Ketamine Infusion Therapy: Everything You Need to Know

According to the ADAA, depression is one of the most devastating mental health and mood disorders in the United States. Affecting over 16 million Americans, it is the leading cause of disability in the country. While there are several holistic treatments to combat depression, such as meditation or TMS, some cases of major depression require further intervention. 

For treatment-resistant depression (TRD) cases, low dose ketamine infusion therapy may provide more mid- to long-term relief than traditional treatments or antidepressant drugs. In fact, ketamine infusion has been shown to reduce not only symptoms of depression but also suicidal ideation. 

This means that even in the most severe cases of major depressive disorder and suicidal patients, ketamine infusion therapy may provide immediate and lasting relief. Of course, no single treatment is best for every individual. There are plenty of factors to consider before pursuing ketamine treatments, and we’ll walk you through them.

What is ketamine?

Researchers originally studied the use of ketamine in the 1950s. They were looking for an anesthetic with analgesic (pain-relieving) effects. While ketamine was first used in these ways in operating rooms and on battlefields, researchers soon found additional uses for the drug.

By 1975, researchers began studying ketamine for its antidepressant effects. By the year 2000, studies showed the rapid efficacy of the treatment, with patients experiencing significant improvement within 72 hours.

What is the difference between ketamine and morphine? Ketamine is a non-opioid medication that operates differently from morphine. Morphine is an opioid.

Ketamine affects the brain’s N-methyl-D-aspartate (NMDA) receptors. It also appears to help the brain produce glutamate, a neurotransmitter that has been linked to depression. Glutamate helps the brain repair damaged neurons and neural connections and form new ones. 

Ketamine has anti-inflammatory properties, which may help reverse damage to the brain by cortisol or other stress hormones.

The drug is sometimes combined with morphine for pain relief. However, it may prove as an effective alternative to opioid medications entirely, as ketamine offers less severe side effects.

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Common Uses for Ketamine Therapy

Ketamine infusion therapy can help treat several conditions. In addition to being an effective anesthetic and analgesic, the drug’s anti-inflammatory and anti-depressive attributes make it an effective treatment option for nervous and mental health conditions such as:

• CRPS (complex regional pain syndrome)
• Migraines
• Fibromyalgia
• PTSD (post-traumatic stress disorder)
• Bipolar disorder or borderline personality disorder
• Various anxiety disorders
• Obsessive-compulsive disorder
• Suicidal thoughts 

At this time, ketamine therapy is most commonly used to treat depressive and nervous disorders.

Risks & Side Effects

What are Ketamine infusion side effects? Side effects of ketamine may include:

• Nausea or vomiting
• High blood pressure
• Involuntary muscle movements
• Trouble sleeping
• Loss of appetite
• Dizziness
• Drowsiness
• Confusion
• Double vision or blurry vision
• Disturbance in the perception of time, color, texture, or sound
• Dissociation (feeling outside of one’s body)

These physical and cognitive side effects may occur after both short-term and prolonged exposure to ketamine.

Some individuals have also described a dream-like state during their treatment in which they feel drowsy yet awake.

Due to these risks, ketamine infusion therapy is suggested only for patients who do not respond to more conventional treatments. However, for those with severe symptoms or suicidal thoughts, the benefits of ketamine treatment may outweigh the risks.

What to Expect

Intravenous (IV) infusion ketamine, or racemic ketamine, is the most commonly used ketamine treatment for depression. Racemic ketamine combines the “R” and “S” ketamine molecules. This type of ketamine has been researched more thoroughly than other types.

As ketamine treatments have developed, other modes of administration have become available. One other standard option is a nasal spray comprised exclusively of “S” ketamine. We’ll come back to that.

Before Infusion

The first step in any treatment is a consultation with your physician or health care provider. Because many factors affect mental and physical health, we recommend finding a physician who performs extensive whole-person testing.

Your doctor will ask you about:

• Any previous mental health treatment
• Medications you’ve tried and why they didn’t work for you
• Lifestyle changes you’ve made to manage your condition
• Any questions you have regarding ketamine therapy

If you and your doctor decide that IV ketamine is the right choice for you, your doctor can then take steps to get you approved and scheduled for ketamine therapy. 

