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What Is It?
AN EFFECTIVE, FAST-ACTING THERAPY FOR TREATMENT-RESISTANT CONDITIONS
Developed in 1963 by researchers from Wayne State University as an anesthetic and analgesic agent, ketamine is one of the most widely used drugs in modern medicine. It was FDA approved in 1970 and has been used safely in surgical settings, including pediatric surgery, as well as in managing acute and chronic pain conditions.
In 2000, scientists from Yale University published a landmark study which found that ketamine can produce rapid, though short-lived, improvements in mood for those with treatment-resistant depression. In as quickly as a few hours, some patients report feeling energized, more engaged with life, and better able to cope with everyday tasks and decisions. Although a course of ketamine typically produces effects that only last for a few months, its efficacy is impressive. Repeated infusions have shown to have a cumulative effect, prolonging mood improvements.
Ketamine therapy has been hailed in Science magazine as the “biggest breakthrough in depression research in a half century” and has provided much-needed, fast-acting relief to those with chronic, treatment-resistant mental health conditions, including unipolar and bipolar depression, anxiety, alcoholism, substance dependencies, PTSD, OCD, suicidal thoughts and tendencies, and several other psychiatric diagnoses.
Leading medical centers including the Mayo Clinic, Yale University, and Kaiser Permanente have launched ketamine clinics, and numerous private practices continue to spring up around the country.
Nearly 70% of patients respond positively to ketamine and more than 75 studies have been completed to demonstrate that it is both safe and effective. Researchers continue to study ketamine’s mechanisms and long-term effects, as well as refine formulation for the most effective treatments.
Is Ketamine Right For Me?
Ketamine can be incredibly effective for those with depression, anxiety, OCD, and PTSD who have not responded to conventional treatments. Very often, our patients have tried various forms of talk therapy and multiple antidepressants without sufficient response.
Because Ketamine is so fast-acting, often within hours or as soon as minutes, it can also be particularly helpful for those with suicidal thoughts or ideation. If you have suffered with a treatment-resistant mental health condition, we encourage you to explore ketamine as a therapy option.
Before beginning any course of treatment, our team will conduct a thorough interview to determine if you are a good candidate. We will review your medical history and records, including current medications, and administer brief psychological tests. We will also discuss potential side effects, as well as the dissociative feelings that may occur during treatment.
Patients are ineligible for Ketamine Therapy if they are:
- Pregnant or nursing mothers
- Diagnosed with a dissociative or psychotic disorder
- Currently in a manic or mixed episode
- Have other medical conditions, including uncontrolled hypertension
- Currently taking anti-anxiety medications, opiates, or marijuana
How Does Ketamine Work?
Ketamine regulates the flow of neurotransmitters in the brain to not only improve mood but stimulates neural growth within days, and sometimes hours.
Stress floods the brain with a neurotransmitter called glutamate. Glutamate is generally acknowledged as the most important transmitter for good brain functioning. However, an excess of glutamate can damage the networks of neurons that facilitate normal functioning and can lead to feelings of depression and anxiety. Over time, chronic stress can cause whole areas of the brain to be shrunken and underactive; including the hippocampus and the prefrontal cortex, which regulate mood and impulse control. Meanwhile, neural networks in the amygdala, which governs fear and anxiety, experience growth. Together these mechanisms reinforce a cycle of depressive thinking.
Our present understanding of ketamine’s mode of action is that it blocks N-methyl-D-aspartate (NMDA), a receptor in the brain activated by glutamate. Ketamine thus reduces the flow of glutamate to a manageable level and helps “reboot” the brain. Neural connections that regulate mood and help us cope seem to grow back within days.
However, there is no current standard on mode of action, and other mechanisms may be found central to ketamine’s effects. Scientists continue to research ketamine’s properties, and explore other formulations to improve delivery, efficacy, and durability.
How Is It Delivered?
Ketamine Infusion Therapy (KIT): Treatment Program
We have been providing and perfecting KIT in New York since 2017, making Lenox Hill Mind Care one of the first and most experienced providers in the country. We also offer a standalone Ketamine Infusion Program (KIP) which does not include psychotherapy. Our clinic staff will be happy to discuss your options to determine which program is right for you.
To ensure that you receive sufficient ketamine to activate and maintain a positive response, we ask that you commit to 6 infusions over 2-3 weeks. Additional sessions may be recommended if deemed appropriate and beneficial however you may withdraw from our treatment at any time, for any reason.
Step 1: Intake Session
You will meet with a member of our intake team to review your current and past symptoms, previous treatment attempts, and relevant life history. We will also answer any further questions about ketamine and ensure that it is the right treatment for you at this time.
Step 2: Infusion Sessions
On the day of your infusion, please follow directions given by the medical staff regarding food and medication intake and arrange for a driver to escort you home after the session.
Once in the infusion room, you will be seated in a comfortable recliner and the RN will take your vital signs. You will be offered an eye mask and headphones to facilitate and enhance the experience, and help you maintain an internal focus. Your therapist will be present for support and to guide you through relaxation exercises or an invocation, if desired.
When you’re ready, the RN will perform the infusion intravenously. Throughout the session, the RN will be present to monitor blood pressure and take frequent pulse measurements. During the infusion, we recommend that you speak as little as possible, to maintain focus on the experience.
At this dosage, you will remain conscious and responsive to your surroundings We make every effort to maintain a quiet and tranquil environment to ensure you are not disturbed during this process. You may feel a sense of disconnection or drowsiness, though most find these feelings to be pleasant.
The infusion typically takes 40-45 minutes to complete. Please allow for an additional 10-20 minutes for post-treatment relaxation and recovery time.
Step 3: Post-program Follow-up
After you have completed the six-session course of therapy, we will follow up with your treatment team to assess your progress. If necessary, we will schedule another round of therapy or occasional booster infusions as symptoms persist.
Esketamine Nasal Spray (Spravato)
This therapy option is coming soon! Please contact our clinic for more information or bookmark this page.