FAQs on Ketamine Infusions: What You Need to Know

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FAQs on Ketamine Infusions

What’s the last resort when other antidepressants don’t work for severe depression?Ketamine intravenous (IV) infusion is a breakthrough therapy for people with severe or treatment-resistant depression (TRD). TRD is a condition where at least two adequate antidepressant treatments didn’t work. Ketamine infusion is fast-acting and safe. A single low dose infusion can have long term effects of up to 15 days. It’s also effective for people with TRD who exhibit symptoms of suicidal ideation.Depression is one of the most common psychiatric disorders in the world. It affects people of all communities. If left untreated, depressive symptoms can become chronic and disabling. It hinders a person from doing day to day tasks efficiently.A variety of medicines and psychosocial therapies are available to ease symptoms of depression. But treatment resistance was noted in about one-third of people who fail to achieve full recovery. Thus, there’s ketamine infusion therapy for TRD.The Injection and Infusion Clinic of ABQ offers Ketamine infusions for a better quality of life. If you qualify for IV ketamine therapy, or you are considering ketamine IV infusions, here are some frequently answered questions (FAQs) that we have for you:

What is Ketamine?

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

What are the uses of Ketamine?

Ketamine was originally used in veterinary medicine and for pediatric sedation. Aside from pain management, Ketamine has been noted to have bronchodilator effects (studied in the management of asthma exacerbations in children) and observed to be useful in cases of status epilepticus.The classification of ketamine as a dissociative agent makes it very effective as an analgesic Ketamine has been widely used to provide analgesia in burn dressing changes, during excision and grafting and for sedation, and even in prehospital or battlefield settings where resources are limited. It has been used off-label in the management of chronic pain and neuropathic pain.

Is Ketamine safe?

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

How does Ketamine work in patients with depression?

In simple terms, depression results from imbalances in communication systems in the brain. Ketamine works bystimulating growth of neurons within the brain, allowing the different systems to communicate effectively with one another. Biochemically, ketamine is a non-competitive, glutamate N-methyl-d-aspartate (NMDA) receptor antagonist. NMDA-receptor antagonism is linked to the potentiation of glutamate transmission at α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors and increased brain-derived neurotrophic factor (BDNF) levels, which are associated with antidepressant properties.It has been speculated though, that there are still other mechanisms that remain to be discovered regarding ketamine and TRD – such that studies are still being conducted further to hopefully uncover the exact mechanism responsible for the strong and sustained effect of ketamine infusions against depression.

New Ketamine Patients!

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

What medications interfere or interact with Ketamine?

Ketamine is very safe, but fortunately the drug interactions are only a few. Ketamine is noted to have synergistic effects on some drugs and may decrease the effectiveness of other drugs. People who are suffering from substance abuse or alcohol abuse are often prescribed benzodiazepines – which are known to decrease the effectiveness of ketamine. Specific examples of benzodiazepines are Ativan, Klonopin, and Xanax.Medical practitioners prescribe these drugs for anxiety, muscle spasms, and sleep disorders. However, benzodiazepines can delay and decrease the effects of ketamine if used in conjunction.On another note, people with epilepsy and bipolar disorders are often prescribed lamotrigine. Lamotrigine 150 mg or higher doses for bipolar disorder and seizures decreases the effectiveness of ketamine. Hence, lamotrigine decreases glutamate while ketamine increases it.Lithium stabilizes the mood of people with bipolar disorder. Unlike benzodiazepine and lamotrigine, lithium enhances the antidepressant effects of ketamine.

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

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

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

People diagnosed with psychosis are not allowed to undergo ketamine IV infusion. Ketamine may increase the possibility of dissociative episodes which may aggravate the symptoms of people with psychiatric disorders. Some medical conditions like arrhythmias make ketamine unsafe. Untreated glaucoma and untreated high blood pressure, must be corrected prior to starting ketamine infusions. If in doubt, schedule a free consult with one of our practitioners and they will guide you based on your individual circumstances.

Ketamine for Depression

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

What are the current routes of administration of Ketamine?

Aside from intravenous infusions, there are other routes of ketamine administration. These are intramuscular, nasal, oral, rectal, subcutaneous, and sublingual administrations.The most rapid method to deliver Ketamine is through the intravenous route. This also helps effectively regulate the delivery of the drug in its proper dose. Ketamine IV infusions have the fastest onset and recovery. They are also easiest to adjust the dose/rate throughout the infusion. Ketamine can also be given intramuscularly, however, higher doses are required as compared to IV infusions and the procedure can cause localized bruising at the IM site. The intramuscular route is well studied largely through its role and application in pediatric sedation, where intravenous access is usually difficult.8The most recent route of administration is through the intranasal route, which is the route of choice for esketamine, its enantiomer, in the treatment of TRD.

