Ketamine Treatment
The History of Ketamine
Ketamine was discovered in 1962, first tested in humans in 1964, and approved for use in the United States in 1970. It was extensively used for surgical anesthesia in the Vietnam War due to its safety. Ketamine is on the World Health Organization’s List of Essential Medicines, the safest and most effective medicines needed in a health system.
Since its discovery in 1962, it has been discovered that sub-anesthetic low doses are a successful treatment of mood disorders including Depression, PTSD, OCD, Anxiety and Chronic Pain Syndromes including Central Sensitization Syndrome, Fibromyalgia, Reflex Simplex Dystrophy.
According to the World Health Organization on May 27th, 2016: updates on Ketamine were presented, in which new potential medical applications were identified. These included depression and refractory status epilepticus.
The US Federal Drug Administration (FDA) has approved Ketamine for both anesthesia and pain control. However, the FDA has not approved ketamine for the treatment of mood disorders or chronic pain alleviation. Therefore, Ketamine for these indications are considered to be an “off label” usage of the medication. Due to this fact, insurance companies and government insurance programs such as Medicaid and Medicare do not pay for this treatment. This is a very safe medication, but like all medications, side effects may occur.
The best treatment is the one which works for you
Ketamine & Its Uses
Ketamine For Depression
Ketamine is a highly-effective treatment for depression providing relief—and delivering hope.
While research about ketamine therapy is ongoing, we know that ketamine works differently in the brain than traditional selective serotonin reuptake inhibitors (SSRIs) antidepressants. Rather than boosting the amount of serotonin in the brain, ketamine works on the glutamate system and essentially helps repair damaged neural connections. Ketamine is safe, and has minimal side effects.
Due to the unique way that ketamine interacts with the brain’s glutamate system, it is capable of alleviating the symptoms of depression for weeks or months at a time.
31% of clinically depressed Americans fail to respond to first-line pharmaceutical treatment. Those who struggle with treatment resistant depression (TRD) feel helpless and hopeless. However, ketamine for treatment resistant depression could help—even if nothing has worked in the past.
Depression is considered treatment-resistant after a patient fails to respond to two or more first-line treatments, including talk therapy and antidepressant medications. While patients certainly have the option to explore alternative antidepressants, change the dose of their existing antidepressants, or engage in different types of therapy, many still find their efforts futile. If you or a loved one are struggling to find an effective depression treatment, ketamine therapy may be an option.
Most traditional medications for mood disorders require many weeks to months to determine how effective they are for you. They often include a host of unwanted side effects and ultimately provide inadequate relief, are highly addictive, and also include many unwanted long-term side effects.
Ketamine for PTSD (Post Traumatic Stress Disorder)
For people who have experienced significant traumatic life situations, from veterans and first-responders, to healthcare workers and other trauma survivors, ketamine can alleviate symptoms… even when other PTSD treatments have failed.
One of the areas of the brain that is affected by PTSD is the cerebral cortex. This part of the brain is partly responsible for the thought processes that occur during and after a trauma. The current understanding is that certain synapses within the brain fail to function properly during and after a traumatic event. These neurotransmitters then begin to misfire later on in life. Using Ketamine to treat PTSD stimulates the brain to release glutamate, which is a hormone that is associated with regrowth and regeneration within these critical neural synapses.
Ketamine Treatment for PTSD has been shown to reduce the rates of suicide for people who struggle with this condition. Those with co-existing conditions, such as depression, also find relief from those symptoms. This allows many people to use a single type of treatment instead of a cocktail of medications. Ketamine may decrease symptoms of emotional reactions, avoidance, intrusive thoughts, negative mood and thinking.
Ketamine for Anxiety
With traditional anxiety medications, only 30-40% of patients will achieve remission. When other anxiety treatments fail, ketamine may be the solution that finally works.
Ketamine for anxiety is a wide-reaching treatment, effective for general anxiety disorder, seasonal affective disorder, and anxious depression.
Most traditional medications for mood disorders require many weeks to months to determine how effective they are for you. They often include a host of unwanted side effects and ultimately provide inadequate relief. Benzodiazepines are highly addictive and also include many unwanted long-term side effects.
Ketamine for OCD
Obsessive Compulsive Disorder (OCD) is a type of anxiety disorder characterized by recurrent, unwanted thoughts and repetitive behaviors.
OCD is diagnosed when obsessions and compulsions consume excessive amounts of time (an hour or more each day), cause significant distress and when it interferes with daily functioning at work or school, or with social activities, family relationships.
The exact cause of OCD is not known, but it is believed to be a neurobiological basis combined with genetic, behavioral, cognitive, and environmental factors.
OCD is generally treated with psychotherapy, medication or both.
Ketamine therapy is an off-label treatment for difficult to treat cases of OCD. For people who don’t respond to first line medications or psychotherapy, Ketamine may help.
While the benefits can truly be remarkable, they often occur in ways that differ from some patients’ expectations. That is, the changes produced by ketamine can be subtle, and not always manifest themselves immediately.
