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- What is Ketamine Infusion Therapy?
- Ketamine IV Infusion Therapy Process
- Pros & Cons of Ketamine IV Therapy
- When is IV Ketamine Infusion Therapy Right for You?
- Cost & Insurance Coverage for Ketamine IV Therapy
- Success Rates, Goals & Outlook of IV Ketamine Therapy
What is Ketamine Infusion Therapy?
Ketamine infusion therapy is an outpatient treatment that involves one or several intravenous infusions to treat psychiatric conditions such as major depressive disorder (MDD). Ketamine functions as a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist.1
Ketamine, initially created as an animal anesthetic, was first shown to function similarly to antidepressants in 1975.2 Early reports from street users of ketamine’s potential antidepressant effects were disregarded because it was an illegal medication despite its medical promise.3 After a trial published in 2000 showed encouraging findings for ketamine infusion therapy, researchers started studying it in humans in the late 1990s.4
The different types of ketamine treatments are explained below:
- IV Ketamine Infusions: Intravenous ketamine treatments must be administered at medical facilities or mental health treatment clinics. Sessions typically last about 40 minutes. Ketamine infusion therapy is the type of ketamine treatment our bodies absorb best.5
- Intramuscular: A single injection of ketamine is given into one of your larger muscles, such as the thigh or arm. Like intravenous, this procedure is delivered in a hospital or clinical setting, lasting around 40 minutes.
- Troche (also known as a lozenge): Troches are oral medications that can be administered at home or in a clinic environment. They can be recommended as the primary course of treatment or as a preventative precaution between intramuscular, intravenous, or intranasal approaches.
- Intranasal: Esketamine (Spravato) nasal spray is the only FDA-approved ketamine medication for treatment-resistant depression (TRD). TRD is a type of major depressive disorder that hasn’t responded to at least two medications. Over 50% of antidepressants don’t work the first time a patient takes one.6 Spravato must be taken in a doctor’s office, and for two hours afterward, you must be observed for any side effects.
Insurance may be able to help cover the cost of treatment. Find out if your insurance provider can help with the costs by filling in our confidential insurance verification form below.
Uses of IV Ketamine Infusion Therapy
Several mental health disorders can benefit from ketamine infusion therapy. However, this medication is most frequently used for patients with treatment-resistant depression (TRD).
Ketamine may also benefit the following conditions:
- Acute suicidality7
- Suicide ideation8
- Post-traumatic stress disorder (PTSD)
- Anxiety disorders
- Bipolar disorders
- Chronic pain
- Obsessive-compulsive disorder (OCD)
How Does Ketamine IV Infusion Work?
It is believed that ketamine works to stimulate the brain’s production of the neurotransmitter called glutamate in the space between neurons. Depression and abnormal glutamate levels are connected. The brain becomes more adaptable as a result of the glutamate by creating new connections and mending those that have been broken.
According to a new theory, ketamine activates connections in another receptor called the AMPA receptor by directly inhibiting NMDA receptors. This activates downstream synaptogenic signaling pathways that restore synaptic strength and connectivity in the prefrontal cortex and hippocampus.9
Thanks to the newly formed neural pathways, you can develop more uplifting thoughts and behaviors. This contrasts with conventional antidepressants, which only function while they are present in the body.10
Ketamine IV Infusion Therapy Process
Although every patient’s experience may vary slightly, most intravenous ketamine treatments are the same. During your initial Ketamine infusion therapy session, you’ll meet with a mental health expert who will ask you many questions about your present symptoms, past illnesses and treatments, and treatment objectives. Then, you will discuss ketamine, your treatment plan, and the risks and advantages of ketamine infusion therapy.
The doctor or nurse will insert a tiny needle into an arm vein to start the ketamine IV. During treatment, the doctor will monitor your blood pressure, oxygen levels, and pulse.
You may experience pleasant feelings or a sense of disconnection from reality. If you feel queasy, the doctor or nurse may administer an anti-nausea medication. Throughout the course of the IV ketamine treatment, licensed therapists will be on hand to respond to any questions or concerns you may have.
Although every patient reacts differently, the effects of ketamine may still be felt after treatment concludes. Most patients need 30 to 45 minutes to recover from the medication’s effects. It is unsafe and unlawful to drive after IV ketamine therapy; therefore, you will need to make transportation arrangements.11
You will typically receive a series of six infusions spread out over about two weeks. Each infusion takes 45 to 55 minutes, but you should allow approximately 1.5 hours for the entire visit. IV ketamine treatment does require booster doses, which usually are administered once a month following the conclusion of your initial six-treatment series.
