Ketamine is a powerful treatment tool that we use to manage symptoms of certain mood disorders. This medication has been used for decades as an anesthetic for surgery.
Over the years, science and medicine have also established ketamine as a safe and effective treatment for:
- Obsessive-Compulsive Disorder (OCD)
- Post-Traumatic Stress Disorder (PTSD)
- Bipolar Disorder II
- Severe Anxiety
- Suicidal Ideation & Hopelessness
At Pacific Pain & Wellness Group, we use ketamine infusions to not only treat patients with any of the above mood disorders, but we can also use ketamine to relieve chronic pain conditions like Reflex Sympathetic Dystrophy (RSD) and Complex Regional Pain Syndrome (CRPS).
Ketamine infusion treatments are used to manage mood disorders along with psychotropic medications and/or psychotherapy (counseling). We have many years of experiencing treating patients using a combination of innovative and standard evidence-based treatments that reduce symptoms.
Our compassionate and caring team is dedicated to improving your quality of life so that you can get back to enjoying the people and the things you love most.
What is Ketamine?
Ketamine can be delivered in two different forms:
Racemic ketamine is the type of ketamine that can be delivered via a vein in the arm or hand. It is added to a sterile bag of saline water and dripped into the vein at a slow rate, usually taking about 40 minutes to complete. According to Harvard Medical School, IV ketamine includes both the R and the S ketamine molecules.
Esketamine is a form of ketamine that was FDA approved in March of 2019. It is administered as a nasal spray. This form of ketamine includes only the S molecule in ketamine. Once the molecule enters the nasal passageway, it is absorbed into the bloodstream through the mucous membranes in the sinuses.
Both forms of ketamine impact the brain and its receptors in different ways. Specifically, it affects the receptors involved in mood regulation and pain perception.
Ketamine infusions quickly deliver the R and S molecules through the bloodstream to receptors in the brain that are responsible for mood symptoms such as obsessive thoughts, anxiety, depressed mood, and suicidal thoughts. One of the most exciting aspects of ketamine infusions is how quickly they work to relieve symptoms…usually within a few hours.
Oral psychotropic medication can take days or weeks to build up in the system enough to make a significant impact in providing symptom relief. With ketamine infusions for chronic pain, treatment can greatly reduce the amount of opioid medications needed. Less painkiller means a lower risk of opioid related side effects such as dependence and tolerance.
Ketamine is usually reserved for treating symptoms that have not responded to standard medications and therapies.
How Ketamine Works
Scientists don’t fully understand how ketamine works in the brain to relieve mood disorder symptoms and pain. It is thought that ketamine binds to the NMDA receptors in the brain. These receptors are thought to be involved in the transmitting of a brain chemical (neurotransmitter) called glutamate. Once the NMDA receptors are blocked, there is more glutamate available in the synapses between neurons.
The presence of more glutamate in between neurons helps to turn on the brain’s AMPA receptors, which initiates the release of other brain chemicals that help improve mood. Glutamate appears to help the brain’s neural circuits to communicate using new routes. Once the brain is using these new routes, mood quality improves and thoughts are more positive.
Because ketamine works on the brain in ways that we don’t yet fully understand, ongoing studies are being done. Some day, we hope that science will discover the exact mechanisms of action so that doctors can expand to treating additional mental health disorders using ketamine.
One interesting finding is that ketamine infusions may help reduce the number of neurotransmitter messages responsible for inflammation. Once inflammation is lowered, it is thought that certain brain areas responsible for depressed mood may be able to communicate better, thus greatly relieving symptoms.
Important Facts About Ketamine Infusions
- Ketamine, when used as an anesthetic in surgery, is meant to put you to sleep so that you’re unaware of what’s going on during your operation. When ketamine infusions are used to help relieve depression or other mood disorder symptoms, a micro-dose is used. The dosage used is generally 0.5 mg per kg of body weight. This allows you to remain awake and alert throughout IV administration.
- Ketamine infusions are generally reserved for patients who have not responded well to antidepressants or other psychotropic medications. This is referred to as being “treatment-resistant.”
- There are certain pre-existing medical conditions that may disqualify you for receiving ketamine infusion therapy. Your doctor will discuss your medical history with you to confirm whether you’re a good candidate for treatment.
- Be prepared to have a series of ketamine infusions once or twice weekly before reaching “maintenance.” Depending on your situation, treatment response history, and severity of symptoms, your doctor will decide how many initial sessions are recommended, how far apart they will be, and when you should come in for periodic “booster” infusions to maintain your results.
- Ketamine infusions are usually done weekly for several weeks, and then periodically every few weeks after that to maintain symptom relief.
- Ketamine infusions are sometimes, but not always, reimbursed as “out of network” by medical insurance companies. Treatments in our office must be paid for upfront out-of-pocket. If your health insurance covers a portion, you will need to file a reimbursement claim with them.
- Your doctor will go over the common side effects of ketamine infusion with you to keep you well informed before agreeing to treatment.
- In some cases, psychotherapy, or talk therapy, will be recommended to help you get the most out of your ketamine infusions. Because ketamine helps to create new neural circuit pathways in the brain, you may be able to gain more ground on controlling your mood and thoughts when ketamine is combined with psychotherapy.
Who is Not a Good Candidate for Ketamine Infusions
Individuals with a history of psychosis (mania, hallucinations, delusions, etc.), intracranial pressure, or a prior reaction to ketamine are not good candidates for treatment.
