What is Ketamine?
Ketamine was established as a safe anesthetic for humans in 1965 and was given a US patent in 1966 under the trade name of Ketaler. The US Food and Drug Administration (FDA) approved Ketamine in 1970 for use in children, adults, and the elderly.
During the Vietnam War, ketamine was the most widely used anesthetic in the battlefield because of its fast onset, nominal adverse respiratory side effects, and potent analgesic properties, and cardiovascular stability in trauma patients. The World Health Organization (WHO) has put ketamine in the WHO Model List of Essential Medicines.
Although ketamine is only FDA approved as an anesthetic, it is increasingly being used off-label for treatment-resistant depression, pain, anxiety, and other mood disorders in medical centers and clinics around the world.
How Does Ketamine Infusion Therapy Work?
Ketamine acts differently than SSRIs, tricyclics, MOAI inhibitors, benzodiazepines, other antidepressants, and anti-anxiety medications. Low dose Ketamine triggers a cascade of events in the brain, resulting in the re-wiring of neuropathways. According to research, pain and depression can be decreased if these neuropathways can be reset with low-dose ketamine infusions.
What conditions can Ketamine Infusion Therapy treat?
Ketamine is being used to decrease depression symptoms, the depressed phase of bipolar disorder, postpartum depression, anxiety, post-traumatic stress disorder (PTSD) and OCD. Ketamine infusion therapy is also being used to aid pain syndromes such as fibromyalgia and complex regional pain syndrome (CRPS), and addiction.
How Does Ketamine Infusion Therapy help with depression and mood disorders?
Glutamate is one of the brains main neurotransmitter. Glutamate affects the formation and number of brain synapses, a connection between neurons. Glutamate acts with GABA, another neurotransmitter, to maintain a healthy, operational nervous system. An imbalance between those two neurotransmitters can lead to anxiety, sleep disturbances, and difficulty focusing. Major depressive disorder may be partly caused by an imbalance in the glutamate system. According to research ketamine (receptor antagonist) helps rebalance the glutamate system.
Ketamine blocks the NMDA (N-methyl-D-aspartate) receptor, one of three primary glutamate receptors. The NMDA receptor is involved in synaptic plasticity and memory function. When ketamine blocks the NMDA receptor, an increase in glutamate occurs. That increase begins a cascade of neurobiological events that experts believe is the cause of ketamine’s rapid antidepressant effects.
How Does Ketamine Infusion Therapy help Chronic Pain and Complex Regional Pain Syndrome (CRPS)?
Complex Regional Pain Syndrome (CRPS) and other chronic pain disorders, (a process known as central sensitization) are believed to amplify pain by increasing the number of NMDA receptors. Ketamine interferes with the NMDA receptor, blocks, and “resets” pain signals, offering relief. When peripheral nerve NMDA receptors are blocked, peripheral nerve pain transmission is interrupted before reaching the spinal cord and brain, allowing desensitization to peripheral pain signals.
What conditions are contraindicated with Ketamine Infusion Therapy?
Ketamine is an extremely safe medication when administered in a controlled setting, in subanesthetic dose and monitored by a qualified provider. There are few conditions which may prevent safe use of ketamine infusions: AIWC does not treat patients who are in current suicide crisis. Patients who are experiencing acute suicidal thoughts are advised contact their local crisis center, mental health provider, the National Suicide Prevention Lifeline at 1-800-273-8255, or simply call 911.
1. Uncontrolled high blood pressure
2. Recent stroke (1 year or less)
3. Unstable heart disease
4. Recent heart attack (6 months or less)
5. Untreated hyperthyroid disease
6. Renal insufficiency
7. Liver impairment
9. Current manic phase of bipolar disorder
10. Active psychotic (hallucinations or delusions) symptoms
11. History of ketamine dependence
12. Hypersensitivity (allergy) to ketamine
13. Current pregnancy
14. Active substance abuse
15. Uncontrolled seizures
17. No one to take patient home from the clinic or care for them at home.
Patients with serious medical conditions will be evaluated by our questionnaire and one of our Advanced Registered Family Nurse Practitioners. Patients may either be disqualified or asked to obtain consultations before treatment.
What are Ketamine Infusion Therapy side effects?
