Ketamine Infusion for Depression and Chronic Pain
Ketamine infusions can help people after surgery, people with chronic pain especially CRPS, and people with depression. IV ketamine gives you the longest exposure at predictable doses, unlike all other forms of ketamine. If you go to a ketamine clinic, make sure it offers amenities that make you feel comfortable. The more relaxed you feel, the better your experience. Make sure you have some opportunity for privacy during treatment. Have they taken steps to make it so that if you have a reaction, they are ready to treat it? Do they monitor you constantly and have a system to keep track of your progress? Do they work with your other treating doctors? Do they only do ketamine or do they provide a more comprehensive approach? These are all important considerations.
Here at Acute Pain Therapies, we provide visitors more than just ketamine treatments. We offer Bellevue patients a professional and comforting environment with amenities including espresso service, high-end baked goods, lunches for long stays, and table-mounted iPads. For some patients, we don’t just give ketamine. We have a comprehensive approach and work closely with other providers in the area who specialize in your condition. Take a look at our clinic on our virtual tour or visit our clinic for a free discussion with our doctor who has established ketamine protocols in hospital systems.
Protocols employed by the clinic include a combination of the following:
- Ketamine infusions for both the psychological pain of depression and physical pain
- Placement of short-term nerve catheter infusions that can be continued at home
- Nerve cryotherapy
- Diagnostic musculoskeletal ultrasound
- Ultrasound guided PRP and Stem Cell injection therapy
- Sedation as needed for the afore-mentioned procedures by a board-certified anesthesiologist
Candidates for Ketamine Infusion Therapy
If you are suffering from depression in the Seattle area, schedule a consultation with Dr. Zachary Fisk to learn more about ketamine infusion therapy.
Anyone suffering from perioperative pain can benefit from ketamine infusions that can help get patients through the worst of their pain after surgery. These infusions can allow patients to rehabilitate and facilitate their own self-guided recovery. Ketamine has been demonstrated to reduce the need for addicting pain medications.
Patients suffering from CRPS who need to rehabilitate can also benefit from ketamine for a similar reason. Often movement of any sort with this condition is too painful to contemplate rehabilitation. Ketamine infusions are a tool CRPS patients can use to begin healing their own body with their own strength.
Top frequently asked questions and answers about side effects
Q. Why are these infusions expensive?
A. Ketamine is a relatively inexpensive medication. However, running a ketamine clinic is extremely expensive. Ketamine administration requires physician supervision for multiple hours. Only RN’s should perform the tasks of administering and monitoring the infusion. Medications need to be kept on-site for treatment of any side effects that might occur. Emergency equipment needs to be checked and up to date in the extremely rare case that it would be needed. Hospital grade monitoring and infusion equipment needs to be available. Entertainment options including music, video, and other applications designed to enhance the ketamine experience should be made available. The facility should provide for privacy and a large enough space to allow patients’ families to sit with them. Proper documentation of the entire process is costly and time consuming. This winds up costing the facility a lot per hour of infusion, and this must be compensated for the clinic to remain in business. Unfortunately medicare rates for ketamine reimbursement cover only a small percentage of these expenses, and most third party companies use a multiplier (averaging 1.5 of medicare rates) to come up with their reimbursement schedule. It is therefore difficult to get insurance companies to pay the full cost of treatment. This forces most ketamine clinics to remain out of network and bill patients for the majority of the cost of infusion.
Q. I’ve heard ketamine causes scary hallucinations?
A. Ketamine in high doses can consistently cause hallucinations that can be vivid. At the lower sub-anesthetic infusion doses, hallucinations do still occur, though usually patients can tell that they are hallucinations. In addition, this side effect can be controlled via the environment in which patients experience the side effect. Our office is specifically designed to provide an extremely peaceful, beautiful atmosphere where patients can relax completely. Finally, medications can help control these side effects quickly and safely. This is why a ketamine infusion is better than trying to “go it alone” at home with other non-IV forms of ketamine.
Q. Can ketamine cause health problems? Is it safe?
A. Overall, ketamine is a very safe drug when administered by a specialty clinic such as ours.
Ketamine at high doses can cause high blood pressure and high heart rate which can be dangerous in patients with uncontrolled cardiovascular, lung, or kidney disease. At the sub-anesthetic doses our office provides, ketamine does not commonly cause high blood pressure and heart rate. Nonetheless, it is important to be evaluated by a board-certified anesthesiologist when deciding whether a ketamine infusion, a form of light anesthesia, is safe.
Our office provides this evaluation for every patient that comes through. If it is determined that a patient requires further medical optimization prior to ketamine administration, appropriate referrals to specialists can be made. For the most part patients will qualify for treatment via ketamine. Ketamine is extremely safe especially when administered under the supervision of a board-certified anesthesiologist. Our anesthesiologist has extensive experience with ketamine. As the head of the pain service at a major hospital, he made ketamine available to all patients throughout the hospital and developed protocols for managing patients on ketamine infusions. He also provided instruction to all levels of staff involved in administering the medication for the treatment of pain. He is fellowship trained to provide the drug.
Q. Other things that can happen with ketamine?
A. There are reports of liver enzymes going up with ketamine use. Thus liver enzymes are monitored frequently in patients receiving intensive treatment with ketamine infusions. There are other extremely rare things that can occur as well, but with sub-anesthetic doses, these things are exceptionally uncommon. Nonetheless, they are reviewed with our patients prior to ketamine administration so that our patients have a full understanding of the treatment.
PLEASE NOTE: Our clinic requires a ride home by a family member or friend at the end of the infusion. Taxis, Uber, or other means of transportation are not acceptable.
Schedule an informal consultation with Dr. Zachary Fisk in Seattle to have all of your questions about ketamine infusion therapy answered. We recommend patients have a one-on-one consultation before their treatment to see if they are the right candidate.