Frequently Asked Questions
What is ketamine and how is it administered?
Ketamine is a synthetic medication that has been used in humans for over 50 years. It is a non-addictive treatment option for major depression, mood irregularities, and various chronic pain conditions. Recent evidence has strongly supported its’ effectiveness. Ketamine can be administered multiple ways, however, the most efficacious route is intravenous. At Ketamine Healing of Los Angeles, we use the intravenous route.
Is ketamine safe?
Under the care of a board certified Anesthesiologist, intravenous Ketamine is extremely safe, even in large doses.
Do I need a psychiatrist's referral for treatment?
You do not need a Psychiatrist’s referral for treatment. However, we will speak with you on the phone to discuss your prior treatment history and assess your candidacy for IV Ketamine treatments.
How long do the benefits of ketamine last?
The duration of efficacy for Ketamine treatments depends both on the number of infusions received as well as the person receiving them. Every person has specific brain chemistry and also comes from a different background in terms of life events, upbringing, etc. These factors and many more will determine how long Ketamine will benefit you.
How long does it take for treatment to take effect?
We have seen patients wake up with positive results. The average length of time to noticeable benefits is anywhere from the same day to 48 hrs later. The number of treatments also influences the time to chronic relief.
What are the common side effects of treatment?
A small percentage of patients experience nausea or headache. For our infusions we always place an anti-nausea medication called Zofran. If this does not work we add a second type of anti-nausea medication for the second and subsequent infusions. If a headache does occur, we add a medication called Toradol to the infusion for subsequent treatments - this medication is similar to aspirin.
Between intravenous (IV) and intramuscular, which is better for ketamine treatment?
With the IV route, you get a more controlled and pure experience, since with an intramuscular injection one must wait for the Ketamine to enter the bloodstream from the muscle. With the IV route, the Ketamine is directly placed into the bloodstream which reaches your brain quickly. The intramuscular route, because you have to deposit all of the dose in one (or two) injections, you get more of an intense high and fast come down. The IV route allows for a gradual onset and and longer experience. The ideal route is the IV route.
Are there any medications or substances that can interfere with ketamine treatments?
Patients who are taking benzodiazepines (alprazolam, lorazepam, clonazepam, etc.) or lamotrigine (Lamictal) should work with their prescribers to try to lower their intake or wean off these medications prior to beginning ketamine therapy in order to maximize the treatment's efficacy. If this is not possible, the dose prior to each infusion should be held. This can be further discussed with the doctor and a plan will be made between you and him. Taking the above medications does not mean Ketamine will not work for you. Marijuana can also impede in Ketamine's efficacy, and should be held at least 3 days prior to a Ketamine infusion, if not longer.
How long is the infusion?
All our infusions take approximately 60 minutes to administer. We don't interrupt you for 75 minutes however, since Ketamine levels are still high at the 60 minute mark.
What is the best regimen for ketamine therapy?
The optimal regimen for ketamine therapy has not been established and may vary among individuals. We do know the following from various studies and from our own clinical experience over 4 years:
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Serial infusions have been shown to be more effective than single infusions.
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Closely spacing infusions in the initial treatment phase (two to three infusions per week), then fine-tuning an individual's regimen with well-timed maintenance infusions and the Ketamine spray, appears to confer the best hope of success.
How quickly will I notice a change?
Some patients begin to feel a difference by the evening or day after their first infusion. Even for "responders," periods of sadness or depressed mood may still occur between infusions, but the overall trajectory of mood symptoms should be one of improvement. Responders may also find urges to self harm and suicidal thoughts diminished and ability to cope with stress improved. Patients may find that functional improvements - getting a to-do list done, socializing more easily, etc. - occur before improvements in mood. Family and friends thus sometimes observe that a patient "seems better" even though the patient still feels the same. Changes can be gradual.
What if I consume alcohol, marijuana, or other illicit drugs?
PLEASE REFRAIN FROM CONSUMING ALCOHOL, SMOKING OR INGESTING MARIJUANA, OR USING COCAINE, HEROIN, OR OTHER ILLICIT SUBSTANCES. Not only can they pose a safety risk when combined with ketamine treatment but also they can interfere with the effectiveness of ketamine therapy.
Are there any food or liquid restrictions prior to treatment?
Please do not consume solid food or liquids in the 3 hours preceding your appointment.
How many infusions do I need?
Typically we offer four to six infusions within a two to three week period, with subsequent infusions as needed to relieve symptoms. Most patients require “maintenance” infusions. The response of individual patients varies and is impossible to predict with current available resources. Each Ketamine treatment plan is designed according to the particular needs of any given patient
Does ketamine cure depression?
Ketamine should not at this time be thought of as a cure for depression but rather as an adjunct to ongoing treatment that can help reset a person's baseline, relieve some of the suffering and hopelessness of major depression, and give other therapies such as oral medication and psychotherapy a chance to progress.
Do I have to stop my anti-depressants?
