FREQUENTLY ASKED

Questions

What is Ketamine?

During the Vietnam War, ketamine was the most widely used battlefield anesthetic because of its rapid onset, minimal negative respiratory side effects, and potent analgesic properties. It also allows the ability to maintain cardiovascular stability in trauma patients.

Ketamine was originally introduced as a dissociative anesthetic and painkiller in the 1960s, used most frequently on battlefields and in acute emergency situations. Since then, it has been added to the World Health Organization’s list of essential medicines because of its wide range of pain management and sedation applications.

In the early part of this century, researchers discovered the antidepressant effects of ketamine. Study after study has continued to reinforce the effectiveness of ketamine as an antidepressant, proving that ketamine works to repair damaged neural connections and promote the development of new, healthy neural connections.

In 1974, ketamine began to be used as an adjunct to antidepressant psychotherapies in Argentina, and in the 1990s its antidepressant effects began to be studied in the US. Ketamine is rapid acting, has a short duration or action, a high lipid solubility, and can be given via multiple routes – intravenous, intramuscular, intranasal, sublingual and orally.

Peak plasma concentrations of ketamine occur within 1 minute after intravenous (IV) administration, 5-15 minutes following intramuscular (IM) injection, 5-10 minutes when given intranasally, and within 30 minutes of oral administration (Wolfson, 2016)

Today, ketamine infusion therapy in Palm Beach County & Palm Beach Gardens is known as one of the most effective treatments available to those suffering from severe depression, anxiety, PTSD, bipolar disorder and other psychiatric conditions. Ketamine also helps those who suffer from chronic pain and neuropathic pain. There are now studies showing that it helps those with certain kinds of cancer pain.

Is Ketamine safe?

In the hands of a qualified clinician, ketamine infusion therapy is very safe. It has been used as an anesthetic and painkiller since the 1960s, and has been offered by private ketamine clinics for the treatment of depression for many years. When administered by a trained professional, ketamine infusion therapy is highly effective for the treatment of psychiatric conditions and pain.

Ketamine was synthesized more than 50 years ago and has been in use since 1970. There is currently a lot of information, data, patient response, and results that show the safety and efficacy of Ketamine Therapy.

Compared to traditional antidepressants, ketamine has been used on a much larger population for a much longer period of time with successful outcomes and without any apparent long-term side effects. The nurse practitioner, clinical psychologist, and doctor oversee the process, as well as work on the treatment plan that best works for you.

We understand that trying a new treatment can be scary.  To offset these fears we would utilize the medications and medical machines available if an emergency occurred. Currently, all the side effects from ketamine can be easily treated.  

Receiving ketamine intravenously is the only method of administration that has been clinically proven to be effective, thus being the only current method we use at Allay. If there are any undesired side effects, we have an IV established at our facility, which can quickly administer medicine to manage nausea, or anxiety – it begins working within 1 minute.

If there are any adverse side effects, we can stop the infusion immediately. IV allow us to provide crucial continuity of care.  We know exactly how much medicine you received down to the microgram. We can ensure that you receive less, or more at your next infusion depending on the response. The medicine is felt very quickly, usually within 5 minutes of the IV starting, and it dissipates usually within 15-20 minutes.  

Of course, like many other medications that offer immense benefits to suffering patients, ketamine can be abused if it finds its way into the wrong hands. Our ketamine clinic does not offer take-home doses of ketamine – we only administer ketamine infusion therapy in a closely-monitored clinical setting, thereby dramatically reducing the risk of abuse. Here, at Allay Health & Wellness, we have a team of medical professionals that will be monitoring you throughout and walking you through what will be taking place.

How is Ketamine administered?

The most effective way to administer ketamine is intravenously. IV ketamine infusions trigger the best biological response, as the medication can be delivered at a slow and precise rate and 100% of the medication ultimately reaches the bloodstream and brain. Also, IV ketamine is administered in a clinical setting under close supervision from qualified doctors and nurses. This prevents ketamine from getting into the wrong hands where it could be abused recreationally.

At Allay Health & Wellness, Ketamine can also be administered intramuscularly, intranasally, orally, or sublingually. However, these routes of administration can be unpredictable, as the amount of ketamine that actually reaches the brain and bloodstream varies from patient to patient. This can result in undesirable side effects, and potentially less effective relief of depressive symptoms. Our specialists will work with you to establish what means of administration will be best suited to your needs.

What are side effects of Ketamine infusion?

The side effects of ketamine infusions are generally mild and short-lived, subsiding about 2-hours post-infusion. Side effects include nausea, dissociation and mild, non-threatening hallucinations. Our ketamine clinic can supplement your ketamine infusion with an anti-nausea medication if you experience nausea during your infusion. Someone will be in the room with you walking you through the experience and providing support so that you do not feel alone.

Once you’ve submitted your patient intake forms, we will schedule an initial consultation to discuss your unique needs and determine the proper ketamine infusion treatment plan for you. If we believe that you are a good candidate for ketamine infusions, we will go ahead and schedule your first appointment—oftentimes for the same day.

On the Scheduled day we do a physical and health assessment and we obtain as much information as possible and we check your vitals. We make sure to have a full medical history to ensure that this is the right treatment for you. You will have someone personally walking you through the process and sitting with you to make sure you are comfortable and able to get the most out of the infusion. We understand that some individuals struggle with anxiety and depression that can cripple their ability to function with simple day to day tasks and we provide a safe environment for whatever you struggle with. On your second visit you get to have the infusion and it is followed up with talking to a therapist to make sure you have are comfortable with your treatment plan and your experience.  

