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Frequently Asked Questions about Ketamine Injections

What does Ketamine Treat?

There have been 100's of thousand Ketamine infusions & injections administered for treatment resistant depression (TRD), bipolar depression, anxiety, postpartum depression, OCD, addiction and PTSD over the past decade and many of the clinical trials have shown upwards of 80% of clients receive significant relief from a series of these powerful treatments.

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Ketamine Injections have also been shown to treat:

  • Major Depression

  • The depressed phase of bipolar disorder

  • postpartum depression

  • Anxiety and obsessive compulsive disorder (OCD)

  • post-traumatic stress disorder (PTSD)

  • Feeling numb and disconnected

  • Addiction/Withdrawal 

  • restless leg syndrome & severe migraines

Our treatments will be tailored specifically to your condition and treatment plan in terms of frequency and dosing. Ketamine West can safely and effectively give therapeutic doses via Intramuscular Injections (IM) which are clinically just as powerful as IV infusions. Our goal is to offer you the best chance of success. By listening to your story we can create a treatment plan that is safe, flexible, and helps to rapidly relieve your suffering

How is ketamine different from traditional antidepressants?

A healthy functioning brain vs a depressed brain

Traditional antidepressants known as SSRIs  like Prozac, Zoloft, Lexapro, and effexor are believed to work by altering levels of neurotransmitters (chemical messengers) in your brain such as serotonin and dopamine. These neurotransmitters play a major role in shaping our moods on a daily basis. These traditional medications may work well for some but can take months of guessing and waiting and still will only work for less than 36% of the population, who fail several med trials and are considered treatment resistant. 

Treatment resistant depression (TRD) affects millions of people each year. Sadly, many of these people are still  suffering with little to no relief and a deep feeling of hopelessness as they continue to struggle and isolate from family and friends.
With treatment resistant depression its likely we're targeting the wrong route to relieving one's suffering all the while their hope continues to shrink and their medication list and side effects continue to grow. 

Ketamine's rapid antidepressant and anti suicide effects are unique and very different from traditional antidepressants in that it bypasses the traditional antidepressant route and works rapidly, within hours, on a super highway in your brain called the glutamate system. Researchers believe glutamate is the most abundant neurotransmitter ( super car) in your brain. glutamate is also responsible for creating new neuronal pathways and synapses (super highways) in your brain in the form of memory, emotions, and optimal brain functioning. Ketamine and glutamate can restore your broke down car (dopamine and serotonin) and repair your damaged freeways (neuronal synapses) in your brain in order to get you get you back onto the road of feeling happy, healthy, and excited about the direction of your life.

How many Injections will I need?

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Much of the research done over the past two decades has shown that intravenous (IV) ketamine and Intramuscular ketamine (IM) at low to moderate doses has been shown to have rapid and remarkable benefits on about 80% of those suffering from severe depression or treatment resistant depression (TRD). There's no doubt that the benefits of ketamine are remarkable and very real when it comes to depression.

For treatment resistant depression, PTSD, anxiety, and other mental health disorders we recommend  Approximately 4-6 office visits with 2  injection per office visit. After speaking with you and reviewing your unique case, we will establish a treatment plan with the goal rapid relief and remission. By giving intramuscular injections (IM) with our unique dosing protocol and schedule, we can safely administer ketamine with one goal of safely and effectively relieving your suffering 

Some clients can see improvement the day after their first office visit but some may not see benefits until after their 2nd or 3rd office visit depending on the severity of their symptoms. On the first Injection, we want to get your body and mind used to ketamine by giving you a dose that feels safe to you. This will allow us to see how you respond and tolerate ketamine injections. Our goal will always be to relieve your suffering.
 