Pros & Cons of Ketamine IV Therapy
- Rapid symptom relief
- High success rates
- Long-term symptom remission
- Dissociative effects
- Potentially addictive12
Side Effects of IV Ketamine Therapy
Although the dosage of ketamine used in ketamine infusion therapy is lower than that used in anesthesia, some adverse effects may be similar. The good news is that the side effects of ketamine frequently disappear by the time the infusion is finished or within a few hours.
The following are the most common potential side effects of IV ketamine therapy:
- Double Vision
- Reduced appetite
When is IV Ketamine Infusion Therapy Right for You?
Suppose traditional depression therapies haven’t helped your symptoms, and you’re in good physical health. In that case, ketamine infusion therapy could be a beneficial option for you.
Remember that ketamine is not a first-line treatment for depression and is typically only used when other, more established treatments have failed.13 In addition, you’ll need a diagnosis of major depressive disorder, PTSD, bipolar disorder, and/or suicidal ideation to be considered for ketamine therapy.
Although many people handle ketamine infusions well, on the whole, there are a few things that might make it not right for you, including the following:14
- You have schizophrenia
- You have high blood pressure
- You have cardiac/pulmonary issues
- You have a history of substance abuse
- You are pregnant or breast-feeding
- You’re an older adult with symptoms of dementia
- You’re a teenager
Cost & Insurance Coverage for Ketamine IV Therapy
Costs for ketamine infusions range from $400 to $2000 for each infusion, depending on the physician, location, dosage, length of infusion, and the illness being treated.
The average cost of IV ketamine therapy for depression is $400 to $800. Most facilities administer a course of 6 injections over 2 to 3 weeks. For a complete course of IV ketamine treatment for depression, you could pay between $1600 and $4800, depending on the cost of each infusion.15
Some insurance companies do not cover ketamine infusion therapy since it does not currently have FDA approval. Therefore, it is prescribed “off-label,” which means a doctor prescribes medication in a manner that the FDA does not expressly permit.16 Coverage specifics will vary, depending on many factors, including your insurance provider and your location.
Athena Care conveniently offers outpatient mental health services throughout Tennessee. We are also in-network with most major insurance plans. Filling out our free, confidential, no-obligation online insurance verification form is the most efficient method to determine if your insurance covers ketamine infusion therapy.
Our highly skilled care coordinators will handle the difficulties of contacting your insurance provider for more information about IV ketamine therapy in Tennessee. After you’ve completed the form, a care coordinator will review your policy and thoroughly explain your options. You may rest assured that all information discussed and exchanged will be kept private.
Success Rates, Goals & Outlook of IV Ketamine Therapy
In five placebo-controlled clinical trials over 13 years, 163 patients with major depressive disorder or bipolar disorder and 25 healthy controls provided information on side effects to the NIMH Intramural Research Program (IRP). The NIMH IRP assessment looked at potential side effects, such as headaches, dizziness, fatigue, and dissociative sensations.
Thirty-four of the 120 potential side effects that were examined were shown to be strongly linked with ketamine infusion therapy. Eight of them—feeling unusual, weird, or peculiar; feeling spacey; feeling woozy/loopy; dissociation; floating; visual distortions; difficulty speaking; and numbness—occurred in at least half of the subjects. Fortunately, none lasted longer than four hours. A three-month follow-up revealed no evidence of drug-related major adverse events, urges, an inclination for recreational use, or substantial cognitive or memory losses.17
Additionally, researchers at the Icahn School of Medicine at Mount Sinai found that repeated IV ketamine treatment significantly reduces symptom severity in people with chronic PTSD. The recovery was quick and sustained for several weeks.18
Furthermore, A single, low-dose ketamine infusion has been proven in numerous clinical studies to rapidly reduce depressive symptoms and suicidal thoughts in patients with TRD. These effects can last for up to one week. Interestingly, intermittent, repeated infusions can extend ketamine’s antidepressant effects and result in stronger therapeutic results than a single infusion.19
Overall, the effectiveness of IV ketamine therapy is promising and clinical studies have produced successful results. If IV ketamine therapy is administered one to three times, those who feel some relief from depression will likely continue to benefit from it for several more sessions. Instead of producing a more significant reduction in symptoms, the successive sessions may help sustain the positive effects of ketamine.20
Even though some studies have resulted in patients experiencing complete remission in reducing their symptoms, additional research is needed.
- Psychiatric Research Institute. “Ketamine Infusions.” University of Arkansas for Medical Sciences, psychiatry.uams.edu/clinical-care/interventional-psychiatry/ketamine-infusions. Accessed 10 Mar. 2023.
- Sofia, R D, and J J Harakal. “Evaluation of ketamine HCl for anti-depressant activity.” Archives internationales de pharmacodynamie et de therapie vol. 214,1 (1975): 68-74. https://pubmed.ncbi.nlm.nih.gov/1156026/
- Domino, Edward F. “Taming the Ketamine Tiger.” Anesthesiology, vol. 113, no. 3, Lippincott Williams and Wilkins, Sept. 2010, pp. 678–84. https://doi.org/10.1097/aln.0b013e3181ed09a2.
