Intravenous Ketamine

Ketamine infusion therapy is most helpful for those patients suffering treatment-resistant depression. For many, conventional antidepressants simply do not provide depression relief. Ketamine has been proven to rapidly reduce depression symptoms including suicidal thoughts and begin restoring life function for 70% of patients in less than 24 hours.

Ketamine infusions have also been shown to be effective for other conditions such as bipolar depression, post-traumatic stress disorder (PTSD), anxiety, obsessive compulsive disorder (OCD), fibromyalgia, and some pain disorders (CRPS).

Ketamine infusion therapy is NOT for those suffering temporary or situational depression caused by environmental factors, grief, relationship problems, etc. At Klarity, we treat those individuals that have been unresponsive to traditional medications and/or therapy over a sustained period of intense suffering and extreme physical impairment.

Ketamine is a drug approved by the FDA in 1970 for it’s ability to anesthetize patients quickly, safely, and with few side effects. It is only one of two anesthetics listed on the World Health Organization’s (WHO) Essential Drug List as it does not depress breathing and the circulatory system, unlike other anesthetics, and is fast-acting.

In recent years, ketamine’s use has broadened into the mental health field as it’s effect as an antidepressant has become one of the most widely researched topics in the field. Scientists at Yale made the breakthrough study published in Biological Psychiatry in 2000. Since then, numerous ongoing studies and clinical observations have established ketamine as a highly effective treatment for depression and other disorders.

Ketamine works by blocking the N-methyl-D-aspartate (NMDA) receptor, a component of the glutamate system that affects nearly all neurons. This is a different mechanism from most modern antidepressants that operate on other targets. Typical FDA-approved antidepressants target neurons that inhibit the reuptake of serotonin, norepinephrine, and dopamine. Brain scans reveal that ketamine rapidly induces synaptogenesis, repairing damage caused by chronic stress.

The patient will be in a private treatment room. They will be continuously monitored including blood pressure, heart rate, and oxygen saturation. An intravenous (IV) line will be placed and the infusion started. The infusion will be given slowly over 40 minutes. Many patients may find it helpful to listen to music or just sit back and relax. The IV will remain in place until the patient is fully recovered (typically 1-2 hours).

The patient should feel the effects of the ketamine quickly. They will not lose consciousness and should feel relaxed. Some patient may experience a dissociative effect, which is an out of body experience and partially lose awareness of their body. Most patients find this effect is a bizarre, but pleasurable experience. Typically, these dissociative sensations resolve quickly after the infusion is completed. The rate of the ketamine infusion can be adjusted per the individual patient to minimize adverse symptoms.

The relief will be different for every patient. Relief may take several hours or even several days to appear. This relief may be subtle. The patient may have an improvement in function prior to an improvement in mood. Function often improves before mood. There can be a spectrum of results.

There are several routes of administration of ketamine that include intravenous, intranasal, sublingual, intramuscular, orally, and rectally. The fastest route to the brain without being chemically altered is intravenous. When taken orally, the body metabolizes 84% of the ketamine. With intramuscular injection there is no control on the rate of uptake by the body. Intranasal administration can have a variable uptake by the body. Therefore, intravenous infusion of ketamine is the best route of administration.

Yes! Klarity is a consultant in your care. You will need to continue to follow-up with your primary physician who is managing your medical condition. We will work closely with your physician to best benefit your treatment course.

When administered to treat depression, ketamine is considered an “off-label” use since it is not FDA-approved for this purpose. Although recent research and clinical results have illustrated the overwhelmingly positive effects ketamine provides for the treatment of depression, FDA-approval requires extensive, very expensive trials. Since the drug itself is decades old and the patent expired a long time ago, Pharmaceutical companies that usually pay for these studies have no incentive to invest in getting ketamine approved for the treatment of depression.

Some may have heard of ketamine as a party drug under other names such as Special K, Kit Kat, or Vitamin K. However, ketamine has a wide safety margin in the hands of clinicians specially trained to administer the medication. The dose used for treatment of depression is less than the dose used for surgery. It has been found that at these very low doses, in a medical setting, there is virtually no potential for addiction or abuse.

Ketamine is generally safe when administered by a trained professional. Some patients may experience a dissociative effect, which is an out of body experience and partially lose awareness of their body. Ketamine is referred to as a dissociative anesthetic. However, doses used for depression are sub-anesthetic. Most patient feel sedated after their treatment, therefore will not be able to drive themselves home and should not plan any activities for the rest of the day. During the infusion, some patients may experience a temporary elevation in blood pressure and heart rate, which will be monitored continuously throughout the infusion. Other side effects include increased salivation, nystagmus or blurred vision, and nausea.

Most medications do not need to be stopped prior to treatment with ketamine. However, patients on benzodiazepines should work with their primary healthcare provider to stop these 2 weeks prior to treatment for optimal benefit of the the infusion.