FAQs
Since the 1960s, Ketamine has been safely administered as an anesthetic. Today it is so respected by the medical world that the WHO classifies it as an “essential medication”. During infusions, small doses are delivered slowly and controlled with pump technology – allowing you to remain conscious throughout to speak up at any point during your treatment if needed. As for side effects? Rarely more than simple increases in heart rate or blood pressure; though those predisposed to nausea may be more likely to experience slight discomfort – but rest assured we can provide anti-nausea medication if required.
Delivering ketamine intravenously (through an IV) is considered the most effective protocol for treatment, and the data supports it. It has the highest bioavailability, meaning more of the drug gets to where we want it to go. We do not offer other routes of administration at our clinic. IV is the best route for your brain to receive ketamine because of something called bioavailability. In addition, it is also more effective, more precise, and safer for you. Receiving medication intravenously is the only way to have 100% bioavailability. Let’s take a look at the different bioavailability percentages based on what route you receive ketamine:
Intravenous: 100%
Intranasal: 25-50%
Sublingual (under the tongue): 30%
Orally (by mouth): 16-24%
When we give ketamine intravenously, we know exactly where your entire dose is going: straight to your brain. The same cannot be said for other forms of ketamine. You are in a comfortable setting with healthcare providers with you the whole time, the potential for side effects is low, and you are certain that the dose you receive is the dose that is going to your brain, maximizing the benefits of this cutting-edge treatment.
For mood disorders we need a referral from either your primary care or psychiatric provider, which includes documented diagnosis of:
● Depression
● Anxiety
● Post-Traumatic Stress Disorder (PTSD)
● Suicidal Ideation
● Bipolar Disorder
● Obsessive Compulsive Disorder (OCD)
● Postpartum Depression
● Migraines
Ketamine is typically used after other treatments have failed to provide effective relief to symptoms, and should be seen as one part of a wholistic approach to your heath needs. Some patients have seen an elimination or reduction of other medications with their Ketamine therapy regimen, but any changes should be made in collaboration with your provider under safe and controlled conditions.
As things stand, IV ketamine therapy is generally not covered by insurance. We have been seeing a gradual shift as some insurers are providing at least partial coverage/ reimbursement, but we currently do not bill insurance. We are hopeful that the treatment will be more universally covered in the near future.
We recommend a series of six infusions to be given within 3-4 weeks. Our team will be with you every step of the way to ensure your treatment has the best chance of success. After the initial series of infusions, many patients only require an occasional top-up or ‘booster’ according to their individual needs – ranging from weekly for some conditions all the way up to months at a time. For migraines the schedule is much more variable depending upon your exact condition. We’ll work hand in hand together on designing a tailored plan that caters specifically towards your requirements.
Upon arrival, you will be asked to complete some paperwork that will help us keep track of the progress from your treatment. We’ll provide all necessary information about preparation for the therapy so you know what to expect. When everything is ready, we invite you into a private room with a recliner, where vital signs can easily be monitored. A small-gauge intravenous line (IV) will be inserted in order deliver an optimized sub-anesthetic dose of ketamine – administered slowly and in a controlled manner during the session. The majority of patients report a sense of relaxation, even euphoria, however the medical staff remains at hand throughout your entire session should any extra monitoring or assistance become needed.
What we like to call “set and setting” are crucial elements of a good infusion. “Set” is a reference to the mindset of a patient prior to the session. Being open to the experience and trying to steer clear of negative triggers before an appointment will assist with optimal outcomes. For example, you might try and avoid intense confrontations or absorbing lots of negative new coverage the day of your infusion. A clear head helps! Nonetheless the vast majority of patients feel nervous before their first infusion which is totally normal. And “setting” is where you’re physically doing the infusion. We aim to create a warm and safe clinical experience.
We recommend continuing therapy during ketamine treatments. The experience of your first couple of Ketamine infusions can be intense and most patients find it helpful to debrief the experience with a professional. Let us know if you need a referral.
Ketamine therapy offers a safe and effective solution for many patients. However, you may not be eligible if your medical history includes conditions like uncontrolled hypertension or pregnancy, substance abuse issues, or unstable cardiac disease. To ensure that this treatment option is right for you, our team will take the time to review your health background prior to proceeding with care.
You must have a referral from a licensed healthcare provider that is authorized to diagnose your condition. We will also request the most recent visit notes. Ketamine therapy is not deemed as an appropriate first-line treatment at this time. We also have a nurse practitioner you can meet with for evaluation and referral if appropriate. The fee for the nurse practitioner is $150.
Ketamine is a controlled substance. It’s something we take seriously, from both a physical safety and legal perspective. Most patients tend to have a companion or driver with them, but it is not essential; rideshare and taxis are good alternatives. Let us know if that is how you plan to travel. We will not be able to continue offering care if a patient drives under the influence of a controlled substance, which is illegal.
Ketamine has not been shown to have addictive properties. In fact, data suggests it can be a useful approach to overcoming addiction. If you have a history of substance abuse, it doens’t exclude you from treatment, but it’s important to disclose this to us so we can help develop the right treatment strategy for you.