The duration of the effects of ketamine treatment can vary among individuals. Some individuals experience noticeable immediate relief, while others may require longer term treatment to feel improvements.
Most Common OCD Symptoms
- Fear of germs or contamination
- Fear/feelings/urges related to numbers (good, bad and magical numbers)
- Excessive fear of violating religious or moral rules
- Fear/feelings/urges/images related to sexual content
- Fears/feelings/urges related to having something “just right,” “just so” or “perfect”
- Fear that harm, illness or death will occur to oneself or others (including violent or aggressive obsessions)
- Fears/feelings/urges related to discarding something and fears of contamination
- Fears/feelings/urges related to symmetry or order
- Excessive doubting/dread of uncertainty
Ketamine Treatment Pricing
Ketamine Treatment Prices: Monthly office visit $250
ketamine troche prescription mailed directly to your home from the compounding pharmacy: $40-$100 (depending on treatment dose and frequency)
We recognize that, it can be a financial stretch for many to afford ketamine as an alternative treatment. Rest assured, we will very carefully evaluate your response to treatment and recommend against ongoing treatment if the benefits are not apparent.
A Note About Insurance
Insurance companies do not cover ketamine treatments at this time as it is an off-label alternative treatment. We remain hopeful that insurance companies will one day join open-minded medical professionals and continued efficacy studies in recognize the effectiveness of ketamine and begin covering this for patients.
Visit Expectations
Our comprehensive intake process is designed to determine if ketamine is the best treatment fit for you and your goals.
We accept patients over 18 years of age and require that you have an appropriate established diagnosis from a mental health professional and to provide that documentation at your intake appointment.
Your intake appointment will include a questionnaire, a comprehensive medical consultation with Dr. Ewals, and an opportunity for us to answer questions.
We personalize your ketamine dosage based on your weight, comfort level, and response to the medicine and therapy. Dr. Ewals will work closely with you to monitor your progress and optimize your results.
Ketamine FAQs
Studies have shown that ketamine acts on a neurotransmitter in the brain called glutamate. Glutamate plays an important role in neuronal activation or forming new connections between neurons in the brain.
These new connections may allow someone suffering from negative thought patterns to break the cycle and create new thought patterns or pathways in the brain. Due to this, ketamine is an excellent treatment option to combine with therapeutic counseling in order to promote long-term healing.
Ketamine has been safely used for over 60 years as an anesthetic medication and is considered an essential medication by the World Health Organization. You will be receiving a sub-anesthetic or very small dose delivered in a slow and controlled manner through an oral compound formula. This amount of medication will not cause you to lose consciousness. Side effects are rare, generally mild, the most common would be a slight increase in blood pressure or heart rate.
For mood disorders, you must have a documented diagnosis from a healthcare provider that includes the following:
- Depression
- Anxiety
- Post-Traumatic Stress Disorder (PTSD)
- Obsessive Compulsive Disorder (OCD)
Ketamine is not a first-line option, so you must have received previous treatment. Ketamine therapy is designed to be used as one component of a multimodal approach to addressing your health needs. During your initial phone conversation with Dr. Ewals, she will review your history and necessary medical documentation on previous treatment for your condition. However, like any medical treatment, the effectiveness of ketamine therapy can vary from person to person.
Although many patients are able to eliminate or decrease the use of other medications, we do not recommend making any changes to your medication regimen initially. Any adjustments should be made with your prescribing provider in a safe and controlled manner.
*Alternative health plans to expand ketamine therapy to both psychiatric disorders listed above and chronic pain diagnosis in the additional optional form of ketamine infusions in 2024.
Yes, you should not stop your antidepressant medications in order to receive ketamine. It is essential that we review your current medication list prior to beginning ketamine treatments.
Ketamine therapy can be used in combination with other treatments, including psychotherapy and medication management. Our clinic takes a comprehensive approach to your care and will work collaboratively with your existing healthcare providers to develop an individualized treatment plan
Most patients can safely receive ketamine therapy. There are a few medical conditions that might require treatment prior to beginning therapy or stop you from receiving this treatment. A few examples are uncontrolled hypertension, active substance abuse, pregnancy or unstable cardiac disease and history of schizophrenia or schizoaffective disorders.
A thorough review of your medical history will be conducted prior to receiving ketamine therapy to ensure you are a suitable candidate. We do not provide treatment for minors at this time.
Ketamine infusion therapy can temporarily affect your coordination and cognition. It is important to avoid operating heavy machinery or making important decisions for the remainder of the day.
Ketamine has been abused as a recreational drug. Street drug use is in doses vastly higher than the sub-anesthetic doses used for the treatment of depression and other mental health conditions. As mentioned above, ketamine for depression is a very safe medication in experienced hands. Incidentally, a large number of the drugs used in anesthesia practice have the potential for abuse, so ketamine is not unique in this respect. The key is administering the right dose to the right patient in the right setting.
Ketamine is not physically addicting, but has been shown to be psychologically addicting in those using it recreationally at much higher doses and in far greater frequencies than we will use.