Ketamine infusions may be useful in treating depression, including bipolar depression, post-partum depression and related depression and mood disorders. They can be useful for extremely acute symptoms including suicidal ideation, and they can be useful for treatment-resistant symptoms.
In one form or another, depression affects a vast swath of the population. Statistics cited by the CDC show that More than 1 out of every 20 Americans, 12 years of age and older, reported having depression (moderate or severe depressive symptoms in the past 2 weeks) and “About 3% of Americans aged 12 and over had severe depressive symptoms…” Whether a decades-long fight, or recent-onset symptoms, depression can be profoundly life-altering. It is associated with increased risk of mortality, lower productivity, and high risk for developing other medical conditions and mood disorders. And when you’re struggling with depression it can be terrible – hard to get out of bed, hard to get things done, and hard on your relationships.
Depression can have varied symptoms and different causes. The biological mechanisms of the illness are not well understood. Effective treatments can be difficult to find, and the mechanism of action of even the most frequently prescribed treatments are not generally well understood. Talk therapies, SSRIs, lithium, benzodiazepines, TMS, ECT and other treatment options are all used with moderate success against depression. These treatment options take weeks to show any effect and may have substantial side effects.
Ketamine is an exceptional treatment option, even when other treatment options have not worked. Ketamine can often relieve the negative symptoms of depression within a few hours for a large portion of those who receive the treatments, and even for the most treatment-resistant and severe symptoms – often helping those who have been suffering for decades. Studies typically show between 50% and 80% of patients receive clinically significant results from even one ketamine treatment. Our results at Lone Star Infusion show positive results for nearly 70% for our patients, which we think is particularly good given the variety of patients that we see and treatment frequencies that we provide.
The most appropriate infusion option to treat psychiatric symptoms, including depression, is typically a one-hour low-dose infusion. This includes 40 minutes of active infusion and a 20-minute active recovery before being released to go home. In total, patients spend about an hour and a half with us at each visit.
The low-dose infusions typically start around 0.5mg/kg/hr and may be adjusted to the response of the patient. Patients frequently describe the experience of a low-dose infusion as floating or “floaty” and may experience mild visual hallucinations and other similar mild side effects that wear off quickly after the infusion. We work hard to avoid any uncomfortable experiences. Although serious side effects are unlikely we provide physician administration, continuous monitoring, safety equipment, and protocols consistent with best practices for the procedure and with the Texas Medical Board Codes for office-based anesthesia.
A series of infusions followed by maintenance treatments provide greater and longer-lasting relief – with each subsequent infusion in a series building upon the last. We often start with a series of 6 infusions, administered once or twice a week, over several weeks. The initial series is followed by maintenance treatments as needed. Maintenance treatments often start about every 3 to 5 weeks. Over time we work with patients to extend the length of time between these infusions.
Ultimately, the number and frequency of treatments is variable from patient to patient depending on such factors as the severity of the symptoms, the other medications a patient may be on, and the patient’s response to the treatments.