If ketamine does not improve your mood, outlook, and overall functionality right away please be patient and we strongly suggest you complete your series of injections to maximize ketamine's ability to create new brain synapses and pathways while shedding  the pathways that no longer serve you. By completing your series of injections you will  have a much higher chance of repairing synapses and creating new neuronal pathways with one primary goal of remission 
 
 

  • How does IM ketamine compare to IV and what are the other routes?
    There are quite a few different ways to receive ketamine including Intramuscularly, orally, sublingually, nasal, and intravenously. The response and overall effectiveness of the of routes are very different. Despite some clinics claiming IV is the gold standard this is simply not true and primarily a scare tactic for some IV clinics to get clients into their clinics. Its rather silly and laughable, honestly. We do recognize IM and IV as the gold standard for receiving ketamine. We simply chose IM ketamine delivery because: IM is less invasive than IV and its a much smoother experience for clients to get a small insulin needle injection in their shoulder compared to having a clinician stick them in their vein, and potentially miss, with a much larger IV needle. With IM injections you're not connected to IV tubing, an IV drip or pump during your ketamine journey which can cause confusion and agitation for some clients if the pump is alarming or failing. Its much easier to use the restroom after receiving an injection compared to being connected to IV tubing/pump The IM injections simply feel more free to our clients to go on their ketamine journey after receiving their injection (takes 10 seconds to inject) compared to being hooked up to an IV drip and pump for your entire ketamine journey Here's a recent case study with statistical analysis showing IM to be just as favorable if not more favorable than IV https://www.biospace.com/article/releases/klarisana-s-newest-ketamine-study-shows-im-ketamine-therapy-comparable-to-iv-administration/ IM and IV are considered the gold standard for depression and other mental health treatments for rapid and controlled relief with a maximum amount of absorption of 94-100%. Compared to the oral and nasal route which only have about a 20-40% absorption/bioavailability. Bioavailability is the amount of the drug that is available for use in your body after the drug is metabolized (broken down) by the liver. Lastly, we give two IM injections that allows our clients to be in the ketamine journey for about an hour and a half compare to just one IV drip bag infused often over 40-60 minutes. Ultimately, its up to you to decide the best route for yourself and decide which clinic is best for you. We won't give you a sales pitch on IM vs IV and would rather have potential clients focus on the overall feel of a clinic and how they're treated upon first contact. We may or may not fit into your ideal clinical setting. Its up to you :)
  • What can I expect before, during, and after my first ketamine injections?"
    Initially, We will need to complete a medical and psychiatric history in our online forms followed up by your first treatment with a ketamine specialist, who is licensed and trained in psychiatry, anesesthia and ketamine Injections. You can expect to be at the treatment center for about 1.5 hours prior to having a friend or loved one drive you home. You may not drive yourself home after your Injections as this is extremely dangerous! You will need to wait at least 12hrs before driving any vehicle and will need to have a ride home, no exceptions! ​ The process is a step by step process as follows: 1. Before your Injection: a specialist will assess how you're doing and feeling. 2. Then to ensure your safety, we will apply monitors that allow us closely assess and monitor your blood pressure, respiratory rate, heart rate and oxygen levels, which will continue to be monitored throughout the course of your injections. ​ 3. Next, you will receive a pre calculated dose of ketamine based on safety and your unique treatment plan. You will receive this as a injection in the soft part of your upper shoulder area (deltoid muscle). This will be with a tiny needle (30 gauge) and will only take about 5 seconds to inject the medicine. The injections can have a slight burn as it goes into the muscle that lasts about 5-10 seconds. 4. After the injection, we will continue to monitor your vital signs and your response to the ketamine throughout the duration of your session. You will then be given a eye mask and headset that are tailored towards facilitating a journey inwards and reduce external distractions and stimuli. We also offer weighted blankets to help facilitate relaxation, grounding, and safety if you choose to use one. you may bring in your own music as well but consider no lyrics as lyrics can distract one from their journey. You can set an intention prior to starting the treatment in regards to things you want to change or work on moving forward in your life. The pre calculated ketamine dosage given to you will be safe and you will be awake and conscious but may feel like your drifting in the clouds at times especially during the peak of the ketamine injection. During the injection, some clients have a dissociative experience with increased sensitivity to sound and light with an altered perception of time, space, and color. Many clients tolerate this experience without any discomfort