Patients do not have to stop their antidepressant medications to receive ketamine. Ketamine can be used safely with most medications including SSRIs, SNRIs, lithium, Wellbutrin, and tricyclics (with caution). Patients taking aminophylline for asthma or COPD may be at greater risk for developing seizures if they receive ketamine. Patients who are taking benzodiazepines (alprazolam, lorazepam, clonazepam, etc.) or lamotrigine (Lamictal) should work with their prescribers to wean off these medications prior to beginning ketamine infusion therapy in order to maximize the treatment's efficacy. If that's not possible Ketamine treatment can begin with a proper plan discussed between you and the doctor.
Is ketamine addictive?
Because it is abused as a "party drug," there are legitimate concerns about Ketamine addiction. A recent study out of the University of Geneva in Switzerland found the likelihood of Ketamine addiction to be "unlikely," due to the way it acts on the dopamine receptors (different from other addictive substances). It currently does not meet criteria for being physically addictive, though tolerance to its effects may occur with prolonged exposure. It may pose a risk of being psychologically addictive for some. Here at the Ketamine Healing Clinic of Los Angeles and Orange County, we have not found Ketamine to be addictive when given in a controlled setting, in limited instances, under doctor supervision.
Who should NOT receive ketamine?
Ketamine is not beneficial and may in fact be harmful or exacerbate symptoms in patients with schizophrenia, psychosis or individuals having a manic episode that have been diagnosed with Bipolar. If you have epilepsy, Ketamine is still a treatment option for you- however, please let us know so we can take the necessary dosage precautions. If you take Aminophylline for Asthma or COPD please let us know as the combination of Aminophylline with ketamine may increase the risk of seizures. If you have uncontrolled high blood pressure please consult your primary care physician to treat your blood pressure before pursuing Ketamine treatments. Patients with cardiac arrhythmias or a history of a heart attack or stroke need to have a clearance note from a Cardiologist prior to receiving ketamine.
Is the ketamine protocol/treatment the same for depression and for pain?
While some pain conditions do respond to the Ketamine mood protocol, not all pain conditions will. This is especially true of back pain. Chronic back pain does require a much higher dosage which would be infused over multiple hours. For Depression it would be one hour at a lower dose.
If I am taking opiates daily for pain, how does ketamine work in conjunction with opiates?
We ask that opiates not be taken on the morning of an infusion. Eventually, patients whose pain has responded to Ketamine significantly decrease or stop using their opiates. This in turn has led many to see a lifting in their depression and greater daily productivity.
Can ketamine help with opiate withdrawal symptoms?
Ketamine can help with opiate withdrawal that is mild to moderate. Ketamine can also reduce opiate requirements for pain. However, weaning off opiates should always be done under the guidance of the prescribing physician so as to not elicit dangerous withdrawal symptoms.
Can ketamine work well for patients with back pain that may or may not require surgery?
There are no large scale and good studies to provide a statistically significant answer to this question. However, of the patients I have treated, approximately 75% do benefit with significant pain relief, while 25% do not. Generally, if there is a high degree of anatomic pathology or nerve impingement, Ketamine therapy may be limited in providing pain relief. However, if the only other option is open surgery, Ketamine therapy may be worth trying at least once prior to proceeding with surgery.
Do I need to stop my sleep medication the night before?
Any medication with Benadryl, aka Diphenhydramine, or THC can dampen the Ketamine experience. Substances such as Melatonin can potentially contribute to or cause depression (a listed side effect). In general, we recommend plant based substances for sleep, such as Ashwagandha, L-Theanine, Valerian Root, Magnesium, and Starflower.
How will I respond to ketamine?
Responses to ketamine vary from individual to individual. You will be awake and can continue to be able to interact with those around you if needed. Most patients just close their eyes and relax during the infusion. Some people may experience transient dizziness, nausea, mild visual hallucinations, a sense of disconnection from the body, and mild distortions of space and time perception. The infusion is generally a tolerable and euphoric experience for most people, though is commonly described as "weird." It can also leave some people feeling emotionally vulnerable, while others may feel a sense of well-being and openness. You will be back to your baseline about fifteen to thirty minutes after the infusion ends and will be monitored for as long as needed before you are discharged. Less commonly, some people become fatigued after infusions and/or may develop a headache, a feeling of "heaviness," or some nausea. While you may not be groggy after the infusion, we strongly advise that you avoid driving, operating machinery, or participating in challenging mental work or decision-making for at least twelve hours after the infusion, and we require that someone drive you home.
How much does ketamine therapy cost?
It depends on the service you are getting done. Please visit our pricing page to learn more about each service's prices. We do take CareCredit as well.
How do I get started?
Getting started begins with scheduling a first-time consultation. This initial session allows us to understand your goals, review your medical history, and determine whether ketamine treatment is an appropriate and safe option for you.
The consultation fee is $100. If you decide to move forward and begin treatment as a patient, this $100 will be applied as a credit toward your future ketamine sessions. In other words, your consultation fee goes toward your care—it’s not an additional cost. This first step ensures you receive personalized guidance and a treatment plan tailored to your needs, while also giving you the opportunity to ask questions and make an informed decision about your care. Once you select and pay for your consultation, we will call you for scheduling.