- Berman, Robert F., et al. “Antidepressant Effects of Ketamine in Depressed Patients.” Biological Psychiatry, vol. 47, no. 4, Elsevier BV, Feb. 2000, pp. 351–54. https://doi.org/10.1016/s0006-3223(99)00230-9.
- Zanos, Panos, et al. “Ketamine and Ketamine Metabolite Pharmacology: Insights Into Therapeutic Mechanisms.” Pharmacological Reviews, vol. 70, no. 3, American Society for Pharmacology and Experimental Therapeutics, July 2018, pp. 621–60. https://doi.org/10.1124/pr.117.015198.
- “Questions and Answers About the NIMH Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study — All Medication Levels.” National Institute of Mental Health (NIMH), www.nimh.nih.gov/funding/clinical-research/practical/stard/allmedicationlevels.
- Maguire, Lindsay, et al. “Ketamine for Acute Suicidality in the Emergency Department: A Systematic Review.” American Journal of Emergency Medicine, vol. 43, Elsevier BV, Jan. 2021, pp. 54–58. https://doi.org/10.1016/j.ajem.2020.12.088.
- Can, Adem, et al. “Low Dose Oral Ketamine Treatment in Chronic Suicidality: An Open-label Pilot Study.” Translational Psychiatry, vol. 11, no. 1, Nature Portfolio, Feb. 2021, https://doi.org/10.1038/s41398-021-01230-z.
- Aleksandrova, Lily R., et al. “Antidepressant Effects of Ketamine and the Roles of AMPA Glutamate Receptors and Other Mechanisms Beyond NMDA Receptor Antagonism.” Journal of Psychiatry & Neuroscience, vol. 42, no. 4, Canadian Medical Association, July 2017, pp. 222–29. https://doi.org/10.1503/jpn.160175.
- Blanchfield, Theodora, Amft. “What Is Ketamine Infusion Therapy?” Verywell Mind, 4 Aug. 2022, www.verywellmind.com/what-is-ketamine-infusion-therapy-5194302.
- “What to Expect at Your First Ketamine Infusion.” Future Psych Solutions, futurepsychsolutions.com/blog/what-to-expect-at-your-first-ketamine-infusion. Accessed 10 Mar. 2023.
- Spielberg, Ben. “The Real Pros and Cons of Ketamine Infusions.” IOP, TMS & Ketamine Therapy – Bespoke Treatment, 22 Aug. 2022, www.bespoketreatment.com/ketamine-therapy/ketamine-infusion/the-real-pros-and-cons-of-ketamine-infusions.
- Grinspoon, Peter, MD. “Ketamine for Treatment-resistant Depression: When and Where Is It Safe?” Harvard Health, 9 Aug. 2022, www.health.harvard.edu/blog/ketamine-for-treatment-resistant-depression-when-and-where-is-it-safe-202208092797.
- American Psychiatric Nurses Association. “Ketamine Checklist | APNA.” APNA, 12 Mar. 2021, www.apna.org/ketamine-infusion-therapy.
- “Ketamine Infusion Cost.” Ketamine Clinics Directory, 2022, ketamineclinicsdirectory.com/ketamine-infusion-cost.
- Lev, Eliana. “Is Ketamine Therapy Covered by Insurance?” Mindbloom, 23 Feb. 2022, www.mindbloom.com/blog/is-ketamine-therapy-covered-by-insurance.
- Acevedo-Diaz, Elia E., et al. “Comprehensive Assessment of Side Effects Associated With a Single Dose of Ketamine in Treatment-resistant Depression.” Journal of Affective Disorders, vol. 263, Elsevier BV, Feb. 2020, pp. 568–75. https://doi.org/10.1016/j.jad.2019.11.028.
- Feder, Adriana, et al. “A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder.” American Journal of Psychiatry, vol. 178, no. 2, American Psychiatric Association, Jan. 2021, pp. 193–202. https://doi.org/10.1176/appi.ajp.2020.20050596.
- Strong, Caroline E., and Mohamed Kabbaj. “On The Safety of Repeated Ketamine Infusions for the Treatment of Depression: Effects of Sex and Developmental Periods.” Neurobiology of Stress, vol. 9, Elsevier BV, Sept. 2018, pp. 166–75. https://doi.org/10.1016/j.ynstr.2018.09.001.
- Meisner, Robert C., MD. “Ketamine for Major Depression: New Tool, New Questions.” Harvard Health, 22 May 2019, www.health.harvard.edu/blog/ketamine-for-major-depression-new-tool-new-questions-2019052216673.
If you suspect that you or someone you love suffers from mental health disorders, contact Athena Care today.
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