as well as finding the overall experience to be pleasant. However, some may feel some mild to moderate discomfort in the form of anxiety or not feeling in control during the peak or dissociative episode. Once the injection has peaked in 15 minutes, the dissociative experience of ketamine rapidly goes away and is often gone within 10-15 minutes. You will be conscious and awake throughout the injection and able to interact with anyone around you including a loved one or the specialist. However, the best experience is often when the client is able to quietly relax or listen to some relaxing music and sit quitely contemplating what you are wanting to work on or let go of. The sedative effects of ketamine will wear off within 1-2 hours after your last injection. However, to ensure your safety and others we ask that you do not drive a vehicle until 12hrs after your last injection as part of our safety policy. ​ 5. After your last infjection, we will monitor you for approximately 10-20 minutes to ensure your safety and that you're cleared to go home by a clinician. When you're ready, we will remove the monitoring equipment and you can be released to a friend or loved one who can safely drive you home. Most clients experience some mild fatigue after the injections but very much feel like themselves.
  • Are there any side effects during or after my injections?
    you may experience some nausea during your course of injections. If you experience nausea, the specialist can give you some anti-nausea medication and often do prior to treatment as preventive caution. Any sides effects are usually gone within a few hours after completing the injections and completely gone by the following day. Overall, ketamine is considered a very safe medication when administered by a licensed professional. The four primary and most common side effects are: 1. Nausea --we can help you with this. 5-10% of clients experience nausea 2. Short term Increases in Blood Pressure--we will be monitoring this and can treat it if needed. This is a short term side effect and wont last more than an hour. most people see a slight elevation in blood pressure during their injections. 3. Dissociation: can be perceived as pleasant or unpleasant and hard to predict. this only lasts about 10-15 minutes at the peak of the injection. Remember, this is when ketamine is really doing the hard work of creating new neuronal pathways and rebooting your brain so its worth the potential discomfort of the peak ketamine experience. 4. At the peak, ketamine can cause people to feel unstable on their feet due to sedation. Thus, if you need to go the bathroom please have a loved one or clinician escort you for your safety. We will be happy to address any of your medical or mental health concerns before starting ketamine treatments. Overall, ketamine is a very safe medication that has been around for decades and used daily in the medical and mental health community
  • What can I expect after my series of injections?
    We will stay committed to you long after your series of injections are completed. We understand that it is vital that ketamine therapy be a part of a bigger treatment plan for you, which is why it's important that you continue to work with your primary care doctors, therapist, and medical professionals to continue your journey to healing. ​ Following your initial series of injections, some clients will begin an injection maintenance program and returning for additional injections called "boosters" as needed. Often 1 booster office visit is all that is necessary to restore the client and significantly extend the clients results. The time between maintenance "booster" injections will be different and unique to each client and the severity of their symptoms. Some clients will have 1 booster per month approximately 1-3 months after their initial series of injections. Other clients have gone 3 to 6 months before needing to come back for a booster. It truly is unique to each individual and there is no way to predict how often you will require a booster injection until you start your treatments and we can assess your response.
  • Will my current medications interfere with my ketamine injections?
    In your intake form: it's very important that you inform us of any and all medications, supplements, and substances you are taking/using. Please do not stop taking these medications without informing your current prescriber or psychiatric provider. ​ Some medications that have raised questions in regards to blunting the full benefits of ketamine and will need our assessment prior to starting ketamine therapy are: ​ Lamictal (generic name Lamotrigine): If this is a medication you're taking please let us know. Clients will be asked to not take lamictal 6 hours prior to and 6 hours after their injections to get the best results from the ketamine series. Lamictal has been noted to blunt the response of the ketamine. ​ ​ Clients that are taking higher doses of benzodiazepines can have a reduced response to the full benefits of ketamine. This does not mean you can't receive ketamine treatment while taking benzodiazepines such as Xanax (Alprazolam), Ativan (Lorazepam), Valium (Diazepam), and Klonopin (Clonazepam). Taking these medications with ketamine is perfectly safe. However, to ensure the best outcomes and response to treatment we ask that you skip a dose 6 hours prior to your injection and 6 hours after your last injection. ​ ​ SSRIs like prozac and zoloft, SNRIs like effexor and Cymbalta, or Tricyclics like amitriptyline or nortriptyline, do not interfere with ketamine nor does Wellbutrin (bupropion). Generally speaking most medications are safe with ketamine infusions but its crucial we know all your medications, supplements, vitamins, and illegal drugs including alcohol you may be using for your safety. ​ ​ We can help make recommendations with the guidance of your psychiatrist or current prescriber in regards to some of the above medications. Our primary goal is that you receive the full benefits of ketamine injections with the best chances of being happy, healthy, and optimally functioning.
