FAQ

GENERAL

Yes. All infusions are administered in our offices in comfortable, private treatment rooms.

About an hour, with an additional half hour of quiet time before discharge.

Assuming you begin to feel better during the initial treatments, a total of 9 infusions is recommended within a six-week period, which will maximize the ketamine effect on new dendrite and synapse growth. Thereafter, patients are placed on a maintenance program and are asked to return when they feel it necessary for single infusion boosters. During the maintenance period, the duration of relief varies by patient. The average duration of relief between booster infusions is 4-6 weeks. There is no way to predict what your needs will be. Some patients find that as they go through this process, the time between boosters lengthens, prompting them to come in every other month, every 3 months, or even less frequently. In our experience, patients find ketamine boosters effective for as long as needed with no long-term side effects. 

Most patients experience a mild dissociation or inner reflective experience that is generally well tolerated and often quite enjoyable. If you find it unpleasant in any way, we can make adjustments to minimize or eliminate any unpleasant sensations. Within 15 minutes of ending the infusion, your thinking will be clear. There are no delayed “flashbacks.”

No. The low dose of ketamine you will receive does not cause any loss of consciousness.

Your thinking may be a bit cloudy and your walk a bit unsteady for an hour or so after treatment. You may also find that you will be somewhat tired for several hours. Hopefully, there will be a noticeable improvement in your mood shortly after one or two infusions.

Yes. Benzodiazepines, such as Klonopin, Xanax, and Ativan do interfere with ketamine if used daily and at higher doses. Lamictal (lamotrigine) in doses above 150mg/day also can block ketamine efficacy. Please speak with the doctor to discuss if and how to modify your existing medication regimen in order to maximize ketamine’s effectiveness.

Not at all. SSRIs and other antidepressant medications do not interfere with ketamine’s mechanism of action.

Almost none. Uncontrolled high blood pressure or heart failure need to be corrected in advance. Regardless, all patients will be closely monitored while undergoing treatment.

CONCERNS

The treatment is essentially pain-free. Other than a small prick while starting the infusion line, you will feel no pain and may even enjoy the experience.

We’ve treated many patients and have seen no instances of ketamine addiction. Ketamine has been used safely for surgical anesthesia and trauma management in hospitals and elsewhere for over five decades, has been included on the World Health Organization’s Essential Medicines list since 1985, and has few side effects. Although it is sometimes abused recreationally in high doses as a “club drug,” there is no evidence that ketamine is addictive.

Depression treatments require a very low dose, so hallucinations and any uncomfortable side effects that may come with much higher doses are extremely rare. Ketamine has few other side effects.

PREPARATION

A direct referral from a psychiatrist is not required. While a referral from any mental health care provider is encouraged, an initial phone or office consultation with one of our doctors can determine if you are a good candidate for ketamine therapy.

You can eat, but you should not have any food within one hour of your appointment.

Most of our patients bring their own devices and earbuds or headphones to listen to music while undergoing treatment. We strongly discourage using your devices to make phone calls, texting or emailing during the treatment. Those accompanying you are welcome to bring laptops, iPads, iPods and cellphones as well.

Yes. Our offices are all handicap accessible

You do not need anyone to accompany you, though they are certainly welcome. You may also leave on your own following our evaluation, but we recommend that a friend, relative or caretaker accompany you home, if possible. We also recommend not driving until the following day.

EFFECTIVENESS/LONG-TERM

Not necessarily. Mild to moderate depression is often successfully treated by mental health professionals with antidepressant drugs and/or psychotherapy, which we encourage. The treatment of severe depression, major depressive disorder (MDD) treatment-resistant depression and other mood disorders is more difficult and requires a higher level of care, such as ECT, TMS or ketamine therapy. Ketamine infusion therapy is reserved for those patients with severe depression and anxiety that is considered treatment-resistant, or those with suicidal ideation.

The patients we see are all considered treatment-resistant. That is, they have not responded to any available antidepressant medications and in many cases have not responded to ECT or TMS. While we cannot predict with certainty who will respond to ketamine, clinicians across the country have reported that roughly 70%-75% of patients who have not been helped by any other treatment do show a dramatic improvement in their mood with ketamine, and 3 out of 4 patients who present with suicidal ideation cease to have such thoughts. A meta-analysis by the American Psychiatric Association using data from multiple ketamine trials reported similar results, with 70% of treatment-resistant patients responding positively after receiving the initial round of low-dose infusions. 

We’ve shown very good results for patients suffering from all of these conditions, though we cannot predict with certainly which patients will respond.

Once we begin infusion therapy, the number of infusions you will need before feeling mood improvement will vary. A small percentage of patients will begin to feel better the day after the first infusion. Most young adults will need 3 or 4 infusions before noticing significant improvement. Adults over 50 years old may need 4 or 5 infusions before improvement becomes apparent. Although the above are typical response times, your experience will be individual.

We don’t believe so. After the first year or so, many patients find the need for booster infusions decreases over time. In the meantime, several large pharmaceutical companies are sponsoring clinical trials with ketamine-like drugs for more convenient nasal and oral administration. It may be a few years, but those drugs will likely become available. But for now, patients with debilitating severe depression with constant thoughts of self-harm often cannot afford to wait. Currently, ketamine infusion therapy is the most exciting and successful new treatment for severe depression, MDD, and suicidal ideation and is the subject of many ongoing trials.

In general, we prefer to schedule patients 5 to 7 days in advance. We can meet most patients’ scheduling needs.

LEGALITY/CREDENTIALS

The ketamine medicinal product has been approved by the Israeli Ministry of Health only as anesthetic, and not as a depression therapy. However, according to Reg. 29(a)(10) of the Pharmacists Regulations (Medicinal Products), 1986, licensed physicians may prescribe the drug to unapproved indications, subject to filling a special prescription. Under this regulations, all ketamine prescriptions issued in KetaMind clinic are submitted for review of the Ministry of Health’s District Pharmacist.