What is Ketamine?

What should I expect during a ketamine treatment?

Our nurse will start an IV in your arm and give you an amount of ketamine determined by Dr. Fleming based on your body weight. This is not enough to put you to sleep and you will remain awake. Most people feel a pleasant floating sensation but others feel something odd like an “out of body experience.” This experience will likely be somewhat different for you during each of the sessions. It is the whole series of sessions that lead to improvement, not the experience during the session. Once the 40 minute infusion is complete, the immediate effects of ketamine end rather rapidly. There are not usually any delayed “flashbacks” and patients are usually able to travel with 15 to 30 minutes following the end of the IV infusion session. Please remember you may not drive even if you do feel normal after therapy.

Each ketamine treatment session lasts about 40 minutes in a comfortable treatment room accompanied by a skilled RN who will monitor your condition and help you throughout the treatment. Please be sure you fill out and bring the forms on the Forms page to your first session.

You do not need to have someone accompany you during the infusion, but we do require that someone drive you home. We advise you not to drive a car or make important decisions until the following morning.
Occasionally patients experience some nausea following an infusion. If so, we have medication that will help. More rarely, a patient may experience a transient headache. Patients can expect to be tired following the infusion. Very, very rarely patients already at risk for seizure have reportedly experienced one. If you have a seizure disorder please be sure to share that information with Dr. Fleming prior to your therapy.

Please do not eat during the last four hours before your ketamine treatment. Also, continue to drink fluids and hydrate yourself up til one hour before your treatment.

Following the initial series of infusions, most patients will work with Dr. Fleming to begin a maintenance program; returning for single infusions intermittently. The interval between maintenance infusions varies from patient to patient.
Because ketamine therapy for mood and anxiety disorders is recent and still viewed as experimental, insurance companies do not provide reimbursement.

Ketamine FAQs

What most have not heard about ketamine is the extensive studies about its rapid impact on depression and anxiety. The dosing of ketamine is critical. When used for treatment it is given in 1/10 to 1/20th the dose for anesthesia and is given slowly over 40 minutes rather than over 1 to 10 seconds.

If you are not currently a patient of Dr. Fleming’s, he will meet with you to discuss your diagnosis and treatment prior to coordinating treatment. Patients who are already seeing Dr. Fleming will work with him to determine readiness.

A meta-analysis by the American Psychiatric Association using data from multiple ketamine trials reported 70% of treatment-resistant patients responding positively after receiving the initial round of low-dose infusions.

Occasionally patients experience some nausea following an infusion. If so, we have medication that will help. More rarely, a patient may experience a transient headache. Patients can expect to be tired following the infusion. Very, very rarely patients already at risk for seizure have reportedly experienced one. If you have a seizure disorder please be sure to share that information with Dr. Fleming prior to your therapy.

Some patients will begin to feel better within hours of the first infusion. Suicidal thoughts are often reduced rather rapidly. There can be a dramatic relief of dread and hopelessness. Other patients may not notice any mood improvement until the next day. Some patients will require a second (or even a third) infusion before feeling better.

That will depend on your response. Most responsive patients receive a series of six infusions over two weeks, although some may require more. Dr. Fleming will work with you to customize your treatment plan for the best chance of success.

These are very few. Your Neuragain provider will discuss contraindications with you before you receive your first infusion.

Antidepressant medications (SSRIs, MAOIs, and tricyclics) do not interfere with ketamine, and there is no need to stop them. Patients taking large doses of benzodiazepines (Ativan, Xanax, and Klonipin) will have a reduced response to ketamine, but taking these medicines does not mean that ketamine cannot help you. Lamictal in doses over 100mg/day will blunt the ketamine response. Important: You should not decrease or stop taking any prescribed medication without first consulting your prescribing physician.

Probably not. Some patients seem to achieve long-term relief after a series of infusions. Unlike other clinics who push every other week or once a month repeat ketamine treatments, we personalize our approach and offer repeat ketamine only if and when it is needed and we actively explore with you other alternatives to repeat ketamine which may be more helpful than simply continuing in ketamine use.
Traditional medications often produce side effects such as sexual dysfunction and weight gain. However, ketamine therapy from Neuragain results in no known long-term side effects.
Hypomania has not been reported following ketamine therapy.
Dr. Fleming is a Neuragain specialist. All treatments are performed on an outpatient basis in his relaxing and comfortable location.

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