FAQ

Ketamine works through a unique mechanism compared to traditional antidepressants. It primarily targets the N-methyl-D-aspartate (NMDA) receptors in the brain, which are part of the glutamatergic system. By blocking these receptors, ketamine increases the levels of glutamate, a crucial neurotransmitter. This increase in glutamate activates another set of receptors called AMPA receptors, leading to the release of molecules that promote synaptogenesis, the formation of new neural connections.

Rapid Antidepressant Effects

One of the most significant advantages of ketamine is its rapid onset of action. Unlike conventional antidepressants, which may take weeks to show effects, ketamine can produce noticeable improvements in mood within hours to days. This rapid effect is particularly beneficial for individuals with severe depression or suicidal ideation.

Treatment-Resistant Depression

Ketamine has shown remarkable efficacy in patients with TRD, who have not responded to at least two other antidepressant treatments. Studies have demonstrated that a significant proportion of these patients experience a rapid reduction in depressive symptoms following ketamine treatment.

Other Mental Health Conditions

Beyond depression, ketamine has been found effective in treating other mental health conditions, including:

  • Anxiety Disorders: Ketamine can reduce symptoms of anxiety and has been used in patients with generalized anxiety disorder and social anxiety disorder.
  • Post-Traumatic Stress Disorder (PTSD): Ketamine has shown promise in reducing PTSD symptoms, including intrusive thoughts and hyperarousal.
  • Obsessive-Compulsive Disorder (OCD): Some studies suggest that ketamine can help alleviate symptoms of OCD, although more research is needed.
  • Chronic Pain Management: Ketamine also has applications in managing chronic pain. It appears to reduce inflammation and improve communication between specific brain regions involved in pain perception. This makes it a valuable option for patients with chronic pain conditions that have not responded to other treatments.

Administration and Treatment Protocol:

Comprehensive Treatment Plan

Experts emphasize that ketamine should be part of a comprehensive treatment plan that includes psychotherapy and other medications. Combining ketamine with cognitive behavioral therapy (CBT) or other forms of psychotherapy can help sustain the benefits and promote long-term recovery.

In summary, ketamine offers a rapid and effective treatment option for individuals with treatment-resistant depression and other mental health conditions. Its unique mechanism of action and ability to promote synaptogenesis make it a valuable tool in the mental health treatment arsenal. However, it should be administered under strict medical supervision as part of a broader, individualized treatment.

Reasonable expectations

At Salish Ketamine, we view ketamine therapy as a valuable tool in your therapist’s toolbox, designed to help you overcome obstacles in your treatment journey. Ketamine can often facilitate the opening of doors and windows in your mind, helping to remove stumbling blocks that may have impeded your progress in the past. It’s important to understand that ketamine is a treatment, not a cure. While not everyone will experience the same benefits from ketamine infusion therapy, we are encouraged that 60 to 70 percent of our patients do see significant improvements. Our goal is to work alongside your mental health provider to tailor this treatment to your unique needs, supporting you in achieving your personal goals and enhancing your overall well-being.

Medical History and Evaluation

During your initial consultation for ketamine therapy, you will undergo a comprehensive medical history evaluation and consultation with a qualified healthcare provider. We will review the results of your labs together. This step is crucial to ensure your safety and tailor the treatment plan to your specific needs. You will be asked to disclose any pre-existing medical conditions, medications, and previous mental health treatments. This information helps the healthcare provider assess potential risks and side effects associated with ketamine infusion therapy.

  • Review of your medical history
  • Listening. You have been on a journey and reaching out for help. You should be applauded for taking the next step. I’ve found most Physicians talk when they should be listening. Our goal at Salish Ketamine is to help you live better. In order to do that we need to hear what you want and need. With that information we’ll work together, in collaboration with your mental health provider, to help you achieve your goals.
  • Review medications
  • Review your lab work
  • Physical exam

Mental Health Assessment

A mental health assessment will also be conducted to evaluate your current symptoms and treatment goals. This assessment helps in determining the appropriate dose and timing of your ketamine infusions. Open and honest communication during this phase is essential to develop an effective treatment plan. Before, after, and during your ketamine therapy we’ll send you self-administered diagnostic tools to monitor your progress. This can include the PHQ-9, Mood Score, GAD-7, and other progress tools. You can complete them on your phone through our clinic app.

