What should you expect during the infusion?
- Your initial infusion will be started at a low dose to see how you tolerate the medication. As long as you adjust well to the infusion we will continue to make adjustments at each infusion to bring you to the dose that gives you the most symptom relief. We use a set of questions before and after each infusion to help guide how we make adjustments. You will also have access to site call Mood Monitor, which you can access from home to help keep track of your progress. Always keep in contact with your referring physician and our Clinic should you have any changes that you find concerning. If any thoughts of suicide you should contact your physician, our facility or go immediately to the ER. There is help, never think you are alone. (National Suicide Prevention Lifeline 1-800-273-8255, suicidepreventionlifeline.org)
- Generally, we try to avoid benzodiazepines for anxiety prior to infusions, because some studies have suggested they can reduce the effectiveness of Ketamine. However, we will determine their use on a case by case basis. There are other alternatives we can use first should you need something extra to help you be relaxed and calm.
- The “dissociation phase” is thought to be a key phase in the Ketamine treatment protocol. For some patients, this is a pleasant experience where others find it scary. We are here to help. Whether that means we sit with you and help guide back to more positive thoughts or adjust the infusion.
- The mental health infusions generally last about 40 minutes with a short recovery period after.
- Pain infusions go over 4 hours and have a longer recovery time of about 30 to 40 minutes. We will also provide intravenous fluids while you receive this infusion to help with the after-effects and give you a bump in your body’s hydration.
- All patients receiving Ketamine must have a person to drive them home. This can not be any type of public transportation unless another friend or family member is with you.
- All Ketamine patients will receive anti-nausea medications prior to their infusion. Our goal is to prevent it rather than fight it after the fact.
- Most patients during their infusion are not able to walk, because of the effects of the Ketamine, so going to the bathroom is a challenge. We will have you use the restroom right before we start and as soon as you are able to ambulate. Some patients feel their not able to control holding it so they wear a Depends for their infusions. We recommend you do whatever makes you feel the most comfortable. Most of the fluid we will be giving will be at the end of the infusion while your recovering, to try to avoid having any issues.
Typical Effects of Ketamine Infusions
- Dissociation (disconnection with thoughts, memories, surroundings, and actions)
- Profound analgesia (reduction in pain)
- Vivid dreams (normal side effect)
- Hallucinations (normal side effect)
- Patients with severe coronary artery disease (All heart disease patients will require cardiac clearance prior to any Ketamine infusions. Ketamine does increase heart rate, blood pressure, and other cardiac functions during the infusion. Some patient’s heart health can not handle these changes and it is safer to not undertake these treatments in those cases.)
- Glaucoma patients (would require clearance by your ophthalmologist)
- Patients with elevated intracranial pressure
- Patients taking beta blockers with a history of congestive heart failure
- Patients with Wolff-Parkinson White (WPW) Syndrome
- Nausea and vomiting (medications can be given to counteract these effects). This is also part of the reason we require nothing by mouth for 6 to 8 hrs prior to infusions. (That includes: food, non-clear drinks, candy, chewing gum, or chewing tobacco). It is recommended to help reduce nausea to have a high clear carbohydrate drink prior to infusion. We will provide options and instructions for you. Diabetic patients, please let us know what diabetic medications you are taking so we can give you instructions on how to adjust your medications. The nausea can last during and several hours after infusion.
- Lightheadedness and dizziness can last a few hours to a few days after depending on the dose and number of infusions received.
- Increase in cerebral blood flow (not an issue with patients that have no issues with intracranial pressure)
- For high dose infusions, blurry vision or double vision can occur, which may last for several hours after.
- Mood swings and mild anxiety on and off for the first few days post-infusion, until the ketamine has a chance to work fully in the brain.
- Increase in heart rate and blood pressure during infusion (Usually resolves once infusion is complete. If you tend to have this occur medications can be given to prevent this from happening).
- Increase in saliva
- Nystagmus (involuntary movement of the eye)
- Hypertonus (muscle overactivity)
Rare and Very Rare Side Effects
- Patients that have used ketamine daily over a long period of time have reported getting Interstitial Cystitis. This is usually not seen with short term IV treatment plans. Always consult a urologist if these symptoms develop.
- Worsening anxiety or Bipolar symptoms (most common in those with Bipolar Disorder). Can cause worsening of mania symptoms in someone with mania. Ketamine should not be given to people with Schizophrenia or severe Bipolar Disorder that are prone to breaks from reality or hallucinations as there is a rare possibility that Ketamine can cause worsening of psychosis in those patients.