Ketamine infusion therapy is sub anesthetic low and safe dose. Some side effects may include slight blood pressure and heart rate increase, dizziness, brief blurred vision, a sensation of "lightness,” euphoria, and nausea. Patients are monitored continuously throughout the infusions. Medications are available to treat any sides. A significant benefit of IV Ketamine infusion compared to other routes of administration is the ability to lower the infusion rate to decrease possible side effects. There is no data to suggest there are long-term side effects when administered in low doses for short periods of time such as is used for mental health issues.
How soon can the Ketamine Infusion Therapy relieve symptoms?
It is possible for patients to notice effects within 24 hours of a ketamine infusion. Many patients see improvement in symptom within 2-4 hours. Patients have reported relief up to 24-48 hours after infusions. Patients fill out a self-administered assessment questionnaire before each treatment. This questionnaire will help us evaluate patients response.
Patients with mental health conditions will typically know within 2-3 infusions if ketamine will help them. Future treatments should be considered if patients feel less pain, more hope, less sad, less suicidal thoughts, calmer, or more motivated to be around people. More relief is often seen further into the course of treatment. If patients see favorable results, a series of 6 infusions within the first 2 weeks is recommended. Maintenance (booster) infusions may be scheduled to uphold response after initial treatment. The total length of treatment is dependent on each patient’s conditions and results.
Patients with chronic pain receive the best response from longer and higher dosed infusions which usually last 4 hours.
Patients with complex regional pain syndrome (CRPS) respond best to 5-10 four-hour infusion series administered daily or every other day. Each patient's response to Ketamine infusion therapy for pain varies and is hard to predict.
Patients can expect to receive several days to several months of reduced pain, depending on the length and number of infusions. Most patients with chronic pain report a remarkable reduction in pain during the infusion and for many hours afterward. Each patient's response varies.
What is Ketamine Infusion Therapy Like?
The initial dose is based on several individual factors and may be adjusted with later infusions to maximize patients results. Patients may experience something called a dissociative effect during the infusion therapy. Patients refer to the experience such as “relaxing,” “floating,” and “pleasant.” Some patients describe feelings of anxiety, disorientation, and hallucinations. A qualified member of our staff monitors patients throughout their infusion therapy. Patients who have experience with other administration methods report significant differences in success from one way to another. Patients will be taken to a private ketamine infusion room for treatment. Once the infusion is complete, patients will be evaluated for 30-45 minutes before discharge.
Please do not eat food for 6 hours or drink fluids for 2 hours before the appointment. Patients initial consultation will last 15-30 minutes. Our team will go over patient’s history and discuss a treatment plan. Patients are welcome to bring a someone with them to the appointment. Patients will be taken to a private room, have an IV catheter placed, and the infusion started. Patients will be monitored throughout the infusion to analyze their response to the infusion. Patients can listen to music, read, relax or even nap during the treatment.
The infusion duration for most conditions will be 40 minutes. Some chronic pain syndromes, may last up to 4 hours. Infusion times will differ based on the disease we are treating.
Patients will be required to stay for a 30-45 minutes recovery time after the infusion. Patients must have an adult to drive them home after the appointment. Patients cannot drive or operate heavy machinery for 24 hours post treatment
Will I Need Ketamine Infusion Therapy forever?
No. Some patients get long-term relief after only one infusion series. Ketamine can restore the brain to a healthy balance after the initial series of infusions. Maintenance or “booster” infusions are provided as needed for maintenance. Ketamine infusions may enhance the impact of antidepressants or provide relief that can be sustained by oral medications, other therapies, and lifestyle changes.
Can I become addicted Ketamine Infusion Therapy?
No. Ketamine is used to treat addiction withdrawal symptoms and medication cravings. Ketamine has been used for years as an anesthetic and analgesic in adults, children and more so in trauma management. Ketamine has been abused recreationally at far higher doses as a club drug; there is no evidence that ketamine is addictive. Ketamine as an infusion therapy is administered under supervision at subanesthetic doses.
What I Do I need the Day of ketamine infusion therapy?
Patients are safe and will leave feeling much better. Please bring the following
1. Government-Issued photo ID with the patient for each appointment.
2. An adult to drive patient to and from our center and stay with the patient during infusion.
3. Please wear comfortable loose clothing; we will be putting heart monitor patches on their chest.
4. Patients may bring tablets, books, mp3 players, and headphones to listen to music, if possible, something soothing to them.
5. Patients are encouraged to sit back and relax.
Do I need a referral to receive Ketamine Infusion Therapy?
