Top 10 Questions to Ask

What is ketamine therapy? 

Ketamine therapy is a type of treatment that uses ketamine to help people with mental health conditions like depression, anxiety, and PTSD. Ketamine is a powerful anesthetic that can also have mood-boosting effects.

How does ketamine therapy work? 

Ketamine therapy works primarily by increasing the levels of a neurotransmitter called glutamate in the brain. Glutamate is a crucial neurotransmitter for learning and memory and affects mood regulation. In the short term, when ketamine increases the levels of glutamate, it can help to improve mood and reduce symptoms of depression and anxiety.

In the long term, ketamine promotes synaptogenesis, neurogenesis, and the reformation and growth of dendrite spines in the brain, 12-72 hours post each dose. This is why it is regularly administered in a series with a couple days between sessions. This helps the mind adapt to healthier thought patterns over time, and once this healing process has occurred, the need for continued maintenance and boosters becomes diminished to the point where many can move to spot treatment as needed.

What are the benefits of ketamine therapy? 

Ketamine therapy treats various mental health conditions, including depression, anxiety, and PTSD. It can also be helpful for people who have not responded to other treatments, such as antidepressants and psychotherapy. See treatable mental illnesses.

See Mad Scribbler’s Complete Guide, Your Therapy Session, Ketamine Assisted Therapy, Benefits

What are the risks of ketamine therapy? 

Ketamine therapy can have side effects, such as nausea, vomiting, and dizziness. During the initial titration process, hallucinations are often experienced. These can be surprising, even disturbing when they first occur. Patients accommodate the hallucinations quickly. And hallucinations become milder as a patient develops tolerance. Eventually, they almost disappear. In rare cases, ketamine can cause more severe side effects, such as seizures.

See Side Effects, Contraindications

How long does ketamine therapy last? 

The effects of ketamine therapy typically last for a few days or weeks. However, some people may need additional ketamine treatments to maintain their benefits. Over time, your brain heals; as that happens, the doses can be tapered off, and the benefits will persist long-term.

How much does ketamine therapy cost? 

The cost of ketamine therapy can vary depending on the clinic or provider, and the route of administration. In general, ketamine therapy is a more expensive treatment option than traditional antidepressants and psychotherapy.

Does insurance cover ketamine therapy? 

The insurance coverage for ketamine therapy varies depending on the insurance plan. Insurance plans that cover ketamine therapy are few but growing slowly. We anticipate that insurance companies will accelerate coverage of ketamine in the next few years. It’s often the case that insurance will cover a significant percentage of the doctor’s consultation but not the medicine. E.g., if the doctor’s monthly fee is $250, insurance might cover that minus the plan’s copay. IVs themselves less likely.

What should I expect after ketamine therapy? 

After ketamine therapy, you may feel more relaxed and calm. You may also experience a boost in mood and energy. In some cases, you may also experience hallucinations or visions. These effects are usually temporary and go away within a few hours.

See Benefits & Brain Changes

What happens if I don’t respond to ketamine therapy? 

If you don’t respond to ketamine therapy, a few options are available. You may be able to try another ketamine therapy provider or try a different ketamine therapy protocol. You may also be able to try other treatments, such as antidepressants and psychotherapy. Of those patients who do respond to ketamine, most will respond in one month. A few more will respond in two months. These time periods are predicated on having an adequate dose for that particular patient for these time periods. If the patient’s titration is very gradual, much of that time at very low doses won’t count as “good time” toward the one and two-month periods. So, to illustrate. Suppose your therapeutic dose were 100 (whatever 100 might mean). Suppose your provider titrates you for one month in ten doses: 10 – 20 – 30 – 40 – 50 – 60 – 70 – 80 – 90 – 100. Most of that time you were well below the dose that we’ve presumed will eventually work. So, don’t start counting the one or two months until you start taking level 90 or 100 doses.

Where can I find more information about ketamine therapy? 

This site is a comprehensive resource and a great starting place. We highly recommend you start with Mad Scribbler’s Guide, which provides a thorough orientation with links throughout the site as additional reference material.

Beyond us, many resources are available to learn more about ketamine therapy. You can find many on our community page. You can talk to your doctor, research further online, or contact a ketamine therapy clinic.

Sanacora, G., Frye, M. A., McDonald, W., Mathew, S. J., Turner, M. S., Schatzberg, A. F., … & Nemeroff, C. B. (2017). A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA psychiatry, 74(4), 399-405.

Wilkinson, S. T., Sanacora, G., & Bloch, M. H. (2017). Hippocampal volume changes following electroconvulsive therapy: a systematic review and meta-analysis. Biological psychiatry: cognitive neuroscience and neuroimaging, 2(5), 327-335.

Davis, S. W., Stanley, B., & Gabbard, G. O. (2019). A review of the safety and efficacy of ketamine in depressive states. Journal of psychoactive drugs, 51(2), 111-125.

Murrough, J. W., Burdick, K. E., & Levitch, C. F. (2015). Neurobiological effects of ketamine in treatment-resistant depression: a naturalistic review. Neuropsychopharmacology, 40(6), 1414-1424.

Krystal, J. H., Sanacora, G., Duman, R. S., & Rapid-Acting Treatment Research (R-STAR) Panel, & et al. (2013). Towards a paradigm shift in treatment-resistant depression: an expert consensus. Acta Psychiatrica Scandinavica, 128(5), 399-408.

Luckenbaugh, D. A., Niciu, M. J., Ionescu, D. F., Nolan, N. M., Richards, E. M., Brutsche, N. E., & Zarate Jr, C. A. (2014). Do the dissociative side effects of ketamine mediate its antidepressant effects?. Journal of affective disorders, 159, 56-61.

Li, L., & Vlisides, P. E. (2020). Ketamine: 50 years of modulating the mind. Frontiers in Human Neuroscience, 14, 612529.

Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., … & Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar disorders, 20(2), 97-170. Tye, S. J., Miller, S. R., & Blough, B

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