Ketamine Infusions: The Answer to Treatment-Resistant Depression, PTSD, and Chronic Pain?

Learn how ketamine infusions help treatment-resistant depression, PTSD, and chronic pain. Discover how ketamine infusions work and what to expect during ketamine treatment.

If you or a loved one has struggled with depression, you know how debilitating it can be. For some, symptoms improve with treatment. Therapy, medications, diet changes, and/or exercise are enough to lift the fog. But for others, depression remains. What can you do when your treatment fails you?

The great news is there’s hope. Ketamine treatment helps with treatment-resistant depression, along with chronic pain and even PTSD. While first introduced in the 1960’s, and originally used as an anesthetic, additional research showed it offered more than just pain relief. It’s so beneficial that the use of ketamine for treatment-resistant depression and chronic pain has skyrocketed in recent years. 

But what is ketamine and how does it work? Let’s look at what ketamine actually is, how  ketamine treatment for depression works, and why it’s a great option to consider.

What is Ketamine?

Ketamine is a safe and effective medication option for treatment-resistant depression, PTSD, and chronic pain. It has both anesthetic and psychedelic effects and at high doses is used for surgical anesthesia. But when given at lower doses such as during a ketamine infusion, it has both pain and antidepressant properties, providing rapid symptom relief of depression and other treatment-resistant mental health conditions. If you’ve tried and failed more than 2 treatment options for depression, it may be time to consider ketamine infusion therapy.

In addition to treatment-resistant mental health conditions, ketamine infusions are well studied for both adolescent and adult pain conditions. Patients with migraines, chronic pain, neuropathic pain, and complex regional pain syndrome (CRPS) have benefited from ketamine infusions in medical studies. 

Most often, ketamine is given through an intravenous infusion. At Arizona Wellness Medicine, IV ketamine infusions are administered by a board-certified anesthesiologist, the most experienced physicians in use of ketamine and its effects. Learn more here.

How Does Ketamine Work?

Ketamine works in both the central and peripheral nervous systems. It also impacts levels of neurotransmitters in the brain. This provides relief from chronic symptoms. – like depression, pain, anxiety, and PTSD.  

Ketamine also works by interacting with a variety of receptors in the brain, most notably the NMDA receptors. These NMDA receptors are involved in:

• Memory and cognition
• Depression
• Chronic neurological disease
• Inflammatory responses
• Anesthesia
• Pain transmission to the brain
• Opioid tolerance

Ketamine also interacts with other key receptors. It inhibits the reuptake of epinephrine, dopamine, and serotonin – essential neurotransmitters. This provides mood-boosting effects. It also interacts with opioid, nicotinic, and muscarinic receptors. Symptoms often start to improve within minutes of the infusion. At higher doses, ketamine is used for anesthetic purposes. But it’s given at lower subanesthetic doses over time for the treatment of chronic conditions.

This is great news if you’ve been debilitated by depression. You know the long list of side effects that can occur with typical antidepressants. Ketamine treatment for depression is a great, safe alternative.

What is a Ketamine Infusion?

A ketamine infusion is done through an IV in your physician’s office. The ketamine is delivered intravenously into your bloodstream at a specific dose. This lasts between 40-45 minutes and provides a reliable increase in ketamine within the body. The effects from the infusion begin several hours after the start and can last several weeks. Generally, the max effect is felt 24 hours after the infusion, and overall effects can last up to 1-2 weeks. 

Before getting a ketamine infusion at Arizona Wellness Medicine or other functional medicine clinic, your physician will obtain labs, gather information about your current and past symptoms, complete pre-screening questions, and check your vital signs and weight. Once cleared for the ketamine infusion, you can schedule your appointment.

Learn more about what to expect during and after the infusion here.

What Can Ketamine Infusions Help With?

Treatment-resistant depression

First off – what is treatment-resistant depression? After trying and failing two depression treatments with less than 50% relief of symptoms, a person has treatment-resistant depression. It’s so common that 30% of people diagnosed with depression have it! While it takes time to find the right treatment, sometimes nothing provides the amount of relief you need. This is where ketamine infusions may help.

Ketamine infusions produce rapid antidepressant effects when given in appropriate amounts. During the infusion, your physician delivers a specified amount of ketamine based on your weight and unique needs. The most well-studied protocol is 0.5mg/kg over about 40-45 minutes. After the infusion, you’ll start to feel improvement in symptoms anywhere from hours to days.

So, what’s the difference between ketamine and typical antidepressant medications? Ketamine’s antidepressant benefits begin just hours after the infusion. It’s a rapid-acting form of treatment. Typical antidepressant medication takes weeks to months to provide a benefit – if they are going to work for you. 

Ketamine infusions for treatment-resistant depression are generally recommended 6 times over the course of 2-3 weeks. This is the most well studied and effective regimen. After remission occurs – achieving a 50% or greater improvement in depression symptoms – then protocols such as 1 infusion a  week for the next 4 weeks, or 1 infusion per month until sustained relief is achieved.  After that, ketamine infusions can become more infrequent due to prolonged symptom relief, such as on a quarterly basis. How many infusions you will need varies tremendously from person to person, however the goal is to get each patient on the least number of infusions that works to maintain symptom relief. 

