Ketamine Infusion Centers
Get your life back! We are able to offer the most effective and innovative treatment for depression, particularly treatment-resistant depression.
Modern research has found that ketamine – an NMDA receptor antagonist can have a dramatic effect on depression.
Building on two decades of research on how antidepressants actually work, scientists now understand that antidepressants, such as the SSRI’s or SNRI’s do not work at the level of the serotonin receptor. Rather, these medications cause changes in pathways called “second messenger” pathways 46. One of the key second messenger pathways is mediated by the chemical glutamate, acting on a particular receptor called the NMDA receptor. This is where ketamine comes in. Ketamine, an anesthetic that has been in clinical use for many years, works very powerfully on the NMDA receptor 46. The NMDA receptor is involved in learning, memory, and plasticity of the brain. This glutamine receptor alters ion channels in brain cells and sets off a chain of secondary events, increasing brain growth factors and regenerative pathways. The result is a tremendous lifting of the depression in a great majority of cases. The relief of symptoms can begin almost immediately or over the next few hours.
Ketamine is a unique medication in the treatment of depression.
It is not an SSRI, SNRI or a MAOI. Ketamine can be safely combined with most medications, so patients do not have to stop their current medications to begin ketamine 45-48 .
Ketamine is administered intravenously. It is slowly delivered at a very low dose and the process of infusion usually takes about 40 minutes. Our infusion centers are very comfortable and you can relax, read or listen to music during the infusion. There are very few side effects with ketamine. Some patients may have mild visual hallucinations. Some patients may feel dizzy afterwards. Patients often notice an improvement during the infusion or within a few hours to days afterwards.
The effects of ketamine vary from individual to individual.
In general, patients feel relief of their symptoms for a few weeks. During this time, changes in their oral medications may provide ongoing relief. Alternatively, repeat infusions are often utilized in a maintenance program tailored to the individual patient’s symptom profile.
On average, patients receive four to six infusions.
And many of them have resolution of their depression.
Patients often note a cyclical pattern to their response to ketamine. They may feel complete symptom relief for a week or more. After that, they may note a gradual return of symptoms 47 , 48. Determining when to administer the next infusion will be made on an individual basis. Long-term, many patients notice an overall reduction in the severity of their depressive symptoms. That is to say, over a period of months, their depression is not as bad as it was when they first began ketamine treatments. Patients often report more depression-free days and less overall misery 48. One promising outcome is that a carefully crafted oral medication regimen may keep the depression at bay. Our Master Psychopharmacologist may be able to help in finding a longer lasting medication regimen.
Master Psychopharmacological Review:
While patients are welcome to continue their current medications, it is often helpful to participate in a comprehensive review by a psychiatrist with advanced understanding of the medications. A Master Psychopharmacologist understands the intricacies of the brain, the complex second messenger systems, and the interplay of different medications. A comprehensive psychiatric evaluation can reveal more effective medication strategies that can stabilize the improvements that ketamine can trigger. Thus, over time, a patient may find that they are no longer depressed and repeat ketamine therapy is no longer needed.
Please feel free to give us a call if you have any questions
Click here for references
45. Diazgranados N, Ibrahim L, Brutsche NE, Newberg A, Kronstein P, Khalife S, Kammerer WA, Quezado Z, Luckenbaugh DA, Salvadore G, Machado-Vieira R, Manji HK, Zarate CA Jr. A randomized add-on trial of an N-methyl-D-aspartate antagonist in treatment-resistant bipolar depression. Arch Gen Psychiatry. 2010 Aug;67(8):793-802.
46. Mathew SJ, Keegan K, Smith L. Glutamate modulators as novel interventions for mood disorders. Rev Bras Psiquiatr. 2005 Sep;27(3):243-8.
47. Rasmussen KG, Lineberry TW, Galardy CW, Kung S, Lapid MI, Palmer BA, Ritter MJ, Schak KM, Sola CL, Hanson AJ, Frye MA. Serial infusions of low-dose ketamine for major depression. J Psychopharmacol. 2013 Feb 20.
48. Murrough JW, Perez AM, Pillemer S, Stern J, Parides MK, Aan Het Rot M, Collins KA, Mathew SJ, Charney DS, Iosifescu DV. Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions in Treatment-Resistant Major Depression. Biol Psychiatry. 2012 Jul 26.