Based on published research data, and in our experience, up to 70% of all patients can expect to have responded by the time they have received 6 infusions.
If you are not currently a patient of Dr. St. John’s, she will meet with you for a consultation to discuss your psychiatric condition and history. She may want to obtain medical records and/or discuss your diagnosis and treatment history with other doctors whom you have been receiving treatment from.
Patients who are currently receiving psychiatric treatment from Dr. St. John will work with her to determine appropriateness for ketamine infusion therapy during a routinely scheduled appointment or may schedule an additional office visit to discuss the treatment option.
All treatments are performed within our existing outpatient offices.
Most responsive patients receive an initial series of 6 (six) infusions. This is generally referred to as acute phase treatment or induction treatment.
Some patients will choose to stop receiving IV ketamine therapy after 6 infusions and rely on another form of treatment instead to maintain or sustain improvement in their mood. These patients view ketamine infusions as a “stop-gap” treatment to bring about a rapid improvement in mood while they are also planning a change in medication or planning to start another treatment like TMS therapy or ECT – all treatments which take more time for patients to experience results.
Other patients choose to obtain IV ketamine therapy on a longer-term basis. These patients may instead return to the office at various intervals for booster or maintenance infusions - generally when they begin to feel the initial series wearing off.
Patients who do not experience an improvement in mood by the 3rd or 4th ketamine infusion during the acute phase may opt to discontinue IV ketamine therapy and try a different treatment instead.
Some patients will begin to feel better within several hours of the first infusion. Patients with thoughts of self-harm often notice those thoughts dissipating first. Other patients may not notice any mood improvement until the next day. Some patients will require a second (or even a third) infusion before feeling better.
Ketamine therapy results in no clear long-term side effects, though irritative and inflammatory urinary tract and bladder symptoms including cystitis have been reported in individuals with a history of chronic ketamine use or abuse.
Hypomania has not been reported following ketamine therapy.
There are very few psychiatric contraindications. Dr. St John will discuss contraindications with you before you receive your first infusion. Patients with significant elevations of blood pressure may require treatment of their hypertension prior to beginning ketamine infusion therapy.
Ketamine has been reported being used as a drug of abuse.
All patients are screened for substance use disorders. A thorough discussion including the risks and benefits of trying Ketamine Infusion therapy will take place between all patients and Dr. St. John, especially those with a history of a substance use disorder.
Patients are required to follow clinic policies and will be dismissed if any evidence arises indicating that the patient has obtained oral, IV, or nasally inhaled ketamine from another source or provider.
Ketamine dependence and tolerance are possible following prolonged administration.
Anti-depressant medications (SSRIs, SNRIs, TCAs, etc.) do not interfere with ketamine, and there is no need to stop them. Ketamine infusions can provide relief during the time it takes antidepressant medications to begin working.
Important: You should not decrease or stop taking any prescribed medication without first consulting with your prescribing physician.
Ketamine is administered over a period of 40 or more minutes. The dose is determined by your weight. The amount of ketamine administered is not enough to cause a loss of consciousness, so you will remain awake. During the infusion, some patients experience odd perceptions—like seeing bright colors. Some report what is referred to as a “dissociative” or “out of body” experience. Most commonly, patients describe experiencing a pleasant dream-like state. Once the infusion is complete, the dissociative effects of the drug rapidly dissipate. There are no delayed “flashbacks,” and patients generally leave the office within 30 minutes of the infusion feeling quite normal.
Occasionally patients experience some nausea or dizziness during an infusion. More rarely, a patient may experience a transient headache. Patients can expect to be tired following the infusion. Increases in blood pressure and heart rate are also not uncommon. Your vital signs will be measured at intervals to ensure your safety.
You do not need to have someone bring you or accompany you during the infusion, but we request that you have someone drive you home. We advise you not to drive a car until the morning following your infusion.
You cannot eat for the 4 hours prior to your scheduled appointment. You may have clear liquids up until 2 hours before your appointment.
Following the initial series of infusions, most patients will work with Dr. St John to begin a maintenance program, returning for a single infusion intermittently. The interval between maintenance infusions varies from patient to patient.
Yes and no. We are “in network” with many insurance plans and can bill any required psychiatric evaluations and assessments directly to the insurance companies.
However, because ketamine infusion therapy for mood and anxiety disorders are non-FDA approved indications, insurance companies view it as experimental and/or investigational and DO NOT provide reimbursement for the infusions.