Treatment-resistant mental health conditions such as depression can be hard to live with. Ketamine infusions offer a great addition to improve your symptoms.

PTSD

Post-traumatic stress disorder is a complex mental health condition. There are limited medication options that offer effective relief of symptoms. But, when used together with psychotherapy, ketamine infusions can result in the remission of PTSD symptoms. These results are enhanced further with a series of ketamine infusions. One study found that 80% of participants had significantly less PTSD symptoms after psychotherapy combined with ketamine infusions.

Just like with treatment-resistant depression, it can take hours to days after the infusion for symptoms to improve. A series of infusions over time help maintain the gains from each session. With limited treatment options, ketamine infusions offer great symptom relief for PTSD.

Pain Management

Ketamine can provide both short and long-term pain relief. So much so, that it’s been found to be as effective as IV morphine for pain management. Most studies show a 40-50% reduction in pain. Plus, results from the infusion can last up to 3 weeks! 

Pain conditions that can improve from ketamine infusions include:

• Neuropathic pain
• Cancer pain
• Phantom limb pain
• Opioid induced hyperalgesia
• Fibromyalgia
• Complex regional pain syndrome (CRPS)
• Migraines with prolonged aura

When specifically given for migraines with aura, studies show a 75% reduction of pain at the 7-10 day follow up!

Since pain relief is long-lasting, you can often decrease other pain medications and reduce your reliance on other pain-relieving treatments. Adverse effects from a ketamine infusion for pain are few and more often occur with higher doses.

What Else Can Ketamine Do?

Research continues to emerge on the benefits and treatment possibilities of ketamine. Preliminary studies show ketamine may help with OCD, chronic fatigue, inflammation, and cognitive decline. There is also evidence that it improves sleep quality and plays a role in circadian timing. While studies are still preliminary, the potential benefits are exciting for both physicians and patients.

Are Ketamine Infusions Safe?

While not yet approved by the FDA, ketamine infusions are considered safe within the medical community. There are many evidence-based studies on the efficacy of ketamine infusions on treatment-resistant depression, PTSD, and chronic pain. It has been widely used for depression and chronic pain for many years.

The most well-studied dose for a ketamine infusion is 0.5mg/kg over 40-45 minutes. The dose is dependent on your body weight and tailored for your unique needs. This causes no respiratory depression – unless combined with opioids. This makes ketamine one of the safest anesthetics available, and thus also safe for low dose infusion therapy. 

To ensure your ketamine treatment is safe, your provider will discuss current medications and counsel you on what to avoid during treatment.  Your provider may ask you to reduce or avoid  use of prescription medications like opioids and benzodiazepines to prevent any respiratory depression during treatment. Lamotrigine can also become less effective and potentially precipitate seizures in some patients when taken during ketamine treatment. Theophylline, a medication to treat asthma and other lung problems, should be avoided due to its potential to cause seizures. Let your provider know what medications you currently take to make an individualized treatment plan for you.

During an infusion, there are some other effects on the body that ketamine may contribute to, such as increased blood pressure and heart rate, and increased blood flow to the brain. These effects wear off after the infusion is complete, and additional treatment is generally not needed. 

Also, in a small percentage of patients, ketamine can cause psychomotor effects that resolve spontaneously, such as irritability, euphoria, apathy, delusions, hallucinations, altered smell, altered sensations.  These are seen more often with higher doses given in a short period of time, such as the doses given for general anesthesia. 

Because ketamine infusions are slow and at lower doses generally 45-60 minutes – any systemic effects that occur tend to quickly subside. 

Learn more about what to expect before, during, and after your ketamine infusion here. 

Who Is Not Right for Ketamine Treatment?

While ketamine infusions are a great treatment option, it’s not right for everyone. Ketamine infusions may not be right for you if you have the following:

• Uncontrolled high blood pressure 
• Uncontrolled diabetes
• BMI over 40
• Currently pregnant
• Heart conditions, such as a cardiac arrhythmia, heart failure, severe coronary artery disease, a recent heart attack or stroke, or have a pacemaker
• Conditions with thick mucus, such as cystic fibrosis or chronic bronchitis
• Kidney or liver dysfunction
• Psychosis or psychotic symptoms, including schizophrenia and delirium
• Impaired cognitive function
• Increased intraocular pressure (high eye pressures), including glaucoma

These are things to talk with your functional medicine physician about. It’s important to make sure ketamine treatment is a safe option for your unique needs. 

Arizona Wellness Medicine: Now Offering Ketamine Infusions in Phoenix and Surrounding Area

If you’ve tried everything – changing your diet, exercising, stress management, and medications – but continue to struggle with depression, chronic pain, or PTSD, it’s time to try something new. Whether you’re in Phoenix, Scottsdale, Paradise Valley, or the surrounding area, Arizona Wellness Medicine is the leader in ketamine treatment for depression. We offer ketamine infusions to support patients like you who’ve struggled long enough. We assess our patients thoroughly before considering ketamine treatment to make sure it’s a safe treatment option for you.

Our team of highly trained functional medicine physicians work one-on-one with you to provide you with the best treatment plan. And with a board-certified anesthesiologist overseeing each ketamine infusion, you know you’re in safe hands. We want to help you reach optimal health – leaving behind chronic pain, PTSD, and depression. Get in touch here to make your first appointment.

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