Frequently Asked Questions
About Neuropathic Pain

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 in New York, Yale University and other prestigious universities and hospitals since 1990 have shown that ketamine is exceptionally effective in treating neuropathic pain, CRPS (Complex Regional Pain Syndrome), RSD, treatment-resistant depression, PTSD, anxiety, suicidal ideation and some mood disorders. Ketamine is often fast-acting and can sometimes show immediate efficacy after a single intravenous dose. Because of its fast-acting nature, ketamine can also be an extremely important tool in preventing suicide and immediately alleviating the suffering caused by major depressive disorder (MDD).

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 chronic pain. 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 for this off-patent medication. With or without it, ketamine’s use for chronic neuropathic pain treatment follows all required rules and regulations, and has safely and effectively been prescribed as a chronic pain treatment for almost a decade in private medical practices and some hospitals and HMOs.

Yes. Ketamine infusions for chronic pain is an outpatient procedure requiring no hospital admission. All infusions are administered in our office and all patients will have their own, private treatment room.

We have had great success treating various types of central neuropathic pain such as CRPS/RSD (Chronic Regional Pain Syndrome/Reflex Sympathetic Dystrophy), Trigeminal Neuralgia and Phantom Limb Pain, and have made a vast difference in the lives of many patients. The causes of pain vary greatly, making it more difficult to determine ketamine’s ultimate effect. While some types of chronic pain respond better to ketamine infusions than others, there is no guarantee that ketamine will help alleviate your pain. That said, if you’ve tried other alternatives and nothing has helped, we would encourage you to call us for a consultation.

We strive to achieve a significant decrease in your pain level. With less pain, you can expect a marked increase in your activity level, a lifting of your mood and spirits, and improvement in your overall quality of life and function.

We will be able to determine your required course of treatment and number of visits by observing your first two infusions. Depending on your response and our experience in working with the type of pain you are experiencing, you will receive a minimum of 2 and a maximum of 5 infusions.

The best results are achieved when infusions are administered on successive days.

Be prepared to stay for 3 to 5 hours. In order to safely gauge your response, the first two ketamine infusions will be at lower doses and of shorter duration. Starting with the third dose and thereafter, the duration of the infusions will average about four hours.

You won’t technically be asleep, but you will be resting comfortably and not responding to outside stimuli.  To those accompanying you, you will appear to be sleeping.

Ketamine infusions for pain are generally well tolerated, but it’s best to be fully informed about what you may experience during chronic pain treatment. Because ketamine is a derivative of phencyclidine or PCP (a psychedelic compound), it can cause hallucinations in some patients if not combined with sedation. You will be given a benzodiazepine which controls this potential side effect. There are no delayed “flashbacks.” Following treatment, you will likely be tired for several hours.

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.

Your thinking may be a bit cloudy and your walk a bit unsteady for an hour or two after treatment. You may also find that you will be unusually tired for several hours. Hopefully there will be a noticeable improvement in the pre-treatment level of your pain and in your mood as well.

Following a series of infusions, we hope to see a prolonged period of significant pain relief measured in weeks to months. Most patients will need to return from time to time for a booster infusion to maintain that level of relief.

We don’t believe so, but each patient’s experience varies. Many patients being treated for chronic pain find the need for booster infusions decreases over time.  Choosing a healthy lifestyle and following an appropriate aftercare plan of therapy and exercise can be beneficial in extending the treatment’s effectiveness.

We’ve treated almost 2,000 patients and have seen no instances of ketamine addiction. Ketamine has been used safely for surgical anesthesia and trauma management in hospitals and elsewhere for over five decades, has been included on the World Health Organization’s Essential Medicines list since 1985, and has few side effects. Although it is sometimes abused recreationally in high doses as a “club drug,” there is no evidence that ketamine is addictive.

We can often see you immediately if it’s a true emergency, but we prefer to schedule patients 5 to 7 days in advance. Since our offices are open seven days a week and we open early and close late, we can meet most patients’ scheduling needs.

The cost of each infusion is $900. This fee is all-inclusive with no additional charges. We accept all payment methods and provide financing options if necessary. While we do not accept insurance, some insurance companies will cover all or a portion of the treatment as an “out of network” service. If so, we will gladly provide you the necessary forms to submit to your insurance company for potential reimbursement. Our experience shows that about 30-35% of patients are receiving some reimbursement.

We also offer affordable financing options to our patients, available through Advance Care, a medical funding company. For details please call them directly at 800-432-9470, or visit their website at advancecarecard.com.

Yes. Though we may use midazolam in office to mitigate certain side effects, 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.

Almost none. Uncontrolled high blood pressure or heart failure need to be corrected in advance. Regardless, all patients will be closely monitored while undergoing treatment.

You do not need anyone to bring you or remain with you during the infusion (though they are certainly welcome), but a responsible friend, relative or caretaker must accompany you home. Our staff will monitor you closely while you are receiving treatment. We advise you not to not drive, sign any contracts, or do anything potentially risky until the following day.

No. Please don’t eat or drink after midnight the evening before treatment.

To treat chronic pain, you will require a significant dose over an extended period of time, so hallucinations may be a possibility. We provide a safe, comfortable environment with constant monitoring by our medical team, so dissociative experiences, should they occur, will not create a problem. To limit the occurrence of this side effect, we may administer midazolam — a benzodiazepine — which has proven to be extremely effective. Ketamine has few other side effects, and only rarely will a treatment have to be stopped.

Yes. Our offices are all handicap accessible and ADA compliant.

Yes, WIFI is available throughout our entire office and in all treatment rooms. Many of our patients bring their own devices and earbuds or headphones to listen to music while undergoing treatment. You will not be able to use your devices for making phone calls, sending texts or emailing during the treatment. Those accompanying you are welcome to bring laptops, iPads, iPods and cellphones as well.

We follow all HIPAA rules and regulations. Our privacy policy can be viewed here: privacy policy