  • Is there a licensed medical professional availabale during my treatment?
    Yes, there is a fully licensed specialist in psychiatry, who has had specialty training in anesthesia and ketamine. Our team will be monitoring you throughout your injections to ensure your safety and assess your response to ketamine treatment. Our provider has over 10 years of specialty training in the medical field, psychiatry and anesthesia. With his knowledge, he understands how to relieve suffering in a safe and efficient manner while ensuring your safety and treatment goals are the highest priority.
  • Is Ketamine considered Safe?
    Ketamine has been used in surgical centers, emergency departments, and operating rooms for decades. In fact, if you have ever had a major surgery there is a good chance you have received ketamine. Ketamine is considered a very safe and rapid acting antidepressant and anti suicidality when administered by a properly trained specialist. Ketamine is actually used thousands of times daily in modern medicine as an anesthetic in operating rooms, in psychiatry, ERs and medical centers across the world for the past 53 years. Ketamine is considered by the World Health Organization (WHO) as one of the safest and most essential drugs in a health system.
  • Do I need to bring someone with me to my ketamine treatments?
    It is not necessary to have someone stay with you during your injection series but it is nice to have support if you feel you will need it. Someone must bring you home! You may NOT drive a car, operate any motor vehicles including heavy equipment, sign any contracts or partake in any other risky activities until at least 12 hours after your last injection as that mental function and reflexes may be impaired. Another adult will need to drive you home and must be present prior to your discharge from the clinic to sign you out.
  • Can I eat or drink prior to my appointment?
    Please do not eat or drink any solids 3-4 hours before the injection, water and healthy liquids are the only exception and please limit your fluid intake that morning so you don't have to use the bathroom as much. If you need to eat for a medical issue or to keep your blood sugars stable eat a piece of fruit and some healthy protein please. You may drink water up to 2 hours before the injections. About 5-10% of people get nausea with Ketamine and its best to have a empty stomach. If nausea or vomiting does occur we can administer an anti nausea medication by mouth to help relieve the nausea. Also, please empty your bladder right before your first injection as that ketamine does make some people have to urinate and ketamine is sedating, thus walking to the bathroom can be a hazard. If you need to use the restroom please inform staff before going to the bathroom as that we don't want you to fall!
  • I dont have a psychiatrist, is that a problem?
    You do not need a referral from a psychiatrist, therapist, or PCP as that we have a licensed psychiatric provider in the treatment center, who can assess your need for ketamine treatment. However, your current prescriber will still be fully responsible for your medications and any changes you make. It is best to ensure you have someone to work with you and your mental health moving forward for the best treatment outcomes and a successful treatment plan that involves discussing your experience with someone you trust like a licensed therapist. Ketamine can significantly enhance one's feeling of openness and connection to self and others. Thus, having someone to share and discuss this experience with can be crucial to your recovery. Thus, we strongly suggest having an established therapist prior to engaging in ketamine treatment. Pleas do not make any drastic medication changes without first consulting your current prescriber as that they will still be responsible for your medications and any changes you make to your medications.
  • What is dissociation and how is it significant to my relief or remission?
    Dissociation is the sense of being detached from yourself or your body. This is often described as a gentle floating or dream like quality as if you're daydreaming and very relaxed. Metaphorically, you may feel like you're floating in the clouds or drifting through the universe but at the same time you will know you're sitting relaxed in a recliner. If a clinician speaks to you, you will easily be able to respond and know where you're at. Generally, dissociation is enjoyable when you can fully relax and let go of control. Dissociation can feel like a sense of well-being while feeling more connected to yourself and others during or immediately after the experience. Often, dissociation is a pleasant to neutral experience but can cause anxiety for people that have a hard time letting go of control which we can assess prior to your treatment :)
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