Some medications and procedures for depression can’t be combined easily. But ketamine can be added to other treatments and, in fact, we often recommend combining ketamine infusion therapies with other treatments for longer-lasting depression relief.
There aren’t many contraindications for the use of ketamine and ketamine therapy does not disrupt the majority of other common treatments typical to our patient population to the best of our current understanding and based on its extensive history to date. The biggest drawback to using other treatments at the same time as ketamine treatments may be difficulty in ascribing results: If you start or change any two treatments of anything at the same time, for instance, it may be difficult to attribute changes in your symptoms to one or the other treatment.
There can be distinct benefits to using other treatments or therapies or antidepressants at the same time as ketamine treatments. Studies show positive results from Ketamine with Cognitive Behavior Therapy, for instance. If the treatments work well for a patient on their own, it is probable that they will work even a bit better together with ketamine.
We have had many patients use many different combinations of treatments to alleviate depression symptoms. Some of these have more studies and data to back them up than others, but they may all be used with ketamine therapy. Adjunct treatments may include:
- Electroconvulsive Therapy or “shock treatments” (ECT)
- Transcranial Magnetic Stimulation (TMS)
- Cognitive Behavior Therapy (CBT) and Behavior Modification Therapy (BMT)
- Memantine or Namenda
- D-Cycloserine and/or Lurasidone (Latuda) the combination together being tested as NRX-101
- Scopolamine or ‘scope’ patches
- Naltrexone or Contrave
- Riluzole or Rilutek
- Dextromethorphan and Quinidine or Nuedexta
- SSRIs, SNRIs, and MAOIs
- Meditation and mindfulness
- Sleep testing for OSA and other sleep dysfunctions
- Lifestyle Modifications, including:
- A whole foods, or unprocessed diet, or anti-inflammatory diet
- Vitamins and supplements such as Fish oil, Vitamin D, Magnesium, Zinc, B vitamins
- Avoiding news, social media and other electronics
There is at least one exception. While there are few contraindications for ketamine, the best information we have indicates that benzodiazepines (such as Ambien and Xanax), as well as heavy alcohol use, mute the effect of ketamine for the treatment of mood disorders, including depression. While we successfully treat patients on benzodiazepines, we expect that it may take more treatments to see the same effect they might otherwise see without these drugs.
Whether to reduce negative symptoms, or extend positive results, it makes sense to consider all appropriate treatment options as tools that can each add something to your efforts to achieve the best possible overall results. Depending on your needs, circumstances, and the advice of your doctors it may make sense to pursue one treatment alone or multiple together. Ketamine may be effectively used by itself, added on to an existing treatment plan, or supplemented with other treatments.
About Me, Dr Allison Wells: I started Lone Star Infusion, here in Houston, to provide ketamine infusions for depression, anxiety, PTSD, CRPS and other mood disorders and pain conditions. I am a licensed, board-certified anesthesiologist. I am super passionate about being a partner in helping people feel their best with evidence-based medicine.
An Important Disclaimer: The information in this and other blog posts represents my informed opinion or the opinion of others, and does not constitute medical advice and should not be relied upon to make decisions regarding medical care. To address the specific details of your medical conditions and treatments please speak with your doctors.