What is Treatment Resistant Depression?

Treatment-resistant depression is a term used in clinical psychiatry to describe cases of major depressive disorder (MDD) that do not respond adequately to appropriate courses of at least two antidepressants.

If you have been treated with at least (2) or more classes antidepressants with no results, you may have a form Treatment-Resistant Depression.

What is Ketamine?

Ketamine was first developed in 1962. Since its development, Ketamine has been primarily used to induce and maintain anesthesia during surgery in children, adults and animals. The first clinic study of ketamine use for depression was published 15 years ago. Since, Ketamine has been shown to be highly effective in treatment resistant depression and anxiety disorders.

Is there a potential for addiction with Ketamine treatment?

Historically, Ketamine has been termed a “party drug” creating worry about possible addiction. Studies and clinical trials have determined no potential for addiction or abuse due to the low doses used, clinic setting of delivery, no access outside of the clinic setting, and intermittent dosing.

How does Ketamine work?

Ketamine is completely different from SSRIs, SNRIs, Tricyclic antidepressents, MOAI inhibitors, Benzodiazapines, or any other antidepressant/anti-anxiety medication.  The exact mechanism that causes ketamine to relieve depression is quite complex. In short, stress, anxiety, depression, and pain cause damage and degeneration to certain cells within the brain called neurons. This damage shrinks the size of the neurons therefore decreasing communication between different parts of the brain. This damage can render the patient unable to heal without intervention. Ketamine is able to promote healing of damaged cells of the brain, resulting in repair of neurons and alleviation of symptoms within hours of treatment.

Are there any pre-existing conditions that make ketamine dangerous or ineffective?

Uncontrolled/untreated high blood pressure, illegal substance abuse, untreated thyroid disease, unstable heart disease, mania, or active psychosis. These conditions and past medical history will be discussed with our physician/staff prior to treatment to ensure patient safety.

Are there any risks?

The dose of ketamine used during each treatment for depression and anxiety is minuscule (a tenth of the dose used for sedation in the emergency room) and safe. During the active infusion there is a chance of a transient rise in blood pressure and heart rate, however vital signs are monitored before, during and after treatment to ensure patient safety.

What can I expect during my visit for ketamine infusion?

The medication is given intravenously while you are in a reclining chair in a relaxed private environment. The medicine is slowly infused over approximately 40 minutes. Historically, patients have described the first 15-20 minutes of infusion as uneventful with no noticeable effects. The second half of the infusion is when you may notice some effects such as blurry vision, a feeling of “floating” or feeling “light”, a feeling of being disconnected or dreaming, heightened perceptions of color, noise, or sounds, or a feeling described by previous patient’s as “weird, interesting, squishy”. Towards the end of the infusion you make experience nausea, headache and perspiration, though these effects are not common. All of these feelings start to subside approximately 10-15 minutes after infusion is complete. The remainder of the session will be a time period of recovery lasting approximately 30-45 minutes. Most patient’s can plan to be with use a total of 90 minutes though each session length is dependent on individual patient needs. We require you have a trusted friend or family member available immediately after treatment for transport.

Will I be awake and alert?

Yes. The ketamine treatment will not put you to sleep. If you arrive in a tired state or sleepy you may dose off for a short nap, but will arouse easily. You will be able to move freely in your room during the infusion.

What should I do during the treatment?

Patients are encouraged to bring their own music to each appointment or listen to provided relaxing sounds through speakers or headphones to create a relaxing environment. You may also want to bring a pair of sunglasses or shades as lights can seem brighter than usual. You will be monitored by licensed staff during your infusion. You are encouraged to direct your own experience. If you would like to talk we will be there to listen and guide you, however if you desire to remain quiet that is also acceptable. It is important to remember you may feel “weird” during this treatment and to accept ahead of time this is ok and you will leave feeling better than when you arrived.

How should I expect to feel after the treatment? How do I know if it worked?

Prior to treatment and approximately 24 hours after the first treatment, and each additional treatment, you will fill out specific depression and anxiety scales to help us determine your response to treatment. Some patient’s have noticed positive effects in as little as 40 minutes after the initial infusion, however most improvement starts 2-4 hours later, but can be up to 24 hours following treatment. When the treatment is finished you should not expect to feel as if everything is fixed but there should be noticeable improvement in feeling more hopeful, lifting of the depression, less sad, increased desire to engage in activities and with people. More noticeable improvements are expected to be seen throughout the course of your treatment.

What is the usual course of treatment? How long will results last?

The improvements in your depressive symptoms are most often subtle and gradual. Typically, after several hours you will begin to notice an improvement in your mood and/or outlook.  If you are experiencing positive results, we recommend a series of 6 total infusions over a period of two weeks. Following these two weeks we will develop a treatment plan for each individual patient regarding maintenance infusions. Every patient is unique, therefore no treatment plan will be the same. Your referring practitioner will receive a treatment summary from us following each treatment as well to ensure continuity of care with your primary mental health specialist/physician.

A single infusion can last anywhere from days to 1-2 weeks. A series of 6 infusions can last from weeks to months, with maintenance doses restoring response when effects are wearing off. Each patient is different with responses varying. Find out if you're a candidate for ketamine infusion therapy today.

 

Cancellation Policy?

Cancellations must be made  48 hours prior to scheduled appointment to avoid a charge