+ What is ketamine?

Ketamine is a medicine historically used for anesthesia during surgeries and medical procedures. It was synthesized in the 1960s and is FDA-approved for procedural sedation and anesthesia. It is widely used in hospitals and ERs and is on the World Health Organization's "List of Essential Medicines." Ketamine is now being used "off-label" to treat depression, as well as anxiety, post traumatic stress disorder (PTSD), and some chronic pain disorders. This medication has a long track record for its safety when used appropriately.

+ How does it work?

The exact mechanism of how ketamine works in depression, anxiety, and chronic pain is not fully known. However, we do know that ketamine works on the NMDA receptor to block the glutamate neurotransmitter. And scientific study is showing ketamine improves the health of the neurons (brain cells) by increasing the connection between the neurons and improving the brain’s ability to adapt (aka neuroplasticity).

Ketamine also changes the way the central nervous system processes pain, so it’s like hitting the reset button on your computer, to restore normal pain processing. Research is also showing in animal models, the potential for ketamine to increase resilience and recovery from stressful traumatic events which can trigger or cause depression and anxiety disorders.

Furthemore, ketamine decreases activity in the Default Mode Network (DMN) of the brain, which is more active is those with depression, anxiety, and chronic pain.

+ How do I know if ketamine is for me?

Ketamine infusions may be for you if you suffer from certain anxiety disorders, PTSD (post-traumatic stress disorder), pain disorders, or depression. Many who have not found relief from traditional oral medications for these disorders often benefit from ketamine infusions. This may be for you if you want to avoid side effects of more traditional treatments or if current treatments are not working for you.

+ Is ketamine addictive?

Ketamine has a long proven track record of being a safe FDA-approved anesthetic since 1970. It is part of the List of Essential Medications the World Health Organization (WHO) recommends to have in every hospital. Addiction has not been found in individuals who receive ketamine infusion therapy at the dosing, treatment, & schedule in the appropriate setting with a medical professional.

+ Isn’t ketamine a street drug?

Yes, you may have heard of “Special K”, “Kit Kat”, or “K”, and yes, they are referring to ketamine. However, ketamine IV therapy is not used at the dose, duration, intention, mindset, setting, and method which individuals abuse on the street.

+ Do I need a referral?

No, however, you will need to provide documentation from your primary care, pain specialist, psychiatrist, or therapist related to your diagnosis and past treatment. You will be required to continue regular ongoing contact with them during and after your ketamine infusions. We will contact them to confirm your diagnosis. Then we will contact you and schedule your appointment.

+ Will I continue to follow up with my doctor, psychiatrist, psychologist, and/or therapist?

Yes. We are serving in a consulting capacity to provide this infusion and recommend to continue seeing your physician.

+ If ketamine infusions are so great, why aren’t all doctors providing this service?

Three main reasons: 1) comfort of administering the medication, 2) awareness of this treatment, and 3) acceptance of this treatment. Outside of emergency room doctors, anesthesiologists, few other medical specialists are comfortable with administering this treatment. Many doctors are not educated on the latest research about ketamine, and only recognize it as an anesthetic or street drug use. While there are some doctors who don’t know about this treatment, there are others who are used to the current traditional model of treatment and not ready to accept this novel treatment.

+ How am I going to feel DURING the infusion?

Some patients report feeling like they are in a dream or feel sedated. Some feel like they have changes in their thought process, vision, and or speech. If you experience unwanted sensations or unpleasant hallucinations, we may decrease the amount of the medication or how fast we infuse it to minimize these experiences. Remember, there will always be a healthcare professional close by making sure you are safe and well taken care of during your infusion.

+ How am I going to feel AFTER the infusion?

Many patients recover 20-30 minutes after the infusion. You may feel a little tired, notice a mild difficulty in walking, or even “cloudy thinking” for a few hours after. We advise you to take it easy, and have a relaxing day following the infusion. We will make sure you are ready and safe after your infusion, before we let you go home!