On the day of your infusion, please refrain from eating solid foods, milk, pulp-filled juices or soup for at least six hours prior to your appointment. You may enjoy water and other clear liquids, Gatorade, apple juice, black coffee or tea up to two hours prior to your appointment.

For ketamine infusions for depression, plan to be at our clinic for about 2-hours. For chronic pain infusions, plan to be at our clinic for one hour longer than your scheduled infusion time.

At the start of your infusion, we will apply monitors and set an IV. Once we begin the ketamine infusion, you will be awake and able to interact with others, though most patients choose to relax and listen to music. During your infusion, you may experience mild side effects, such as dizziness, subtle and non-threatening hallucinations, or nausea. We are equipped to supplement your infusion with an anti-nausea medication should you need it.

After your infusion, we will monitor you for about 30-minutes, and then release you into the care of a friend or family member who can drive you home. Though the side effects of ketamine infusions generally wear off within 2-hours, we do ask that you please not drive for 24-hours.

How many Ketamine infusions will I need?

Each patient varies in regards to how many ketamine infusions he or she needs to effectively treat depressive or pain symptoms. In general, we recommend 4-6 infusions over the course of 2-weeks, with maintenance infusions on an as needed basis moving forward. Studies have shown that serial infusions are the most effective way to depression and other psychiatric disorders. A similar ketamine infusion treatment plan in recommended for chronic pain patients, though each patient will require a unique protocol depending on his or her needs.

Does insurance cover Ketamine Infusions?

With regard to insurance, the limitation is that ketamine therapy has not been approved by the FDA. The use of ketamine for treating major depressive disorders is currently off-label and off-patent.  Some of the underlying reasons for ketamine therapy not being covered could be that pharma companies do not want to accept ketamine as a credible treatment for a multitude of disorders. Just because insurance companies are not covering it at this time does not mean that it shouldn’t be used as a treatment.  We currently offer financing options and payment plans. We encourage you to do your own research and see if you can find others who have tried this treatment.

Can I continue taking my other medication?

You should never discontinue the use of any medication without first consulting your primary care physician. Before we make your first ketamine infusion appointment, we will review your list of current medications and ensure there are no contraindications.

Is the medical staff in-room?

At Allay Health & Wellness there is a licensed medical professional present, who is BLS (Basic Life Support) certified and ACLS (Advanced Cardiac Life Support) certified.  We have a medical professional in the room with you throughout your first session and after your first session you have the ability to choose if you would like a medical professional in the room with you.  Due to us having a central monitor system we are able to know everything that is going on without being physically present in the room. However, we do make sure to do a check up every 15 minutes.

Do I need a prescription?

Yes, the prescription is needed. We provide a writing order on site. We do a full comprehensive health and physical that encompasses a complete check of your vitals.  We have a central monitoring system that allows us to have access to your vitals as the infusion is taking place. Because we provide the ketamine intravenously, we have the ability to slow it down and stop the infusion right away. We encourage you to speak to your primary care doctor before coming in.  We work with any of your current providers to make sure we are providing the highest level of care.  

Does it hurt?

Because we infuse the ketamine through an IV we use the smallest gauge needle and we freeze the area that we will put the infusion in. Our medical team has over 30 years’ experience using IV’s, so no one has been hurt by the infusion process. 

How do I get approved for treatment?

Our ketamine infusion in Palm Beach County, including Palm Beach Gardens comes with a free consultation on the phone, or in person. We want to gather as much information about you as possible to see if you qualify to get the full health and physical exam. During the health and physical you will also go through a depression, anxiety, PTSD, and chronic pain assessment.  If approved, then we schedule a date and time for you to start the treatment, if the day of your health and physical does not work. 

Multiple infusion vs Single infusion

Early research conducted was based around a single infusion.  Some of the limitations associated with a single infusion, include that most patients do not respond to treatment until their 2nd infusion.  Another limitation is that the positive results are to last an average of 7-10 days.  This caused many people to say “it works but does not last.” Because of this we offer a series of 3 to 6 infusion over a 2-3-week period followed with a treatment plan to determine what is the best course of action for you.  We continue to do follow-ups with you throughout the week of your first infusions to assess what your needs are. Additionally, before each infusion you go through the psychological assessments and an updated health and physical. 

Is Ketamine a horse tranquilizer?

Ketamine, like many other valuable medications, has many uses. One of those uses is as a veterinary anesthetic. Again, these medications are used in a much different manner than they are when administered to humans for the treatment of depression or chronic pain.

Is Ketamine addictive?

Like many other medications, ketamine can be abused for recreational use. When used recreationally, it is used in doses much higher than anything we would administer at our ketamine clinic. Contrary to popular belief, ketamine is not a physically addictive substance. When abused recreationally, it can become psychologically addicting.

Our clinic for ketamine therapy in Palm Beach County/Palm Beach Gardens only administers ketamine in a clinical setting under constant supervision. Ketamine is not provided to patients as a take-home medication or prescription. This reduces the risk of ketamine making it into the wrong hands.

References:

Wolfson, P., & Hartelius, G. (2016). The Ketamine Papers Science, Therapy, and Transformation