about the medication at our practice and I thought it would be beneficial to all of you to share the information I have regarding this new medication.

Spravato is a new antidepressant medication manufactured by Johnson & Johnson’s pharmaceutical company, Janssen, for management of Treatment Resistant Depression. According to the FDA, “Patients with major depressive disorder who, despite trying at least two antidepressant treatments given at adequate doses for an adequate duration in the current episode, have not responded to treatment are considered to have treatment-resistant depression.”

How is Spravato administered?

Spravato comes as an intranasal spray. The FDA set strict guidelines for the administration of Spravato which has a Boxed Warning. The Boxed Warning states that “the patients are at risk for sedation and difficulty with attention, judgement and thinking (dissociation), abuse and misuse, and suicidal thoughts and behaviors after administration of the drug.” Therefore, the patient must self-administer Spravato at a doctor’s office and the patient cannot take the medication home. After self-administration, the patient must be watched and monitored for 2 hours after administration. In addition, the patient must arrange for a driver since they will not be allowed to operate any heavy machinery after the treatment. The frequency of the administration is as follows: the first month- the medication must be taken twice a week; the second month- the medication must be taken once a week; and thereafter- once every other week. Click here for Janssen’s prescribing package insert

Does Spravato work?

The FDA reported 3 short-term (four week) clinical trials and one longer-term maintenance-of-effect trial. “In the three short-term studies, patients were randomized to receive Spravato or a placebo nasal spray. In light of the serious nature of treatment-resistant depression and the need for patients to receive some form of treatment, all patients in these studies started a new oral antidepressant at the time of randomization and the new antidepressant was continued throughout the trials. The primary efficacy measure was the change from baseline on a scale used to assess the severity of depressive symptoms. In one of the short-term studies, Spravato nasal spray demonstrated statistically significant effect compared to placebo on the severity of depression, and some effect was seen within two days. The two other short-term trails did not meet the pre-specified statistical tests for demonstrating effectiveness. In the longer-term maintenance-of-effect trial, patient in stable remission or with stable response who continued treatment with Spravato plus an oral antidepressant experienced a statistically significantly longer time to relapse of depressive symptoms than patients on placebo nasal spray plus an oral antidepressant.” [i]

What is the cost of Spravato?

The wholesale acquisition cost, or list price, will be between $590 and $885 per session. This means the first month of treatment will range from $4720 to $6785. This does not include the costs of a physician visit and monitoring. The medication will most likely be added to most major health insurance plan’s formulary. There is no information yet regarding in what specialty tier Spravato will be placed and what the out of pocket expenses will be for the patients. In addition, we are uncertain what the pre-authorization approval process from the insurance companies will entail.

Where can I get Spravato?

The FDA says, “due to safety concerns, the drug will only be available through a restricted distribution system and must be administered by a certified medical office where the health care provider can monitor the patient.” Only clinics that are certified in REMS (Risk Evaluation and Mitigation Strategy) can treat and monitor patients enrolled in REMS. In addition, only specialty pharmacies that are certified in REMS will be allowed to dispense Spravato directly to the medical offices. REMS is a program required by the FDA to manage known or potential serious risks associated with a drug product.

Will Infusion Clinic of ABQ become a REMS center and offer Spravato?

We are currently obtaining more information regarding this process. We already know it is a multistep process that will require some time. In addition, we have yet to receive any information from the Center for Medicare and Medicaid Services (CMS), who is responsible for coding and setting the fee schedules for Medicare. All private insurers follow the guidelines set by CMS. Therefore, there are still quite a few unanswered questions regarding the logistics of treating with Spravato. We hope to have more answers for you in the coming months.

What is Esketamine, the main compound in Spravato?

Esketamine is half of the active ingredient of the medication Ketamine. Ketamine is a medication containing equal parts R-ketamine and S-ketamine (Esketamine). R-ketamine and S-ketamine are mirror images of each other. The pharmaceutical company Janssen isolated the S-ketamine molecule to create a medication they can patent and sell. At Infusion Clinic ABQ, we use Ketamine (containing both active components) to treat mood disorders. This includes both the R-ketamine and the S-ketamine.

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What is Ketamine?

Ketamine is a medication that is FDA approved for anesthesia. It is being used off-label for the management of treatment resistant depression. It is a NMDA (N-methyl-D-Aspartate) receptor antagonist. NMDA receptors are found on nerve cells where they transmit and receive signals. They are critical for the development of the central nervous system, generation of rhythms for breathing and movement, and the processes underlying learning, memory, and neuroplasticity[i] (your brain’s ability to adapt to new situations or injury).