What should I expect during my Ketamine IV Infusion session?

Upon arrival at the clinic, you will be asked to do some standard paperwork and you will be set up on Mood Monitor, a tool that allows the clinic to monitor changes before and after each infusion. After processing payment, you are then ushered to the back of the clinic to start IV therapy. Once done, the nurse addresses your concerns, and you are then ushered back to your infusion chair. Once you are settled comfortably, you will be set-up on the monitors and your ketamine infusion will be initiated. Please do not be afraid to raise any concern to the staff , especially your expectations on what you will be going through on your first session.During the infusion, most patients are noted to dissociate. This is entirely normal, and the staff will be there to monitor and guide you throughout the process. You will feel dreamy or light after several minutes, a mood that some call a “reflective state”. Please do not hesitate to call the staff’s attention once you feel uncomfortable during your infusion. Once the infusion is complete, you will be given time to rest and recover for 30 minutes. In the absence of any untoward effects, your IV line is then removed, and you will be discharged. The day following your infusion, expect to receive a questionnaire from Mood Monitor. Kindly complete the questionnaire as this is extremely important to monitor your response to the infusion. So, there you go! It will be so easy, and you can breeze your way through it! For a more detailed description, check out this video below so you can have an idea what to expect during your first ketamine infusion appointment at The Injection and Infusion Clinic of ABQ.

What are the possible side effects after getting Ketamine infusions?

Patients often report feeling “strange or loopy” within minutes of the start of the ketamine infusion, and resolves within two hours. There were also reports involving minor and temporary effects such as nausea, vomiting, dizziness, double-vision, drowsiness, restlessness, and confusion. When this happens, kindly call the attention of the staff assigned to you to assist you with your needs. Other than that, there were no serious drug-related adverse effects noted, no reports for dependency and tendency for recreational use, no significant cognitive or memory deficits noted within a three-month period of monitoring and follow-up. Thus, the best way to get your Ketamine IV infusion is through a professional clinic where you can be monitored by a healthcare professional, and you are given the right dose for your therapy. The Injection and Infusion Clinic of ABQ assures you that you are monitored well and given the safe dose, hence quality of care is not compromised.

Ketamine for Postpartum Depression

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

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

Ketamine as a recreational drug was first reported in the 1970s. “K-hole”, “Super K”, or “kai-jai” are some of the terms associated with ketamine. The misuse of ketamine as a club drug increased at the turn of the century.As a therapeutic substance, you will be unlikely to get addicted to it since the dosage and frequency of infusion is controlled at low and specific doses. Moreover, chances of addiction are nil unless you are self-medicating. 

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

Ketamine has been approved since the 1970s for anesthesia purposes. However, it does not mean that because it is “off-label’ for depression, it can’t be used safely for this indication. It only means that the drug manufacturer can’t advertise for its use in depression.Take for example, aspirin is FDA-approved for fever and pain, but is widely used off-label for preeclampsia, emergency management of stroke or a heart attack, and even prevention of blood clots in people who have atrial fibrillation. Off-label only indicates that it is not FDA approved for depression, but a significant amount of research and data already shows that it is effective and safe, and has already been used widely by doctors and medical health professionals as an adjunct to current therapeutic methods

How long will each ketamine IV infusion session last?

The standard regimen followed at The Injection and Infusion Clinic of ABQ is six infusions spread over two to three weeks. Adjustments are made based on individual response. Though randomized controlled studies have documented responses even on the first day of infusion. Our experience in the clinic is that most patients have a response by the fourth infusion. When this occurs, remaining infusions are then spaced out a bit longer (e.g. instead of the 5th infusion occurring in two-three days, we postpone it to five or even seven days). Take note however that the number of sessions for each patient are extremely variable and is based on patient response and preference. Please do not forget to complete Mood Monitor so we can help you get the optimal management plan for your condition here at The Injection and Infusion Clinic of ABQ. We are highly committed to give you the best experience in our clinic.

Ketamine for Post-Traumatic Stress Disorder (PTSD)

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

How long will each Ketamine IV Infusion session last?

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

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

You can come on your own. And most of our patients prefer this. However, you may bring someone to sit with you. Since we encourage “letting go” during a ketamine infusion, we have observed that having a friend or family member can interfere with that process. You are not advised to drive right after a session for safety reasons. You need to plan for your ride prior to the start of your ketamine session. Most of our patients have us call their ride once they enter recovery. Uber or Lyft is also allowed. Kindly inform the staff of your after-recovery plan before the start of the session.

Can I eat prior to a Ketamine IV infusion session?

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

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Schedule a FREE Ketamine Consult now!

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