FAQs

Frequently Asked Questions

Ketamine is an FDA approved medication that has been used since the 1960s as an anesthetic in humans and animals and as a pain medication. It’s a remarkable anesthetic in that it does not lower blood pressure or impair respiratory function. Due to its excellent safety profile, it’s one of the top ten most widely used anesthetics in the world and commonly used in pediatrics. When used in small doses, much less than the anesthetic doses, ketamine has been found to be highly effective in treating various mental health conditions. Research on its antidepressant effects began in the US in the 1990s.

While it’s commonly been used as an anesthetic and analgesic for over 60 years, its use in psychiatry is relatively new and considered off-label. Use of off-label medications is a very common practice. One in three psychiatric medications are prescribed off-label.

Depression, post-partum depression, suicidal thoughts, bipolar disorder-depressed type, PTSD, anxiety, OCD, and BPD.
According to research studies, ketamine can be effective for 60-80% of individuals. Effects can be seen within an hour. They typically last for several weeks while some people can experience symptom relief for months. There have been reports of people experiencing relief up to two years.

We don’t know exactly how ketamine works but we do know that it’s unlike any other antidepressant medication. Conventional antidepressants increase levels of neurotransmitters such as serotonin, norepinephrine and dopamine. These neurotransmitters serve as messengers that relay communication between brain cells via receptors. The theory is that having more of these neurotransmitters allows for better communication between brain cells, which positively affects mood.

Interestingly, there’s another neurotransmitter called glutamate which works on a receptor called NMDA. This is an entirely different pathway than what conventional antidepressants work on. Scientists have found that if you block the NMDA receptor with ketamine, you increase levels of glutamate and you get an antidepressant effect. Blocking NMDA receptors also activates receptors to release other molecules that help brain cells communicate with each other along new pathways. This process is known as synaptogenesis and is thought to affect mood, thought patterns, and cognition. It also aids in the restoration of damaged neurons in the brain caused by stress and mental illness.

So what do we know for sure about ketamine? We know that it works, it works fast, it works in a higher percentage of people than those taking conventional antidepressants and it has much fewer side effects.

As mentioned above, ketamine is the only anesthetic that does not suppress the body’s cardiovascular and respiratory systems. When ketamine is administered in a controlled and monitored setting, by a licensed provider, it is very safe. Outside of this setting, at higher doses such as with recreational use, it can have serious effects.
Like with any drug, abusing ketamine can lead to addiction. It has been used and abused recreationally as a “club drug” but at much higher doses. With that being said, ketamine is less inherently addictive and has fewer withdrawal symptoms than other psychoactive drugs. The course of your ketamine treatment will be carried out under medical supervision and in a controlled environment further lowering the risk of developing a dependency on the chemical.
As with any medication, there are contraindications and not everyone is a good candidate. Ketamine infusion therapy is not recommended for patients who have been diagnosed with psychosis or patients with bipolar who are experiencing mania/hypomania. Additionally, if you have pre-existing high blood pressure, or certain cardiac and/or pulmonary conditions, it may be necessary to obtain medical clearance from your primary care physician before initiating ketamine infusions. You will meet with the provider so he/she can review and discuss your current medications and medical history.
Patients should not take benzodiazepines, stimulants, or any prescribed narcotics such as pain medications on the day of their infusion.
It is suggested to undergo six infusions within a span of two to three weeks to fully harness the benefits of ketamine. After completing the six infusions, you will move into the maintenance phase which is patient specific. Generally, patients can expect to receive maintenance infusions about every four weeks for the first 12 months following treatment onset. The overall effectiveness and duration of treatment varies according to each patient’s specific situation.
During your infusion, you may experience nausea, headache, dizziness, anxiety and dissociation. Following your infusion, the nausea may continue and you may feel tired for the rest of the day. There are no lingering side effects and you should be back to normal by the next day.

We recommend that you not consume any solid foods and/or milk six hours before your treatment. However, clear liquids such as water, fruit juices without pulp, carbonated beverages, clear tea, and black coffee can be consumed up to 2 hours before your treatment. You can eat and drink after your treatment.

*****IT IS IMPERATIVE THAT YOU AVOID CONSUMING ALCOHOL OR USING ANY ILLICIT DRUGS, AS THEY CAN BE EXTREMELY DANGEROUS WHEN COMBINED WITH KETAMINE.

We want this experience to be a relaxing one. Feel free to bring anything that helps you feel relaxed and comfortable. Some things people bring include music (Spotify has some great ketamine infusion playlists), calming sounds, blankets, and eye masks. You will be provided with noise canceling headphones. Please refrain from talking on the phone and/or using social media as this serves as a distraction and interferes with the experience as a whole.
No. The dose of ketamine you will receive does not cause any loss of consciousness. Some people become relaxed and fall asleep.
Plan to stay for one and a half to two hours. Prep time is 15-30 min at which time the IV is placed. The infusion lasts 40-50 min. At the start of the infusion, you may not notice any effects, but as the infusion progresses, you may experience a feeling of “lightness” or “floating,” which for some feels as a “weight being lifted off their shoulders”. Dissociation was mentioned above under side effects. Most patients experience this and the symptoms are generally well tolerated. Patients have described this as an intense relaxation as if they are floating or are outside their body. This along with other side effects should start going away within 15 minutes of completing the infusion. By the end, you will feel normal. Your vital signs are monitored continuously throughout the process and someone will be available to you should you need support or reassurance. Remember, we want this experience to be a relaxing one.
The effects of a single infusion typically last up to two weeks. Most patients report overall improvement by the 3rd infusion and more than 80% report remission by the 4th infusion. As mentioned above, some people can experience symptom relief for months. There have been reports of people experiencing relief up to two years. Generally, patients receive maintenance/booster treatments. These will be determined by you and your provider.

You will need to arrange for a ride home after your treatment. It is recommended that you rest until the next day. 

No, there is no need to stop any of your psychotropic medications. As a matter of fact, ketamine is thought to improve the way your brain responds to the medications.
Yes. Ketamine can be given by intramuscular injection, intranasally and by lozenge. Ketamine is absorbed by the body differently and unreliably when taken orally or nasally and does not appear to be as effective for depression. Around 90% of the clinical research has been done on the IV route of administration.
Typically, infusions are not given to anyone under the age of 14 but requirements vary from clinic to clinic. Here at VIVE Infusion and Wellness, we do not perform infusions on anyone under the age of 18.
No. We do not administer ketamine to those pregnant and/or nursing.

Unfortunately, ketamine therapy is not commonly covered by insurance. A medication has to be FDA-approved for the condition it’s treating to be covered. It is not FDA-approved for the treatment of psychiatric conditions. Ketamine therapy is a qualifying medication expense for some HSA/FSA plans. Please contact your benefits provider to confirm.

VIVE Infusion and Wellness does not want the cost to impose a barrier to treatment. We offer discounts if treatments are purchased and booked in advance. Veterans may qualify for discounted or fully covered services through the VA. Financing is also available through Advance Care Card.

Manage your expectations. Just as with antidepressants, ketamine is a treatment, not a cure. It’s not a standalone. All of the other elements of practicing mental wellness, lifestyle optimization and freedom from cognitive impairments are crucial. In other words, take care of yourself, get enough sleep, exercise, hydrate, put good food in your body, avoid drugs and alcohol, limit stress and surround yourself with positive people. Also, consider therapy! Research has shown that medication in combination with therapy helps improve mental health more quickly than either modality alone. With ketamine therapy, it’s recommended that you have a therapist who is able to help you process any emotions and/or thoughts you encounter during your treatment. 

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