Ketamine infusion therapy

Ketamine infusion therapy


You may have heard of ketamine infusion therapy for chronic pain disorders, depression, PTSD, and other mood disorders. Ketamine is not a new drug; it historically has been used as an anesthetic and hypnotic agent, often used in combination with other anesthetic drugs, or even by itself for sedation in the emergency room for quick procedures. Recently, ketamine is giving hope to patients suffering from a variety of mood disorders and chronic pain syndromes as many patients receive significant, long lasting improvement with little to no side effects unlike other current therapies and medications. Ketamine works by antagonizing (blocking) NMDA receptors in the brain which modifies the levels of glutamate. At higher doses, patients experience a dissociative state which means they are unaware of their surroundings and don’t experience pain. The advantage of ketamine is that it has very little effect on a person’s breathing, whereas many sedatives and anesthetic agents can inhibit natural breathing. At lower doses, patients retain consciousness but can experience pain relief, relaxation, and changes in mood and insight. This is the target for waves of new research and treatment for depression, PTSD, and chronic pain with exciting and promising results. Ketamine is very safe at these low doses and side effects are minimal. Occasionally a patient may experience drowsiness, dizziness, nausea, and sometimes increases in heart rate or blood pressure. You may receive an additional sedative agent to help minimize these side effects. Your doctor will modify the infusion rate or dose, or stop the infusion, if you experience any significant side effects.

What makes our clinic different? Dr. Bishai is a pain specialist who has been treating patients for a variety of pain disorders for many years and believes in a comprehensive treatment program that goes beyond just prescribing narcotics. He is an expert in leading pain procedures such as spine injections and spinal cord stimulators. Dr. Bishai has teamed up with a dedicated group of board certified anesthesiologists experienced in the use of ketamine as an adjunct to anesthesia who follow current literature and updates to ketamine infusion therapy. You will have a board certified anesthesiologist overseeing your infusion, as opposed to other infusion clinics where physicians may not be present. Should you experience any unusual side effects or have questions, the doctor is present and available to immediately evaluate you and decide the next best step. We believe that our team is equipped to offer the best experience to our patients in the safest way possible.

Ketamine used for the treatment of these conditions is considered an off-label use by the FDA. What does this mean? Simply that the FDA has not formally approved ketamine for this use. Ketamine is an older drug formulated in the 1960s, and the pharmaceutical research and studies required to get medications approved costs millions of dollars. However, there is a plethora of research and studies to support the use of ketamine (see below links for more information). You can also perform your own simple web search as well, just search for “ketamine and depression” or “ketamine and chronic pain” for a wealth of resources for specific studies and evidence supporting ketamine therapy.

Contact us today to discuss if ketamine infusion therapy is an appropriate option for you. We do not need referrals from your doctor; however we advocate comprehensive care and discussing ketamine therapy with your doctor as part of a whole treatment program. Do not stop current medications without first discussing with your doctor as many medications can be unsafe if stopped abruptly.

FOR CHRONIC PAIN

For those suffering from chronic pain disorders, constant stimulation of pain pathways leads to hypersensitization, a ramping up of pain pathways and exaggerated, difficult to control pain. Current treatment options often include potent opioids (narcotics) which can many adverse effects and can lead to addiction and the need for increasing doses. Ketamine infusion has been shown to be effective for a variety of conditions including:

  • Migraines

  • Chronic back pain

  • Chronic regional pain syndrome

  • Irritable bowel disease

  • Fibromyalgia

  • Neuropathic pain

  • and others

Ketamine infusions for chronic pain are typically higher than for depression which requires a longer infusion time to minimize side effects. Infusions for chronic pain conditions are customized to each patient as each person’s response may be different; some require longer and more frequent infusions than others. Talk to us to see what options we can offer you.

FOR DEPRESSION AND MOOD DISORDERS

For patients suffering from depression, mood disorders, or PTSD, ketamine is giving hope and often dramatic improvement in quality of life and functionality to patients. Traditional antidepressant medication in the form of pills can take several weeks to take effect, require several weeks to taper off if they need to be discontinued, as well as sometimes causing undesirable side effects. A series of low dose ketamine infusions has been documented to have significant improvement in 70% or more of patients with severe depression and even suicidal thoughts. A serious of 4 to 6 infusions over 2 to 3 weeks is recommended to start. Those who respond positively typically notice improvement within the first 1 or 2 infusions. Maintenance infusions are administered as needed based on the patient’s symptoms.

More References

https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.12094
http://www.ketamineadvocacynetwork.org/
https://www.nimh.nih.gov/about/strategic-planning-reports/highlights/highlight-ketamine-a-new-and-faster-path-to-treating-depression.shtml
https://www.youtube.com/watch?v=yDd7JzBPgaY&list=PLZip3anpBh1iKIDzcx3QFQ_IaGIINpxfo&index=8
https://www.ncbi.nlm.nih.gov/pubmed/25698228

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