- Elevated liver enzymes can occur. (More likely to occur in patients who take Opiates, drink alcohol, use a lot of Tylenol, or have a fatty liver)
Frequently Asked Questions
How do you prepare before your infusions?
- A few days before, try to drink lots of water and eat higher protein meals and less junk food.
- Surround yourself with positive activities and people.
- Watching uplifting or happy programs on TV.
- You want to come into this thinking positive and believing this is going to work. If you start off doubting it will be effective then most likely it will not help you. We can be our own worst enemy sometimes.
- Make yourself a playlist of music that brings a smile to your face or happy memories. Bring earphones or earbuds so that you can listen while your treatment is going on. (We will also have earbuds in case you do not). This helps prevent unwanted stimulation during the infusion.
- Wear comfortable clothes, even bring a blanket or pillow that makes you feel more at home.
- Bring sunglasses for after in case your eyes are sensitive to light.
- Pick out a place in your mind that brings you joy. Use that image throughout your treatment to help you keep your thoughts positive.
Once infusion is complete how will I feel once I go home?
- Many patients will feel sleepy. It is important to go home and try to get some rest and don’t push yourself. Your body needs some time to recover.
- If you are hungry try eating a higher protein meal. Protein shakes are a great way to replace a meal and give you adequate fluid intake if you don’t feel like eating. Healthier foods are always going to make you feel better.
- If you are not steady on your feet plan for either a wheelchair or walker to be used after your infusion. Avoid stairs until you feel you have good balance.
- Some patients rebound very quickly after their infusions, those patients can go back to work the next day. The patients that do not rebound as fast may find they need to stay home while receiving infusions. Every patient experience is different and you will have to do what is best for your situation.
Will Ketamine alone help me?
- Ketamine is just one piece to the puzzle to try to complete your journey to feeling yourself again.
- Many patients coming to us will need time to wean off their current medications. Your referring physician will help you with that process, making sure to take things at a pace that is best suited for your situation. Abrupt stopping of medications can cause you serious harm. ALWAYS talk to your doctor first.
- Physical therapy helps aid patients increase their overall physical condition. Ketamine is just one part of the process of getting you back to the level you want to achieve. We can determine if that is right for you and help organize that treatment plan.
- Improving diet and nutrition truly helps your body feel better. We can give you some resources to help aid you in this process.
- Simple daily exercise like taking a walk for 30 minutes a day can make a huge impact not only physically but mentally as well.
- Helping you be you again is not just us giving you some treatments but also helping you find the tools to achieve your goal. We are just a small part of your journey to feeling better. You have to want to succeed and add in all the components that will help you obtain your end goal, and ensuring lasting results.
How many infusions will I have?
Each protocol is determined after our initial discussion with you and what your physician has sent to us regarding what they are treating you for. Generally, infusions for pain are every day for 5 consecutive days with the weekend as a break then another 5 consecutive days. Mental health infusions may vary. Some will be 6 infusions spread out over two weeks while others will be 10 infusions spread out over several weeks. Boosters will be discussed towards the end of your initial infusion plan. Initially, boosters will be more frequent to try to give you the best long term results.
How much do Infusions cost?
Mental health infusions are 400$ ( 40 min. session) each treatment and Pain are 810$( 4 hour session) per treatment. Some patients may not require the full duration of the pain infusion and will have a reduced rate depending on what they require. We will discuss all fees upfront when you have your initial free consultation.
What is needed from my physician prior to scheduling an appointment?
- Signed release of your medical record.
- Referral form from your Physician that has diagnosed your condition approving this treatment plan.
- Recent blood work and ECG.
- Patients may be required to have a cardiac clearance prior to infusions.
- Patients seeking mental health treatment will require a psychiatric clearance if not under the care of a mental health provider.
Does insurance cover Ketamine infusions?
Currently insurance does not cover Ketamine treatments in this setting. A super-bill will be provided to you to submit to your insurance. Payments are due at time of services. We accept Visa, MasterCard, Discover, and have patient financing available. We also accept HSA cards. All military will receive a 25% discount on all services provided.
Do we write prescriptions for medications?
We will not write prescriptions for narcotics or any other medication you receive from your other health care providers. If you are out of a medication you currently take, please call the prescribing provider for your refill.
How are we monitored during the infusions?
All patients are hooked to EKG, Blood Pressure, Pulse OX, respiratory rate and ETCo2 monitors throughout. One of our highly trained staff will continue to observe you while receiving your treatment.