Are Esketamine (S-ketamine) and R-ketamine the same?

No. They have different properties.[ii] [iii]

The studies we have so far regarding R vs S Ketamine have all been from mice and rat models. Nevertheless, it appears that the R- and not the S-Ketamine is the more potent anti-depressant and has longer lasting antidepressant effects. Furthermore, the S-Ketamine exerts a greater dissociative effect than R-ketamine.

Is Ketamine and Esketamine absorption the same whether it is given intranasal or intravenously?

No. Intranasal administration has been shown to be less predictable with greater variability in onset times and peak blood levels[iv] than with intravenous administration. The amount available after intranasal administration varies anywhere from 8% to 45%[v][vi] whereas the amount available after intravenous administration is nearly 100%.

Disclaimer: Katherine Devine, NP is the Director of Infusion Clinic ABQ. She is Board Certified with the American Academy of Nurse Practitioners and is a member of the American Society of Ketamine Physicians. The Infusion Clinic ABQ website does not provide medical advice, diagnosis, or treatment. Our blog is not intended for medical diagnosis or treatment. The information provided on this website is intended for general consumer understanding only. The information provided is not intended to be a substitute for professional medical advice. For medical advice or assistance, readers should consult their healthcare professional.

Change to our info
Optimum Ketamine Center
665 W. North Ave, #101
Lombard, IL 60148
(708) 244-8663
www.optketamine.com

[1] FDA approves new nasal spray medication for treatment-resistant depression; available only at a cerfified doctor’s office or clinic. March 5 2019 https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm632761.htm

[2] Activation Mechanisms of the NMDA Receptor. Blanke and VanDongen, Biology of the NMDA receptor. CRC Press/Taylor & Francis; 2009. https://www.ncbi.nlm.nih.gov/books/NBK5274/

[3] R-Ketamine: a rapid-onset and sustained antidepressant without psychotomimetic side effects Yang, Shirayamata et al. Transl Psychiatry (2015) 5, e632;doi:10, 1038, published on-line 1 September 2015 https://www.nature.com/articles/tp2015136.pdf

[4] R (-) ketamine shows greater potency and longer lasting antidepressant effects than S (+)-ketamine. Zhang, Li, Hashimoto. Pharmacol Biochem Behav. 2014 Jan;116:137-41. E published 3 December 2013https://www.sciencedirect.com/science/article/pii/S0091305713003328?via=ihub

[5] S-ketamine and s-norketamine plasma concentrations after nasal and I.V. administration in anesthetized children. Weber et al. Pediatric Anesthesia, December 2004 Volume 14, Issue 12 p983-988

[6] Plasma concentration profiles of ketamine and norketaminafter administration of various ketamine preparations to healthy Japanese volunteers. Yanagihara et al Biohpar Drug Dispos, 2003 Jan: 24(1):37-43

[7] Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients. Yeaman et al. Emerg Med Australas. 2014 June;26(3):237-42

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Alcohol Addiction and Ketamine

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Alcohol addiction is deadly, we know this. It does not just punish the addict, it punishes their family and society. For those who find sobriety alone or with help from a detox program, staying sober is a lifelong challenge. Relapse occurs when one resumes drinking and is a detrimental problem that deserves more attention. Understanding some basics of alcohol addiction and how to help prevent relapse can be a bit complicated. The next section on “choice” will summarize an article on the neurobiology of addiction by Xavier Noel[i][ii]. It simplifies some popular thoughts about how and why addiction works in the brain. Then, we can see how to target effective treatment with ketamine to help prevent relapse.

Is alcoholism a choice?

The impulse/habit system:

How does the compulsion to drink develop? A part of our brain, called the amygdala-striatum neural complex, motivates us to achieve rewards. This area is driven by dopamine, a naturally produced neurotransmitter in our bodies that has many effects, including feelings of pleasure, or reward. Alcohol, and other addictive drugs, increase overall dopamine levels in our brain. Therefore, a link forms between automatic, repetitive behaviors, such as pouring a drink, and increased dopamine. These actions are saved in our brain as rewarding. And the brain loves rewards.

Increasing dopamine activity also accelerates the change between the first steps of choosing to have a drink and later craving a drink. New pathways in the brain form with repetitive behavior. Cues and memories in the environment to drink are noticed more quickly, like hearing glasses clink, or walking in the front door after work. These cues drive the compulsion to drink. The brain’s automatic response is to seek this reward, but can’t we control this behavior?

