Understanding Ketamine Infusion Therapy: What to Know Before You Start

Ketamine therapy is used for people with treatment-resistant depression. Infusion is a popular administration method. Find out more about the process and BNI Clinics' specialized...

Ketamine therapy is used for people with treatment-resistant depression. Infusion is a popular administration method. Find out more about the process and BNI Clinics’ specialized approach.

Key Takeaways

  • Ketamine therapy is growing in popularity as an effective solution for treatment-resistant depression and other mental health conditions. It can be administered in various ways, but infusion therapy has been shown to be the most effective.
  • Clinicians administer the therapy in a clinical setting with careful oversight and monitoring. Many patients report dissociative effects after the treatment, which can last for a few hours. Driving after treatment is not recommended.
  • Medical experts conduct a careful assessment before therapy to ensure it’s the right fit. Clinicians will evaluate your mental and physical health to rule out contraindications and ensure safety.

Table of Contents

Introduction

According to Epic Research, ketamine treatment is growing in popularity, with 5.47x more prescriptions between 2017 and 2022. Originally used as an anesthetic, the mental health community recognized its use in improving treatment-resistant depression quickly and effectively. It works by targeting the glutamate system to boost neuroplasticity, sometimes providing almost instant relief.

Ketamine can be taken in various ways, and infusion therapy is a popular method. This article explains what to expect so you can prepare for your first session.

What Is Ketamine Therapy and How Does It Work?

Unlike traditional antidepressants (SSRIs, SNRIs), which work by increasing serotonin in the brain, ketamine triggers a glutamate surge and a temporary spike in excitatory signaling in the prefrontal cortex to lift mood and promote synaptic growth and neuroplasticity. The direct trigger of synaptic growth may explain why ketamine works faster than other antidepressants, producing results in hours, rather than weeks.

Ketamine can be taken in various forms, including intranasal spray (esketamine), intramuscular injections, and intravenous ketamine infusions. Infusion therapy is commonly used because it produces meaningfully higher plasma levels than other treatment types.

How Is Ketamine Infusion Therapy Administered?

Clinicians administer ketamine infusion therapy in a clinical setting. Sessions typically last 30-45 minutes. After the infusion, patients typically wait in the clinic for about 90 minutes, where staff carefully monitor them to ensure they are ready to go home and don’t experience serious side effects.

Here are some other things to know about the administration process:

  • Dosing: Patients typically start with a 0.5 mg dose (sometimes as low as 0.2 mg), which may increase as tolerance grows.
  • Treatment Schedule: Initial treatment typically involves six sessions over 6 weeks. Follow-up maintenance sessions, which generally occur every three weeks, are also required.
  • Transportation Arrangement: Patients are not considered ready to drive after a session, so the clinic will release you only when a driver arrives.

What Does Ketamine Infusion Therapy Treat?

Ketamine infusion therapy is best known for its ability to target treatment-resistant major depressive disorder. However, limited research shows it may also be effective for other mental health conditions, such as:

  • Post-traumatic stress disorder
  • Anxiety disorders
  • PTSD
  • Chronic pain conditions (e.g., CRPS, fibromyalgia)
  • Suicidal ideation (acute intervention context)

What Can I Expect Before Treatment?

Before your first infusion, you will be thoroughly evaluated to ensure ketamine therapy is right for you. Clinicians will assess the following factors:

  • Your medical history and diagnosed psychiatric disorders
  • Screening for contraindications such as high blood pressure, pregnancy, schizophrenia, cardiovascular conditions, and active substance use disorder
  • Goals and logistics planning are often discussed during an initial consultation

Preparing for therapy requires fasting overnight, at least 8 hours before treatment, and stopping clear liquids 2 hours prior.

What Can I Expect During Treatment?

During treatment, you may experience a dissociative effect, but you will be monitored carefully by a mental health provider throughout the process.

  • The Setting: Infusion therapy takes place in a private, comfortable room.
  • Administration: Clinicians place an IV in your arm, and the infusion takes place over the next 30-45 minutes.
  • Dissociative Effect: During treatment, patients report feeling woozy. You may also experience floating sensations, visual distortions, numbness, and a dreamlike state.
  • Staff Support: Staff carefully monitor the process to help the patient if they feel uncomfortable or experience complications.

What Can I Expect After Treatment?

After treatment, you may still feel woozy, but you should feel better soon.

  • Recovery Monitoring: Clinicians will continue to monitor you after treatment to ensure a safe recovery.
  • No Driving: You may not drive yourself. A friend, relative, or ride-share driver will need to pick you up.
  • Take It Easy: Side effects typically resolve in a few hours, but most providers will recommend that you avoid work, driving, and complex tasks for the rest of the day.
  • Integration: Some people find it helpful to talk with a therapist or journal to process their feelings.
  • Improvements: Often noticeable a few hours to a few days after the treatment, lasting several days to two weeks, which is why follow-up and maintenance sessions are typically included.

What Are Potential Side Effects and Risks?

Beyond dissociative feelings, you may experience side effects like dizziness, lightheadedness, nausea, blurred vision, and temporary increases in blood pressure and heart rate. Long-term concerns include bladder and urinary tract infections, but these typically only occur with misuse. Ketamine is generally not recommended for people with uncontrolled hypertension, active psychosis, pregnancy, severe cardiovascular or liver disease, or an active substance use disorder.

Is Ketamine Therapy Right For Me?

Ketamine therapy may be right for you if you have treatment-resistant depression or another condition ketamine has been shown to treat, and have the proper support system in place.

  • Ketamine is especially beneficial for individuals who have failed multiple traditional antidepressant trials.
  • It may also help anxiety, PTSD, or certain chronic pain conditions
  • Its speed makes it effective for individuals in urgent need of relief, including from suicidal ideation
  • Patients should have a support system in place to help them get to and from appointments and manage the day of treatment

Get The Help You Need at BNI Clinics

As one of the first providers of ketamine therapy treatment, BNI Clinics of Los Angeles offers an experienced team, personalized treatment plans, and a safe, controlled medical environment. In addition to ketamine, we offer a variety of innovative and traditional mental health services, ensuring effective results. We are dedicated to providing the community with the highest-quality, evidence-based medicines.

Contact us to learn more about our clinic.

FAQs

Is ketamine therapy FDA-approved?

Ketamine infusion therapy is FDA-approved as an anesthetic, but not as a mental health treatment. The intranasal spray, esketamine, is the only type of FDA-approved ketamine option.

Does insurance cover ketamine infusion therapy?

Generally, no. Because ketamine infusion therapy is not FDA-approved, it is difficult to get insurance coverage. However, a minority of insurers make case-by-case exceptions for IV ketamine with sufficient documentation of medical necessity.

How quickly does ketamine therapy work?

Most patients feel the effects of ketamine therapy within hours to days of treatment.

Is ketamine therapy safe?

Yes, ketamine therapy is generally safe. Side effects are typically mild and temporary. However, it is not recommended for individuals with certain contraindications.

Is ketamine addictive?

Ketamine carries some misuse potential, which is why it’s not recommended for people with active substance use disorders. However, when taken with clinical guidance, there is an extremely low risk of dependency.