If you tend to experience anxiousness around needles or in medical settings, we suggest preparing yourself for the best possible experience beforehand. Some tips for your infusion appointment:

• Do your best to arrive at your appointment in a calm state of mind. Avoid stress and engage in calming activities beforehand.
• Bring an eye mask. Some patients find that using an eye mask helps them stay calm during the infusion.
• Prepare calming music. Meditative or otherwise calming music may help ensure a pleasant experience. Don’t forget your headphones.
• Arrange transportation. After an infusion, you will have a recovery time of about 30 minutes but may continue to feel drowsy. We recommend planning ahead for the ride home.

At Infusion

Ketamine infusions are administered via IV infusion in the arm. This will always occur in a clinical setting by a healthcare professional who will prepare a solution of ketamine and saline mixed at the appropriate dosage. 

What is a typical dose of ketamine infusion? The typical dosage for ketamine infusion is 0.5 mg/kg, but this may differ according to individual needs. Some patients may need as little as 0.1 mg/kg. Others may be less receptive, needing up to 0.75 mg/kg. 

A ketamine infusion usually lasts for around 40 minutes, although a session may last up to 100 minutes. However, the length of the clinic stay may change at the clinic staff’s discretion.

As the IV is inserted, you may experience a sharp pricking sensation, but this should not last long. The effects of ketamine will quickly become evident. Many patients become drowsy, but you should remain conscious throughout the session.

Throughout your infusion, your physician will monitor vital signs such as heart rate, respiration, and your degree of sedation.

After Infusion

Patients experience different responses to ketamine infusions. Some people see positive results after the first session, while others may take up to 3 or more infusions. Many clinics will schedule 6 infusions over a few weeks for initial treatment.

If a patient does not respond to treatment after 6 sessions, further sessions are unlikely to show improvements. At this point, you may want to discuss other options with your doctor.

Note: While ketamine infusion therapy is promising, it is not a stand-alone treatment. We highly recommend integrating your ketamine infusion therapy with CBT or alternate psychotherapy with a licensed professional for best results. Some clinics may even include a discussion with a therapist at the infusion appointment. 

How long does a ketamine infusion last? The effects of successful ketamine infusions can last up to 3 months after a full round of treatment. While results vary from patient to patient, the effects of sessions tend to last longer after each infusion.

Other Considerations

Addiction Concerns

Ketamine is less addictive than opioid medications like morphine. This is what makes ketamine particularly appealing as a morphine alternative. 

However, there is still some potential for abuse, and ketamine treatments should be approached with due care. Individuals with a history of or a predisposition toward substance abuse should consider ketamine therapy with caution.

Ketamine vs. SSRIs

SSRIs (Selective Serotonin Reuptake Inhibitors) increase serotonin in the brain. Ketamine affects the brain differently than SSRI medications like Zoloft and other prescription antidepressants. Because ketamine promotes glutamate, it may reduce stress-induced damage to brain tissue. 

If you have taken SSRI medications without results, you may want to consider ketamine infusions.

Ketamine Nasal Spray

Ketamine nasal spray is comprised exclusively of the “S” ketamine molecule, as opposed to the combined molecules used in the infusion form of ketamine treatment. This is called “Esketamine,” also known as Spravato. 

The FDA has approved ketamine nasal spray. It does not appear to be as effective in treating depression. This may be due to the delivery method or how esketamine interacts with brain receptors. More research is needed overall.

Cost

Because racemic ketamine is not FDA-approved, health insurance may not cover it. Depending on the provider and dosage, a single infusion can cost between $400 and $800. This means a full treatment may cost several thousands of dollars in total. 

Because nasal ketamine is FDA-approved, it is more likely to be covered under health insurance and may be the more accessible option.

Key Takeaways

Ketamine infusion therapy is extremely promising for treating major depressive disorder. One study even found an overall success rate of 85%. 

If you think ketamine is right for you, we recommend speaking to your trusted physician. Once again, we highly suggest a comprehensive analysis of your symptoms, history, and all related genetic and lifestyle factors before moving forward with any course of treatment.

As always, we’re here to help. Schedule a free consultation today.

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