Frequently Asked Questions
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Ketamine in an anesthetic developed in the early 1960’s. It is one of the most widely used drugs in modern medicine, and is on the World Health Organization’s List of Essential Medicines. It has a variety of medical uses and is FDA-approved as an anesthetic.
Ketamine has a remarkably safe track record in surgical settings and is frequently used in pediatric surgery. It is also commonly used to treat the extreme physical pain of a condition called CRPS/RSD. The US military has used ketamine as a battlefield anesthetic since the Vietnam War. Ketamine is also used in veterinary medicine.
Ketamine has been shown to stimulate neuron growth in the brain in as quickly as one hour. Many scientists studying ketamine are focusing on the neurotransmitter glutamate, which plays an important role in neural activation.
It’s real. Ketamine treatment is an intravenous infusion procedure performed in a specially-equipped medical office by a member of the Denovo team.
It’s not hype. The National Institutes of Health has been studying ketamine’s effect on depression for more than ten years. There is serious scholarly research behind this treatment, which means controlled, double-blind, peer-reviewed studies at major institutions.
Researchers at Yale pioneered this research nearly 20 years ago and published the first major study in 2000. Since then, dozens more ketamine studies have been conducted at Yale and other major institutions including NIH, The VA, Harvard, Johns Hopkins, Mt. Sinai Medical School, Oxford University, and many more around the world.
About 70% of patients with treatment-resistant depression (including bipolar patients) experience rapid relief after a low-dose ketamine infusion. Similar success rates have been seen in returning combat veterans suffering from PTSD. These patients’ cases are the worst of the worst, lasting years or even decades, which have not responded to any other treatments. Many have hovered on the verge of suicide for years, many have actually attempted suicide, and all have endured a very poor quality of life.
Before ketamine therapy, there was virtually no way to substantially improve the condition of patients like these. The fact that ketamine works rapidly on 70% of them is astonishing, and its discovery has profoundly changed depression research, and our understanding of the very nature of depression.
It’s important to keep in mind, however, that the degree of relief can vary among patients. Some sufferers get only partial relief, some do not get relief until a second or third infusion, and some do not respond to ketamine at all. Some patients have additional medical conditions in addition to depression that can reduce its effectiveness.
You will be awake. The Ketamine Infusion dosage is not high enough to cause you to fall asleep, but you may feel a bit drowsy during and shortly after the treatment.
There are drugs, both legal and illicit, that will reduce the effectiveness of ketamine. Please be sure to inform us of all drugs you take. We will work with your prescribing physician in coordinating your care.
Length of treatment is individual to each patient and can vary a great deal between patients. Most patients who respond to ketamine find that a single infusion will provide at least several days of symptomatic relief. This means relief of the physical symptoms that make depression/bipolar/PTSD so unbearable: anxiety, anhedonia, physical fatigue, dysphoria, cognitive impairment, insomnia, etc. Patients who get a series of multiple infusions over several days often get symptomatic relief that lasts weeks.
But there’s more to it than that. When the physical symptoms are relieved, that can also trigger a dramatic improvement in mood. It can help patients feel healthy, function normally, and stop feeling negatively about themselves, sometimes for the first time in decades. Even if the physical symptoms begin to return, many patients find they can withstand them with more resilience than before, instead of retreating to the fetal position each time a new stress or obstacle arises. This improvement in mood and function can last longer than the physical symptom relief.
The number of patients using ketamine long-term is still very small, and long-term treatment regimens are still being developed.
In our practice we find that the effectiveness and duration of improvements for patients can be increased if ketamine is paired with psychotherapy.
The most commonly reported side effects include mild nausea, drowsiness, and a temporary increase in blood pressure. The Denovo staff will closely monitor your blood pressure and heart rate throughout the course of the infusion. During the treatment you may experience something called a dissociative effect. Most patients describe the experience with words like relaxing, floating, and pleasant. This “dream-like” state or euphoria feeling quickly subsides after the therapy is over, allowing you to leave with your driver after treatment is complete. Less common side effects include vivid dreams, mood swings, or agitation. If these types of side effects do occur, they are controlled by adjusting the dosage of ketamine.
Ketamine is typically well tolerated and we are not aware of any significant adverse reactions at the low dose used for this treatment. At the higher doses used in operating rooms, ketamine has been known to cause hallucinations, as well as other cognitive distortions. Use of ketamine by people with conditions such as unstable heart disease risk aggravating these conditions. It is of utmost importance that you fill out the medical questionnaire fully and truthfully, so we can properly evaluate whether you are medically appropriate for the treatment.
When ketamine is administered in a controlled medical setting by a properly trained provider using established methods, it is very safe. Ketamine is the only anesthetic that does not suppress the body’s cardiovascular and respiratory systems. It does have the potential to elevate heart rate and blood pressure, so the patient’s vitals must be monitored during treatment.
Using illegally-obtained ketamine on your own, without a doctor’s supervision, is a different matter. There’s no assurance the substance you’re taking is actually ketamine at all, or that it hasn’t been mixed with other substances. And since ketamine is an anesthetic capable of sedating patients during major surgery, you can seriously injure yourself while under its influence if you are not in a controlled medical setting. If you are contemplating taking “street” ketamine in hopes of relieving your depression, keep in mind that the antidepressant effect depends on it being administered in a very precise, controlled way that you cannot achieve in a recreational setting.