The control/decision making system:

The decision-making part of our brain is found in the prefrontal cortex. It is also known as the “reflective system”, or executive function system, where we can control impulses. This means we can trade short term rewards, like a drink, for possibly greater long-term goals, such as avoiding a DUI charge. One explanation is that there is a balance between a “cool” and “hot” system that works out how we respond to triggers or cravings. The “cool” refers to basic working memory and inhibition of impulses. The “hot” involves numerous emotional responses that are possible. Damage to either of these systems may impair the ability to say “no” to situations, or drugs like alcohol, that can harm us. Either the impulse side or the emotional side wins when we lose a health balance.

When/How impulse overpowers control:

Poor decision making in alcoholics may also be explained by yet another system called the insular cortex. It responds to imbalance in our bodies from things like sleep deprivation, anxiety and stress. These stressors may hijack our impulse/habit system and increase cravings while promoting decisions to seek out alcohol. Repeated cycles of increased cravings can also essentially rewire brain circuits, reinforcing continued destructive behavior.

Addiction as a “Pathology of Choice”

Other studies support that “faulty brain connections related to decision-making can lead to addictive behaviors and relapse.” [iii] There is a definite shift from blaming addiction on cravings to finding abnormalities in decision making areas of the brain. Thus, the brain is not able to make the right decisions to ignore the craving.

NMDA receptors are at fault too?

Family history of alcoholism is a risk factor for developing alcohol addiction. A study by Petrakis et al showed one answer may lie in the NMDA (N-Methyl-D-Aspartate) receptor, which is vital to the glutamate system in the brain. Alcohol alters this receptor’s function, but if the receptor is not normal, that person may be more susceptible to alcohol abuse.[iv]


How can ketamine help?

Ketamine can play a key role in preventing relapse in those who have either completed a detoxification program or managed to stop themselves.

Over-write memories that drive addiction

It is possible a rewarding memory of taking a drink, for example, can be triggered repeatedly by seeing a glass of beer, going to a restaurant, or maybe returning home from work. These triggers lead to the urge to drink. Ravi Das from University College London explains why people often quit but return to drinking. “The main problem is the really high relapse rate after treatment,” said Das. “People can successfully quit using over the short term while they’re being monitored in the hospital … but when they return home they’re exposed to those environmental triggers again.”[v] The good news, is that each time the brain accesses that rewarding memory, the neural connections that code the memory are destabilized. It is at this moment that ketamine, which blocks the brain receptor required for the formation of memories (NDMA), can help weaken or even erase the memory. In other words, ketamine will help break the power of that trigger.

The psychedelic experience

The benefits from the psychedelic experience while receiving a ketamine treatment may hold benefits. Dr. Tobias Stevens, in his presentation on ketamine as a treatment for alcohol use disorder, postulates the hallucinations and altered mental state from ketamine may help change lifestyle choices. He suggests the experience may alter perceptions and break routine behaviors.[vi] Therefore, a combination of psychotherapy with ketamine, (ketamine psychotherapy or KPT) may prove helpful for some folks. KPT allows the psychedelic effects from ketamine to enhance a psychotherapy session and is shown to be effective helping those with addiction, including heroin and alcohol by Dr. Evgeny Krupitsky.[vii]

Ketamine allows learning


What does ketamine for relapse prevention look like?

Ketamine is not a solitary treatment for alcohol relapse prevention. To say so would oversimplify the disease. Current studies include interesting combinations with ketamine.

KARE – Ketamine for reduction of Alcoholic Relapse

KARE is a multi-site project running in England that is a clinical trial seeking to explore psychotherapy combined with low dose ketamine as a possible treatment for alcoholism.[ix] Participants who completed alcohol detoxification receive IV ketamine 3 times interspersed with 7 therapy sessions. The psychotherapy model, developed by Dr.s Rob Hill and Jen Harris included 3 key areas:

  • Risk reduction strategies: Identify high risk situations, cope with cravings, or restructure unhelpful thinking

  • Wellness promotion: planning weeks, problem solving, relaxation, and mindfulness

  • Education: what is addiction, biological effects of alcohol both acute and chronic, alcohol and sleep, and how alcohol interacts with the brain

Combining ketamine with other medications?

