NY Ketamine Infusions FAQs

Ketamine is a safe, effective anesthetic that has been in use worldwide since 1970 and has been listed on the World Health Organization’s Essential Medicines list since 1985. Multiple studies and trials run at Mt. Sinai, Yale and other prestigious universities and hospitals since 1990 have shown that ketamine is exceptionally effective in treating treatment-resistant depression, PTSD, anxiety, suicidal ideation, neuropathic pain and other related mood disorders. Unlike standard antidepressants like SSRIs and SNRIs which generally take 4 to 8 weeks to work (if they work at all), ketamine is fast-acting and can sometimes show immediate efficacy after a single intravenous dose. Because of its fast-acting nature, ketamine can be an extremely important tool in preventing suicide and immediately alleviating the suffering caused by major depressive disorder (MDD). More recently it has also been used to treat neuropathic pain and the symptoms of PTSD. The small doses and method of administration (intravenous infusion) used to treat depression patients differ greatly from those used in hospitals.

While ketamine can be legally prescribed and administered “off label” by licensed physicians, the drug has only been officially approved by the FDA as an anesthetic and not as a treatment for depression. It is important to note for those considering ketamine infusions that many drugs are prescribed off-label, and an estimated 30% of all prescribed medications are not FDA approved for that particular purpose. Although it has shown the potential to help millions of people find relief from the crushing effects of depression and neuropathic pain, pharmaceutical companies have been hesitant to invest the tens of millions of dollars required to fund the extensive and expensive clinical trial process necessary to get official FDA approval. Since the drug is and will remain off-patent, no company can own the revenue stream. Efforts are being made to create a national registry of the thousands of patients treated by ketamine providers across the country to date which can hopefully pave the way for ultimate approval. With or without it, however, ketamine’s use for depression and neuropathic pain treatment follows all required rules and regulations, and has safely and effectively been prescribed as a fast-acting depression and pain treatment for almost a decade in private medical practices and some hospitals and HMOs.

Yes. Ketamine infusions for depression and pain are both outpatient procedures requiring no hospital admission. All infusions are administered in our office and all patients will have their own, private treatment room in which to receive the infusion and relax before leaving the office.

Not necessarily. Mild to moderate depression is often successfully treated by mental health professionals with antidepressant drugs and/or psychotherapy, which we encourage. The treatment of severe depression, major depressive disorder (MDD) and treatment-resistant depression is more difficult and requires a higher level of care, such as ECT, TMS or ketamine therapy. Ketamine infusion therapy is reserved for those patients with severe depression that is considered treatment-resistant or those with suicidal ideation.

The patients we see are all considered treatment-resistant. That is, they have not responded to any available antidepressant medications and in many cases have not responded to ECT or TMS. While we cannot predict with certainty who will respond to ketamine, clinicians across the country have reported that roughly 70%-75% of patients who have not been helped by any other treatment do show a dramatic improvement in their mood with ketamine, and 3 out of 4 patients who present with suicidal ideation cease to have such thoughts. A meta-analysis by the American Psychiatric Association using data from multiple ketamine trials reported similar results, with 70% of treatment-resistant patients responding positively after receiving the initial round of low-dose infusions. We will usually know after the first two treatments if ketamine infusions will help you.

We cannot predict with certainly which patients will respond, but we’ve shown very good results for patients suffering from all of these conditions.

Assuming you begin to feel better during the initial treatments, a total of six infusions is recommended within a twelve-day period, which will maximize the ketamine effect on new dendrite and synapse growth. Thereafter, patients are placed on a maintenance program and are asked to return when they feel it necessary for a single infusion booster. During the maintenance period, the duration of relief following the initial infusions and the first booster, and between subsequent single booster infusions, varies between patients. The average duration of relief between booster infusions is 4-6 weeks. There is no way to predict what your needs will be. Some patients find that as they go through this process, the time between boosters lengthens, prompting them to come in every other month, every 3 months, or even less frequently. In our experience, patients find ketamine boosters effective for as long as needed with no long-term side effects.

We don’t believe so. After the first year or so, many patients being treated for mood disorders find the need for booster infusions decreases over time. In the meantime, several large pharmaceutical companies are sponsoring clinical trials with ketamine-like drugs for more convenient nasal and oral administration. It may be a few years, but those drugs will likely become available. But for now, patients with debilitating severe depression with constant thoughts of self-harm often cannot afford to wait. Currently, ketamine infusion therapy is the most exciting and successful new treatment for severe depression, MDD, suicidal ideation and neuropathic pain and is the subject of many ongoing trials.

About an hour, with an additional half hour of quiet time before discharge.

Most patients experience a mild dissociation or inner reflective experience that is generally well tolerated and often quite enjoyable. If you find it unpleasant in any way, we can make adjustments to minimize or eliminate any unpleasant sensations. Within 15 minutes of ending the infusion your thinking will be clear. There are no delayed “flashbacks.”

The treatment is essentially pain-free. Other than a small prick while starting the infusion line, you will feel no pain and may even enjoy the experience.

Yes. Benzodiazepines, such as Klonopin, Xanax, and Ativan, do interfere with ketamine if used daily and at higher doses. Lamictal (lamotrigine) in doses above 150mg/day also can block ketamine efficacy.

Pain patients may arrive alone and undergo the infusion without a friend or relative present, though it’s perfectly fine to have someone sit with you during the treatment if you so choose. Our staff will monitor you closely while you are receiving treatment. Mood disorder patients can leave on their own, following our evaluation. Since pain patients require a larger dose, all pain patients must be accompanied by a responsible adult at time of discharge.