+ What side effects does ketamine have?

Ketamine is a dissociative drug, meaning that some people will have an out of body experience. It can also cause nausea, vomiting, and fatigue afterwards. In some cases, it can raise blood pressure and pulse. Accordingly, we will monitor you closely at all times and trained medical professionals will be readily available at your side. One long-term side effect is bladder irritation (AKA cystitis) after chronic use of ketamine.

+ How long is the appointment for the ketamine infusion?

For mood disorders, the infusion will be administered over 40 minutes. However, the appointment may take up to an hour and a half to two hours due to the recuperation time after the infusion. For pain disorders, the ketamine infusions are for a longer time period and can be up to 4 hours.

+ How long will the results last?

A single infusion typically lasts anywhere from a few days to a month. A series of 4 – 6 infusions may last anywhere from weeks to months, and often a single booster infusion when effects are wearing off can restore and extend response. Every patient responds differently, and some patients get several months of relief with just a few infusions.

+ How many treatments will I need?

Ketamine infusion treatments occur in 2 steps: the Initiation and Maintenance steps. At Reset Ketamine, we recognize each individual is different and unique despite their shared diagnosis with our patient. Thus, we tailor each treatment protocol to the individual based on your experience and reaction to the medication. Our goal is to serve you!

+ Can I Drink or Eat before my infusion?

We recommend fasting at least 3 hours prior to your first infusion. This will minimize the risk of nausea or vomiting.

+ What should I wear the day of my infusion?

Loose, comfortable clothing.

+ Can I drive to my infusion appointment?

No. Ketamine can affect your ability to drive, so it is mandatory a trusted friend or family member picks you up from your appointments. We also recommend refraining from operating heavy machinery, caring for small children, participating in strenuous activities, or signing or entering into any legal contracts for at least a day after your infusion.

If you are unable to find a friend or family member to transport your home, we will allow for you to take a ridesharing service or taxi home. However, we require you to stay longer after your infusion and you may incur additional fees. Thus, it’s in your best interest to find a friend!

+ Do I need to stop any of my meds?

There are a few select medications which cannot be taken in combination with ketamine. Please contact us so we can answer questions and discuss these medications with you. There are some medications if taken during your infusion, may reduce the effect such as benzodiazepines (Ativan, Xanax, Klonopin, Valium, etc.) and lamotrigine (Lamictal). We advise weaning your dose at your prescribing doctor’s direction prior to your first treatment. If you are unable to be off the medication, we recommend not taking the medication the night before or day of your infusion. Please restart your medications the night of your infusion or the following day.

+ Who shouldn’t take ketamine, i.e. are there conditions that make ketamine dangerous or ineffective?

Yes. If you are experiencing the following: Uncontrolled high blood pressure (hypertension); Unstable heart disease (arrhythmias, congestive heart failure, chest pain etc.); Untreated thyroid disease; Active substance abuse; Active manic phase of bipolar disorder; Active delusions and hallucination symptoms (not on meds or while taking street drugs). If you have any of the above the day of your infusions, you unfortunately will not be able to receive your infusion.

+ What is the response rate?

It depends upon the diagnosis, but research shows improvement in 70-80% of patients who are treated with ketamine for depression.

+ If ketamine therapy is working for me, how soon will I begin to feel better or notice a difference?

For some people they can experience positive effects within an hour of finishing the infusion. For others, they will not notice an effect until after their fourth or fifth infusion. Commonly the effect is gradual and subtle, noticing thoughts of sadness and hopelessness to begin to lift and go away. Occasionally some people may have a dramatic effect. Function (going out, doing things you enjoy, work) improve before mood does. With improved function you are able to more fully participate and engage in your treatment plan, thus improving your success rate!

+ What is the price of ketamine infusions?

Please see www.resetketamine.com/pricing for more information.

+ Where can I get more information about ketamine?

Go to www.resetketamine.com/resources and www.askp.org for more information.