At Neuro Wellness Spa, the first step is to schedule an initial consultation. Based on the clinical examination, an EKG, BP and HR measurements, and a review of the patient’s medical records, Dr Koo determines if IV-Ketamine is indicated and, if indicated, the treatment protocol, including dosage, duration and infusion rate, recommended. Dosages are generally based on body weight, but can be adjusted in subsequent treatments to maximize the efficacy of the therapy.
During treatment, patients sit in a comfortable reclining chair in a private room. Because patients can experience light and sound sensitivity during treatment, the room is dimly lit and quiet music is played. Patients will be attached to a monitor that measures pulse, blood pressure, and blood oxygenation throughout the treatment, but there is no need to disrobe or wear a hospital gown. The doctor or nurse will locate and place a small needle into a vein near the surface of the arm. Unlike intramuscular injections like shots, the insertion of an IV is generally painless, as it does not hit any highly-innervated muscle. Through this needle and thin flexible tube, fluid and ketamine are delivered at a controlled rate into the blood stream. The procedure generally lasts 45-50 minutes, during which the patient simply enters a deep state of relaxation. Throughout this entire period, the nurse and/or doctor closely and continuously monitor the patient.
As the treatment finishes, the IV is removed and the patient is given time to relax and “wake up.” While there is some variation between patients, most only take a few minutes to be fully alert, oriented and awake. Patient’s may continue to feel slightly sedated for several hours after treatment. For this reason, patients must be escorted home by a friend or family member and are advised against driving or operating heavy machinery for at least 24-hours. Rarely patients experience some dizziness or nausea after treatment, but in the majority of cases, these side effects are time-limited and fully resolve prior to discharge.
Many patients experience symptom improvement as soon as their first treatment. In total, a course of treatment consists of six infusion sessions, performed over the course of three weeks.
The sensation of IV-ketamine therapy may appear controversial to some, as ketamine is a psychoactive drug and does have a history of recreational misuse. That said, IV-ketamine therapy is a far cry from a recreational “trip”. At the slow-delivered, low dosages used for depression therapy, patients do not hallucinate. Instead, the patient will simply enter a deep state of physical relaxation. While they will be unable to stand or converse normally, the patient will not loose consciousness or awareness of their surroundings. In fact, the patients mind may be quite active. This sensation can be strange at first, but most patients quickly become used to it and describe it as pleasant. Some patients may enter a dissociative state, a kind of out-of-body experience, where one partially loses bodily awareness. Again, most describe this state as pleasant, but should it be overwhelming, the sensation can be mitigated by simply opening one’s eyes.
It is important to understand that the sensation is not the most clinically significant element of the therapy. Research suggests that the depression and anxiety relief arise from long-term physical and chemical changes that take place in the brain in response to the ketamine—not the experience or sensation.