All patients are evaluated by our Advanced Registered Family Nurse Practitioners to receive a history and physical. Patients may also bring a written order from their providers. Patients may be asked for a written referral from their mental health or primary care provider in some cases.
What should I bring to my first Ketamine Infusion Therapy appointment?
Patients should bring any medical records from their primary care provider or psychiatrist. Patients should also bring any recent lab work. Some patients may require labs work before infusions and will be discussed during the initial consultation.
What Will Happen During My First Appointment?
Patients information will be reviewed along with any information received from referring providers. Our team will also evaluate the intake forms patients complete. Our Advanced Registered Family Nurse Practitioner will conduct a physical exam and recommend a ketamine treatment care-plan. The initial consultation will last about 15-30 minutes.
What does the research say about Ketamine Infusion Therapy?
Research on ketamine infusion therapy has been very hopeful in the last several years. Research indicates that low dose ketamine infusion therapy can offer rapid and robust relief from the symptoms of depression, anxiety, PTSD, OCD, migraines and chronic pain. Please see the Provider/Referral page for some current Ketamine articles.
Should I stop taking any medications before to my Ketamine Infusion Therapy?
We would like to speak with patients and discuss their current medical issues and medications before to their first infusion. Patients should not take sympathomimetic medications like Adderall, Ritalin, and phentermine the day of an infusion. Patients may obtain better results if they are weaned off benzodiazepines prior to ketamine treatment. We recommend that patients do not take benzodiazepines the day of their infusion. This does not mean patients can’t receive ketamine treatment while taking benzodiazepines. It is entirely safe; we just want to ensure the best possible chances for patient’s success. Some common brand names for benzodiazepines are Xanax (Alprazolam), Ativan (Lorazepam), Valium (Diazepam), and Klonopin (Clonazepam).
Patients should not take opioid pain medications and muscles relaxers 6 hours before an infusion or up to 3 hours afterward. Medical Cannabis should not be used the day of an infusion. Patients should also avoid alcohol the day of a ketamine infusion. Patients should contact us with any questions regarding interactions between current medications and ketamine.
There are currently a few other medications known to interfere or block the response to ketamine: Risperidone (Risperdal), Olanzapine (Zyprexa), Lamictal. These are “relative contraindications” to therapy. Patients should not adjust the dose or frequency of any prescribed medication without first consulting with the prescribing physician.
Is Ketamine Infusion Therapy covered by insurance?
Insurance does not currently cover ketamine infusion therapy. We accept cash, all major credit cards, and money orders.
What Does Ketamine Cost?
Please call our center for our prices. Ketamine Advocacy Network provides a great illustration of price determinatioin.
Is there financing available for Ketamine Infusion Therapy?
Yes, we have a financing option available for ketamine infusion therapy. We offer Advance Care which provides the patient the most cost-effective way to finance elective medical procedures. Advance Care can now qualify patients for up to 14 months of true interest-free financing. The financing application only takes a few minutes and, in most cases, we can provide a credit decision immediately. Please visit their website for more information.http://advancecarecard.com/
Will the Ketamine Infusion Therapy be done in a private room?
All our patients receive their infusion in a private, peaceful infusion room.
Will I Be Awake During the Ketamine Infusion Therapy?
Yes. Ketamine infusion therapy does put patients to sleep. Patients who are already drowsy and feeling calm and relaxed during the treatment may doze off, but most are able to move freely during the infusion.
Can I eat and/or drink prior to my Ketamine Infusion Therapy?
Please do not eat anything for 6 hours prior to a ketamine infusion therapy. Patients may drink clear liquids (water, fruit juices without pulp, carbonated beverages, clear tea, or black coffee) until two hours before an infusion. Do not consume alcohol or use any illicit drugs the day of an infusion. These substances are hazardous in combination with ketamine.
Should I continue seeing my psychiatrist/therapist?
Patients are encouraged to continue working with their outpatient providers for medication management and psychotherapy. If patients do not have a psychiatrist or therapist, our team at Advanced Infusion and Wellness Center can facilitate a referral.
Do I need a referral from my primary care physician?
No, any licensed mental health care professional or physician can refer patients.
How can I make an Appointment?
We are so excited to offer ketamine right here in Wichita.
Patients can call our office at 1-877-393-AIWC (2492).
Patients can email us at info@AIWC.net
Patients can come by in person to 10333 E 21st St. N Wichita KS, 67220.
Please visit our website at AIWC.NET. We are also on Facebook.