KETAMINE THERAPY FAQS

Ketamine was developed more than 50 years ago as an anesthetic agent. Ketamine is a safe, effective, and fast acting medication with few side effects. Physicians regularly use this medication on both pediatric and adult patients. More recently, intravenous (IV) ketamine has been proven to be a highly effective medication for the treatment of depression, anxiety, post-traumatic stress disorder, and certain pain syndromes, used in this off-label capacity.

Supported by an ever-growing and robust series of studies and clinical trials, we use intravenous (IV) ketamine to treat conditions such as: depression, complex regional pain syndrome (CRPS), migraines, suicidal ideation (SI), fibromyalgia, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), generalized anxiety disorder, bipolar disorder, neuropathic pain syndromes.

Approximately 70%-80% of patients positively respond to ketamine infusion therapy for psychiatric conditions.

Ark Integrative Medicine will treat patients over the age of eighteen who are deemed eligible for ketamine-infusion therapy.

Ketamine is considered a safe drug when properly administered at the appropriate dosages.

In general, side effects are minimal and short-lived. Following an infusion, patients may feel tired and/or may experience nausea or a transient headache. There are no reported long-term side effects with ketamine infusions.

The short answer is no, because the dosage that is administered in the infusions is considered minimal and does not produce the effects that a higher dosage would. Ark Integrative Medicine minimizes the addictive potential of ketamine by controlling the delivery of all ketamine medications, as well by carefully monitoring for individual tolerance to the medication.

To be clear, ketamine infusions are not the first-line treatment for these medical conditions, but rather ideally suited for patients who have failed on first-line treatments, such as antidepressants. Ketamine infusions generally work more rapidly than antidepressants, and infusions do not share the common side effects that include weight gain, sexual dysfunction, sleep disturbances, gastrointestinal disfunction, fatigue and emotional blunting. For depression specifically, if depressive symptoms are resistant to traditional oral antidepressants, often the treatment of last resort is electroconvulsive therapy (ECT). Studies have shown that ketamine infusions rapidly improve symptoms in patients with major depressive disorder who did not respond to ECT. (Source)

We will review your medical and psychiatric histories to determine if you are a candidate for ketamine treatment. There are several medical conditions that will preclude a patient from receiving a ketamine infusion, including but not limited to: pregnancy, uncontrolled blood pressure, unstable heart disease, current drug abuse, intracranial mass, untreated thyroid disease, current manic phase of bipolar disorder, acute psychotic hallucinations/delusions.

Some patients achieve long-term relief after a single series of infusions. Some find that these infusions augment and enhance their existing oral medications and therapies. For resistant symptoms, for which ketamine infusions are the only effective treatment, most patients choose to begin a maintenance program, returning for single “booster” infusions intermittently. The interval between maintenance infusions varies from patient to patient.

Although all patients are unique and results cannot be guaranteed, over 70% — 80% of patients with treatment-resistant mood disorders and pain syndromes can expect significant relief with ketamine infusions. We customize each patient’s infusion dosage and frequency to maximize a positive and effective clinical response.

For mood disorders and fibromyalgia, the infusion will last approximately 40 minutes, with 20 to 30 minutes of additional recovery time.

For neuropathic pain and refractory headaches, the infusion will last approximately 2 hours, with approximately 45 minutes of additional recovery time.

For CRPS, the infusion will last for approximately 4 hours, with approximately 45 to 60 minutes of additional recovery time.

Generally, a series of six treatments is recommended for best results. Most commonly, two infusions are scheduled close in time. If the initial infusions are effective, for psychiatric disorders, four additional infusions are scheduled over the following ten days. For pain syndrome patients, generally three additional infusions are scheduled.

Following the initial series of infusions, patients may choose, after consultation with their treating physicians and the Ark Integrative Medicine team, to begin a maintenance program, returning for single “booster” infusions intermittently. The interval between maintenance infusions varies from patient to patient.

Ark Integrative Medicine is committed to providing COVID-related procedures to minimize exposure, including a strict mask-wearing policy, a temperature check upon arrival, and sterile processes.

On the day of your infusion, you will arrive at our clinic and fill out a short health assessment questionnaire that will allow you and the treatment team to track your progress, as well as reviewing the post-discharge instructions and executing any necessary informed consents. Next, one of our experienced nurses will start a small IV to provide access for the infusions. If desired, we provide noise-cancelling headphones, an eye mask, and weighted blanket so you can relax during the infusion. Some patients report feeling sensations such as euphoria, floating, heightened perceptions or a dream-like state. These feelings will subside once the infusion is complete.

During the initial 15-20 minutes, you may have no noticeable effects. Halfway through the infusion, some patients begin to experience feelings described as: euphoria, floating, heightened perceptions, feeling disconnected, or in a dream. You will be monitored continuously throughout your infusion.

Yes. We will work in concert with your primary care provider, as consultants, to individually tailor your treatment plan. This continued care is a key element in your pathway to better health.

Prior to any infusion, we will review the pre- and post-discharge instructions with you in our office. One of the more important instructions is that you may not drive home following an infusion, and therefore you will need to bring a driver with you to our office. The patient is required to avoid eating any solid foods 4 hours prior to an infusion, and to stop drinking clear liquids 2 hours prior to an infusion. Please find additional information in the Ketamine Infusion Welcome Packet, found under Forms.

Anti-depressant medications (SSRIs, MAOIs, and tricyclics) do not interfere with ketamine, and there is no need to stop them. Ketamine infusions can provide relief during the time it takes antidepressant medications to begin working. Important: You should not decrease or stop taking any prescribed medication without first consulting your prescribing physician.

Benzodiazepines have been shown to possibly decrease the effectiveness of ketamine therapy in patients with treatment resistant mood disorders. We will give you instructions on managing these medications prior to your infusion. Do not self-taper these medications if you are currently prescribed them.

First, please schedule a complimentary medical consultation to determine your eligibility for ketamine therapy. If you are accepted, then further sessions may be scheduled per your treatment regimen. Please call us or use our automated online scheduling system to schedule your complimentary medical consultation. If possible, please fill out the Ketamine Infusion Welcome Packet and bring these forms with you to your consultation. If you are not able to print out these forms, please arrive in our office 15 minutes early to your consultation and you may fill out the forms while in our office

No. Ark does not contract with any insurance carriers. Ark Integrative Medicine requires payment prior to any rendering of services.

Insurance company reimbursement for ketamine infusions vary widely. If you would like to submit a claim to your insurance provider for reimbursement of your out-of-pocket costs, we will provide you with the necessary documentation to aid in this process, but Ark Integrative Medicine does not investigate coverage by any health carrier.

You do not need to have a referring doctor to become a patient. However, Ark Integrative Medicine believes that a multidisciplinary “team approach” is very important for your health and safety, and strongly encourages you to secure a primary-care physician or psychiatrist.

The infusions are provided within the comfort and safety of our state-of-the-art clinic. Ark prioritizes clinical expertise and safety. The medical clinic features an automated external defibrillator (AED), and our nursing staff, comprised of registered nurses (RNs) and advanced practice registered nurses (APRNs), are trained in basic life support and advanced cardiac life support. All nursing staff are seasoned emergency-medicine trained professionals. The ketamine treatments are administered as outpatient infusions.