Combining ketamine with other prescription drugs is debatable as there is conflicting evidence. For example, naltrexone is frequently used with alcohol dependence. It binds opioid receptors and is supposed to take away cravings for opioids and alcohol which can take away reward effects.[x] In reality, it does reduce overall total alcohol consumption, but not necessarily abstinence. Nimodipine is a calcium channel blocker that is also studied for its’ ability to decrease alcohol-type effects from ketamine treatment.[xi] Additionally, some providers prescribe Baclofen to help suppress cravings.

But, isn’t ketamine addicting?

Are we just trading alcohol addiction for ketamine addiction? This is not true according to several studies. A study by Krystal, et al in 1998 clearly showed ketamine did not increase cravings on recovering alcohol dependent patients.[xii] Recently detoxified alcoholics given ketamine did not go on to abuse the drug. Keep in mind, ketamine for alcohol abuse is given by trained providers in a medical setting at doses far less than what one may find on the street. The body does not become physically dependent on ketamine, meaning there are no physical withdrawal symptoms when one stops. However, there is always a possibility of mental dependence on a treatment that is helping. But, lets put this in perspective. Many people are dependent, or “addicted”, to a variety of activities, like exercise, weight loss, meditation, because these things reward them, (ie their brain).

Conclusion

Cindy Van Praag
Spring Center of Hope
www.springcenterofhope.com

Disclaimer:
This article represents my informed opinion and/or the opinion of others. This does not constitute medical advice and should not be relied upon to make decisions about medical care. Please consult your physician for questions regarding your specific conditions and possible treatments

Photo Credits:
Headline: by Gerd Altmann from Pixabay
Baby: by Michal Jarmoluk from Pixabay
Clock: by Michal Jarmoluk from Pixabay
Sign: by Gerd Altmann from Pixabay

References

REFERENCES
Noël X,Brevers D, et al. A neurocognitive approach to understanding the neurobiology of addiction Curr Opin Neurobiol . 2013 August ; 23(4): 632–638. doi:10.1016/j.conb.2013.01.018.
Bergland C, The Neuroscience of Making a Decision: Various brain regions work together during the decision-making process. Psychology Today online, 05/06/2015.
Petrakis I, Limoncelli D, et al Altered NMDA glutamate receptor antagonist response in individuals with a family vulnerability to alcoholism. The American Journal of Psychiatry Oct-2004 161 1776–1782 0002-953X link
Devlin H, Radical ketamine therapy could treat alcohol addiction. Theguardian.com, 01/24/2017. link
Stevens T. Ketamine as a Treatment For Alcohol Use Disorder. Breaking Convention 2017, YouTube 09/13/2017. link
Krupitsky E, Ketamine psychotherapy for heroin addiction: immediate effects and two-year follow-up. Journal of S/ubstance Abuse Treatment 23 (2002) 273–283.
McAndrew A, Lawn W, et al. A proof-of-concept investigation into ketamine as a pharmacological treatment for alcohol dependence: study protocol for a randomised controlled trial. Trials (2017) 18:159 DOI 10.1186/s13063-017-1895-6.
KARE: Ketamine for reduction of Alcoholic Relapse. University of Exeter, England. link
Krystal J, Madonick S, et al. Potentiation of Low Dose Ketamine Effects by Naltrexone: Potential Implications for the Pharmacotherapy of Alcoholism. Neuropsychopharmacology (2006) 31, 1793–1800
Krupitsky E, Burokov A, et al. Attenuation of Ketamine Effects by Nimodipine Pretreatment in Recovering Ethanol Dependent Men: Psychopharmacologic Implications of the Interaction of NMDA and L-Type Calcium Channel Antagonists. [Neuropsychopharmacology 25:936-947, 2001

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Have you seen those food sensitivity tests that are advertised online or Facebook?

Have you heard that Food Sensitivity Tests are “useless”? Understanding those tests and why they are probably useless is very important. Those tests ONLY measure an immune reaction related to IgG. Unfortunately this limited testing, results in ALOT of false positives. You are therefore faced with a long list of foods to avoid and most are not causing you any problems. In this podcast, Joel Evans, MD discusses why 

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“complement” is so important in a food sensitivity test. This testing eliminates the false negatives that make typical testing “useless”. Listen to the podcast to learn more. https://www.mygenefood.com/podcast/10-the-future-of-food-sensitivity-testing-curing-ibs-rethinking-gluten-free-diets-and-the-genetics-of-coffee-metabolism-with-dr-joel-evans-m-d/

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