Ketamine Infusion Protocol: Twice a Week or Three Times a Week?

Ketamine infusions are at the frontier of treating depression, anxiety, PTSD, OCD, and pain disorders. And just like the pioneers of the Wild West, ketamine physicians are also trailblazers. Ketamine infusionists create their protocols based on studies and the responses of their patients to treatment. Since ketamine is still a relatively new treatment, researchers are still investigating the optimal dose and frequency. According to Singh et al, they found receiving ketamine infusions in a twice a week protocol over 4 weeks, was equally as effective as a three times a week protocol over 4 weeks for depression [1].

What is exciting about this study, is that is shows flexibility in treatment without necessarily sacrificing effect.  At Reset Ketamine, we recommend a series of 6 infusions [2]. If you are on a sabbatical, or have a flexible schedule, or the idea of having three times a week infusions sound like way too much, then you won’t sacrifice your effect by getting treatments over three weeks. Now, let’s say you do not have the luxury of time, or you are in need of concentrated focused treatment, then three infusions a week over two weeks may just be for you.

Here is something else to consider, researchers and other studies may not take into account the holistic aspects: such as what the patient is eating, how much exercise they are getting, sleep quality, social support available, spirituality, etc.  When you take other biopsychosocial factors into account, the efficacy of treatment could change.

Perhaps infusions coupled with cognitive behavior therapy or going on a low inflammatory diet before the infusions could decrease the number of needed infusions. We look forward to further research to clarify what is the best protocol. But here’s the thing...there may not be a “perfect” protocol, rather it may be best to tailor a unique protocol for each individual patient. 

References: 

  1. Singh, Jaskaran B., et al. “A Double-Blind, Randomized, Placebo-Controlled, Dose-Frequency Study of Intravenous Ketamine in Patients With Treatment-Resistant Depression.” American Journal of Psychiatry, vol. 173, no. 8, 2016, pp. 816–826., doi:10.1176/appi.ajp.2016.16010037

  2. Murrough, James W. et al. “Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions in Treatment-Resistant Major Depression.” Biological psychiatry 74.4 (2013): 250–256. PMC. Web. 12 June 2018