Chronic pain states result in nervous system hyper-reactivity known as central sensitization. Activation of N-methyl-D-aspartate (NMDA) receptors, residing in the nervous system, are considered the main culprit involved with central sensitization and potentiation of chronic pain conditions. Ketamine exerts its primary effect by blocking the NMDA receptor and as such “resets the nervous system.” Ketamine also acts on a multitude of other non-NMDA pathways that play integral roles in pain and mood regulation.
Traditional opioid treatments for chronic pain are poor long-term solutions and come with many unwanted side effects. Ketamine allows for a re-networking of the nervous system and over time can decrease reliance on opioids and allow for a more substantial pain relief. Ketamine infusions are just one component of treating chronic pain conditions and continued care with primary treating physicians is recommended in order to optimize your treatments.
In addition, the emotional toll of suffering from a chronic pain condition can exacerbate pain. The mind-body aspect of pain should be addressed and continued care with a mental health provider is recommended. As a primary psychiatric clinic, Ketamine for Life is able to offer primary management with one of our trained professionals or community referrals can also be provided.
Yes and no. We are “in network” with most insurance plans and can bill any required psychiatric evaluations and assessments directly to the insurance companies. However, because ketamine infusions for depression is a non-FDA approved indication, the insurance companies view it as investigational and/or experimental and will not cover this treatment.
There is no significant difference in the outcome between IV and IM ketamine administration methods. There are several differences that may make patients choose one over the other. The differences are discussed during the consultation.
Primary psychiatric services are offered by Dr. Jake Hollingsworth and by Physician Assistants, Desanne Gonsalves and Robert Bennett. In addition we offer transcranial magnetic stimulation (TMS) and theta burst stimulation (TBS). Learn more about our other services at our sister website: http://www.pacificpsychandanesthesia.com
Contact the Ketamine For Life clinic to arrange an appointment for a consultation. You will spend approximately 1 hour with the provider discussing your situation, your medical history, the risks, benefits, and alternatives associated with ketamine.
Our office staff can discuss very basic information and guidelines over the phone, so to really find out whether or not you are an appropriate candidate for ketamine, you need to discuss your unique situation during the consultation.
An initial 6 treatments over the course of 2-3 weeks are recommended for treating depression and other psychiatric conditions. If the symptoms are successfully controlled with these initial treatments, then follow-up evaluations will be conducted to determine long-term treatment plans. Follow up treatment usually consist of 1 treatment every 3-6 weeks. Deviations from the protocol are done on a case-by-case basis.
For the pain protocol, in a patient who has never received ketamine treatment before, we recommend an initial series of three two-hour infusions (for a total of 6 hours), over a 1-3 week period. A 2-hour maintenance infusion is then recommended every 3-6weeks. Again treatment plans are individualized to each patient and deviations are done on a case-by case basis.
Very few medical and psychiatric conditions make ketamine infusion treatments contraindicated. History of schizophrenia, ongoing drug and alcohol misuse/abuse, uncontrolled blood pressure, glaucoma, and previous allergic reactions to ketamine will exclude people from being candidates for ketamine infusions.
Note regarding blood pressure: The most common medical condition that prevents and/or interferes with ketamine treatments is uncontrolled hypertension, therefore it is encouraged for patients considering ketamine treatments to ensure their blood pressure is well controlled. They should consult their primary care physician if there is any question regarding the status of their blood pressure. Ketamine infusions can not be administered to persons with abnormal blood pressure on the day of the treatment. Our protocols regarding blood pressure are very strict.
It is highly unlikely. There is no evidence of any increased risk for abuse of ketamine in patients that have been treated for psychiatric conditions or chronic pain with IV ketamine infusions.
No. Patients may refer themselves, but it is required that patients have a consultation at Ketamine For Life prior to receiving ketamine treatments even if they have had ketamine treatments done at another physician’s office.
Depression, OCD, and PTSD are the main psychiatric indications which benefit from ketamine, although other psychiatric indications can be discussed on a case-by-case basis.
As for pain indications, ketamine infusions tend to work best for those with chronic pain conditions that are refractory to opioid therapy such as chronic regional pain syndrome (CRPS), fibromyalgia, and others.
Research shows roughly 70% of people respond successfully to ketamine treatments.
You are not allowed to drive until the morning following your appointment, and you should avoid illegal drugs and alcohol for 24 hours as well. You will need to arrange for transportation home from the clinic following the treatment.