Preparation and Setup

On the day of your infusion, you will be guided to a comfortable room where a small IV will be inserted into your hand or arm. You will be monitored throughout the session to ensure your safety. The infusion typically lasts around 40 minutes, although it may be longer for pain disorders.

Sensations During Infusion

During the infusion, you may experience various sensations such as euphoria, floating, heightened perceptions, and a sense of dissociation. These effects usually begin to manifest halfway through the infusion and subside 10-15 minutes after the session ends. Most patients find the experience relaxing and describe it as “spiritual” or “pleasurable.”

Post-Infusion

After the infusion, you will be monitored for a short period to ensure there are no adverse effects. You may feel groggy or tired, so it is recommended to arrange for transportation home. The mood effects of the infusion can be noticed as soon as one hour afterward, but typically they are more pronounced 4-24 hours post-infusion.

Importance of Music

Music plays a significant role in enhancing the therapeutic effects of ketamine therapy. It helps create a soothing and supportive environment, making the experience more comfortable and effective. The right selection of music can act as a “hidden therapist,” guiding you through the session and evoking positive emotions.

Recommended Music Types

Ambient and Classical Music: These genres are highly recommended due to their soft, slower beats and calming melodies. They help ease racing thoughts and allow you to focus on the therapeutic experience.

Nature Sounds: Incorporating sounds of nature, such as ocean waves, rain, or rustling leaves, can contribute to a peaceful atmosphere and promote relaxation.

Instrumental Music: Music without lyrics is generally preferred as it avoids potential distractions and helps maintain a calm state of mind.

Creating Your Playlist

When creating your playlist, consider the following tips:

  • Choose songs with a slow tempo, soothing beats, and mellow sound.
  • Avoid music with lyrics or words that could trigger negative feelings or memories.
  • Experiment with various genres to find what resonates best with you.
  • Ensure the playlist length matches the duration of your ketamine session, typically around one hour.

Expert Recommendations

Nate Stephens: Jammy Jams. Found on Spotify and Pandora. Instrumental music set to current and older songs you’ll know. Prior to your infusion plan your music. Find something soothing.

Bill Richards: Utilizes supportive, unfolding, and forward-moving music, often featuring a solo voice, orchestra, or maternal voice.

Mendel Kaelen: Recommends music that resonates with your emotional state and evokes a sense of journey during the session.

Spotify Playlist: Some curated playlists include “KAP Rose,” “KAP Hug,” and “KAP Love,” which are designed specifically for ketamine therapy.

By following these guidelines and recommendations, you can enhance the therapeutic outcomes of your ketamine therapy sessions, making them deeply healing and relaxing experiences.

After a ketamine infusion, it is required that you do not drive yourself home due to the potential side effects of the treatment, which can include dizziness, drowsiness, and impaired judgment. Here are the recommended options for getting home safely:

  1. Friend or Family Member: It is best to have a friend or family member drive you home after your infusion. This ensures that you have someone you trust to help you if you experience any lingering side effects.
  2. Taxi or Ride-Sharing Service: If a friend or family member is not available, you can use a taxi or ride-sharing service like Uber or Lyft. However, some clinics may require you to stay for a longer observation period if you choose this option.
  3. Public Transportation: While it is generally not recommended to drive yourself to the clinic, you can use public transportation to get to the clinic and then arrange for someone to pick you up afterward.

It is important to plan ahead and ensure you have reliable transportation arranged before your ketamine infusion appointment to prioritize your safety and comply with the clinic’s guidelines.