We will ask you if you are currently using alcohol, marijuana (cannabis or THC), opioid painkillers, or other addictive substances. Because ketamine has the potential for abuse, it is critical that we clear you to safely use ketamine by doing a lab test to confirm that you’re not currently using any substances.
Someone with a history of a substance use disorder, opioid dependence, or overuse of benzodiazepines would not be a good candidate for ketamine. It is imperative that you provide accurate and truthful information so that we can provide you with the safest care possible.
Women who are pregnant or think they may be pregnant should not receive ketamine. If you are unsure about whether or not you’re pregnant, a test to rule out pregnancy may be requested.
If you have uncontrolled blood pressure, ketamine is not safe. We will gather your full medical history before deciding if this treatment is right for you.
Another major component of deciding whether you would be a good candidate for ketamine is to learn about the treatments you’ve already tried. Some patients come to us after having unsuccessfully tried for years (and after seeing many doctors) to treat their symptoms. Knowing is part of the comprehensive information that our team will gather from you before deciding if ketamine is a good option for you.
Your response to treatment will be constantly monitored throughout each week. Based on your individual response to the infusions, dosages may be increased or decreased. Each patient is unique and requires a different treatment plan.
Due to our many years of experience in safely delivering ketamine infusions, our specialists are some of the most trusted ketamine infusion providers in Southern California.
Treatments to Try Before Considering Ketamine Infusions
Ketamine infusions are not a first-line therapy for treating a mood disorder. It is reserved for people who have not gotten relief from antidepressants, psychotropic medications, or other therapies (such as TMS).
Cognitive behavioral therapy (CBT) is often recommended either alone or with medications to help relieve symptoms. CBT is a treatment modality that helps a person think better so they can feel better. This treatment is evidence-based, meaning that there is scientific literature that supports its use for certain mood disorders such as depression, anxiety, PTSD, OCD, and many others.
If your depression is not effectively treated using medications and/or CBT, then transcranial magnetic stimulation (TMS) may be used to stimulate the area of the brain where depression is. We offer TMS therapy here in the office, so you can rest assured that we have a variety of innovative and effective treatments available to help you feel better.
Ketamine Infusions for Mood Disorders
Ketamine infusions are a viable treatment option for a variety of mood disorders including bipolar disorder II, major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder, anxiety disorders, and suicidal thoughts.
Bipolar II: Ketamine infusions are appropriate for patients who have not responded to prior treatments such as antidepressants or other psychotropic medications. Before ketamine is recommended, patients should try working with a therapist to learn new ways of thinking and to gain coping skills.
Facts about ketamine and bipolar depression:
- Ketamine has been shown to rapidly reduce depressive symptoms in individuals with BP 2.
- Ketamine can quickly relieve depression, hopelessness, and suicidal ideation.
- Ketamine can be safely used with other bipolar medications such as valproic acid or lithium.
- Ketamine works in as little as 40 minutes to relieve symptoms of depression.
Severe anxiety: Several of the neurotransmitters and receptors involved in anxiety appear to be positively influenced by the molecules in IV ketamine. The most important aspect of using ketamine for anxiety is its rapid onset of relieving symptoms.
Where anti-anxiety medications can take hours or days to work, ketamine can start to relieve severe anxiety in as little as an hour. Therapy with a licensed mental health professional is highly recommended as part of a person’s overall treatment plan.
Major Depressive Disorder: Based on data from the journal BMC Psychiatry, only 25% to 50% of people with MDD follow their treatment plan as prescribed by their doctor. This can leave a person with underlying symptoms of depression on a daily basis. Many individuals with MDD are resistant to treatments, leaving them feeling hopeless.
Before trying ketamine infusions for depression, your doctor will evaluate your current and past treatment history and help you to exhaust all viable treatment options. Infusions are reserved for patients who are unresponsive to other treatments such as antidepressants, cognitive behavioral therapy, or transcranial magnetic stimulation.
Ketamine is extremely effective in reducing symptoms of depression such as boosting mood, increasing feelings of hopefulness, and reducing suicidal ideation. Best yet, it works very quickly, so there’s no waiting period of weeks to months as is the case with many antidepressant medications.
Obsessive-Compulsive Disorder (OCD): Studies have shown significant improvement in obsessive thoughts, anxiety, and depression in patients with OCD who receive ketamine infusion treatment.
The data also suggests that due to the way that ketamine works in the brain, patients with OCD are more likely to be responsive to other treatments when ketamine is present in the body. These “open doors” to treatment allow patients to get much more out of other therapies such as CBT, exposure & response prevention, and psychotherapy.
Post-Traumatic Stress Disorder: For people suffering with PTSD, ketamine infusions can help reduce severe anxiety, depressed mood, and suicidal thoughts. If other treatments have not sufficiently helped to curb PTSD symptoms, ketamine can provide fast relief and help a person to be more open and responsive to trauma processing with their therapist. Once these combined approaches are in place, a person can experience significant forward movement in remission of their symptoms.
Get Ketamine Infusions for Mood Disorders in Torrance, Los Angeles
After a comprehensive evaluation to determine if you’re a good candidate for ketamine infusions, you can start to experience the rapid relief that this treatment offers. Whether you’re suffering from depression, anxiety, OCD, PTSD, or bipolar II, ketamine may be able to help.
At Pacific Pain & Wellness Group, we care as much about you as you do. Our goal is to help you feel better so you can live better. Contact our team of specialists today to receive expert, compassionate care for your mood disorder. We can be reached at (310) 437-7399.