IV Ketamine: A Newer & Faster Path to Treating Depression, Bipolar Disorder, PTSD & Suicidality

Although ketamine has been used safely as an anesthetic since the 1960s, the discovery of ketamine as a highly effective and rapid-acting treatment for a wide range of treatment-resistant mood disorders has been hailed as arguably the most significant development in psychiatry during the past few decades.

How does ketamine therapy work?

Ketamine works in several ways at the same time, many of which are still being studied. Research has shown that ketamine stimulates brain derived neurotrophic factor (BDNF) and the growth of neurons in the brain. In patients treated with IV ketamine therapy, researchers have observed increased synaptic connections.

Ketamine also improves neural activation, or communication between brain cells by working as an NMDA receptor antagonist. This neuronal growth and increased neuronal interconnectivity have been shown to improve mood and cognition.

Ketamine also may also work in other ways. For example, it might reduce signals involved in inflammation, which has been linked to mood disorders.

What can IV ketamine therapy treat?

IV ketamine therapy is a safe and effective treatment option for people who suffer from treatment-resistant disorders. It has also been shows to help relieve symptoms of other disorders including:

  • Bipolar Disorder
  • Anxiety
  • Depression
  • Post-Traumatic Stress Disorder
  • Chronic Pain
  • Fibromyalgia
  • Spinal Injury
  • Neuralgia
  • Acute Suicidality

How is ketamine administered?

There are two main types of ketamine:

  1. Racemic Ketamine, sometimes called Intravenous or IV ketamine- Often given as an infusion into the bloodstream, racemic ketamine is a mixture of two mirror-image molecules: “R” and “S” ketamine. Racemic ketamine is FDA approved as an anesthetic and used off-label to treat mood and chronic pain disorders.
  2. Esketamine, also known as Spravato- Given as a nasal spray, esketamine uses only the “S” molecule. Esketamine received FDA approval in March for treatment-resistant depression.

What should patients expect during IV ketamine treatment?

When used to treat mood disorders, ketamine is administered through an IV at a much lower dose than is necessary for anesthesia.

During ketamine treatment, patients recline in a treatment chair surrounded by a calm, quiet and experientially safe environment. As the ketamine is delivered at a slow and controlled dose, a registered nurse accompanies each patient for the duration of the infusion to monitor blood pressure, pulse and oxygen saturation.

Ketamine is well-tolerated. During a ketamine infusion, patients remain aware of their surroundings and experience a deep relaxation. Some patients may also experience dissociation, perceptual disturbances or nausea. Generally, any changes in perception or dissociation dissipate very quickly after the infusion.

Each ketamine infusion lasts about 40 minutes, after which patients should have someone available to accompany them home safely. Typically, patients receive 8-12 ketamine infusions over the course of 3-4 weeks. Most patients experience positive results from ketamine after their first infusion. Subsequent infusions help prolong the positive effects.

What are the side effects of IV Ketamine?

While there are very few side effects with this treatment, a small number of patients experience:

  • Dizziness
  • Nausea
  • Confusion
  • Loss of Appetite
  • Fatigue after the first session. In some cases, fatigue in subsequent sessions

We recommend that you have someone available to accompany you home after your treatment.

Is ketamine treatment covered by insurance?

Although IV ketamine is FDA-approved as an anesthetic, it is used off-label to treat mood and chronic pain disorders. At the present time, ketamine infusions for mood and chronic pain disorders are cash pay procedures.

Which patients should consider TMS vs Ketamine treatment?

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