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TREATMENTS WE PROVIDE

Ketamine Therapy

Andala clinics offer ketamine therapy to treat a range of behavioral health disorders. It is a treatment that provides many people with relief that they might not experience with traditional interventions. Ketamine therapy sessions are done on an outpatient basis and take just a few hours.

General Information

What is Ketamine Therapy?

Ketamine is a substance developed in the 1960s that has been FDA-approved and in widespread clinical use since 1970. Originally, the substance was developed for use as an anesthetic. In the decades of research that followed, researchers began to notice the impact ketamine had on mental health symptoms, as well. In recent years, ketamine has been shown to have a significant positive impact on behavioral health in clinical trials.

Today, ketamine therapy is considered a valuable form of intervention for many patients, including those whose conditions are resistant to traditional therapeutic and medicinal interventions. Ketamine infusion therapy works to inhibit N-methyl-D-aspartate (NMDA) receptors and where it has many effects in the brain. While it is not clear exactly how ketamine works to improve symptoms of psychiatric disorders, one of its primary effects is to block NMDA receptors, which causes a temporary surge in the release of the neurotransmitter glutamate. This has many downstream effects, including triggering the release of “neurotrophic factors” that help increase neuroplasticity.

When used alongside other forms of therapy, such as cognitive behavioral therapy, ketamine can treat a number of different mood disorders.

Ketamine Treats Many Mental Health Conditions

The behavioral health team at Andala uses ketamine therapy in a clinical setting to treat a range of mental health conditions. By working closely with our psychiatric care team, you can develop a plan of intervention that works directly for your needs.

Anxiety

A growing body of evidence shows that glutamate, a neurotransmitter, is responsible for mediating the brain’s response to stress and the formation of traumatic memories. One of ketamine’s effects as an ionotropic glutamatergic N-methyl-D-aspartate (NMDA) receptor antagonist is a temporary surge of glutamate in the brain and activation of synaptic plasticity.

What does this mean? In short, the ketamine bonds to the NMDA receptor, blocking glutamate from binding to the receptor. This, in turn, causes a surge in glutamate, which enhances the ability of synapses to function and communicate. Some studies have shown that within 1 hour of dosing, patients reported reduced anxiety that persists for up to 7 days.

Post-Traumatic Stress Disorder (PTSD)

Ketamine is also believed to reduce inflammation, a condition that may be linked to depression, a significant component of PTSD. Some patients may experience initial relief from PTSD symptoms within 24 hours of their first treatment.

Treatment-Resistant Depression (TRD)

While originally used as an anesthetic, ketamine has been shown to be an effective therapy for people with treatment-resistant depression. Ketamine infusion therapy, in particular, has been shown to improve symptoms of depression in multiple clinical applications.

While ketamine has proven effective in treating depression, esketamine (Spravato) has shown to be equally as effective and also offered at Andala centers. A form of ketamine administered via intranasal spray, Spravato is FDA-approved and particularly effective at treating depression in people whose condition has not been helped by traditional interventions.

When administered in tandem with an oral antidepressant, Spravato has been shown to significantly reduce symptoms of depression and delay relapses.

How Ketamine Treatment Works

One of the most frustrating things for people diagnosed with behavioral health issues is when their symptoms are resistant to treatment. While psychology, psychiatry and pharmacology have made significant inroads into the treatment of conditions such as depression and PTSD, sometimes therapies do not benefit certain patients. Ketamine treatment works as a viable alternative for patients whose conditions have been resistant to traditional treatments.

Unlike oral antidepressants and other medications, ketamine works by stimulating neurotransmitters and repairing neural connectors to address these behavioral health conditions.

What to Expect During Ketamine Treatment

Before the treatment, a monitoring device will be affixed to your arm, and your blood pressure, heart rate, and blood oxygen saturation will be measured throughout treatment.

Ketamine can be administered in different ways. When delivered via an intramuscular (IM) injection, it is inserted in a single injection, quickly and relatively painlessly into the shoulder. Patients typically remain awake and relaxed for their ketamine treatment, while others may feel somewhat groggy and decide to take a nap. Depending on your side effects and how well your symptoms respond to treatment, the dose may be adjusted at later visits after a discussion between you and your provider. During your treatment, you may also receive as-needed medications to treat side effects, such as anti-nausea medications or a mild sedative for anxiety. As low as 25% of patients experience temporary mild anxiety.

After the injection, you will be observed for approximately 2 hours to ensure the acute effects of the ketamine have dissipated and you are safe for discharge from the facility.

The number of treatments needed will vary from patient to patient. Research has shown that patients are best served with two treatments a week for 3 weeks as an initial series. Some patients start to experience results by the end of week two, others  by the end of week three, and some take up to 4 weeks. We will closely monitor your symptoms over your initial 3-week series. If, after 3 weeks, the treatment has not been helpful, your provider will discuss other treatment options with you. Patients need at least 3 weeks of twice weekly treatments to determine if ketamine will be helpful for them, but some patients may need four weeks.

Ketamine Side Effects

All administration of ketamine at Andala clinics involves close monitoring by a medical professional. While safe, there are some side effects that can occur with ketamine, including:

  • Headache
  • Fatigue
  • Grogginess
  • Dizziness
  • Confusion
  • Perceptual disturbances

Most patients will have a transiently elevated blood pressure during treatment. Andala patients are closely monitored and treated for any potential side effects. We prioritize our patients’ comfort and well-being and ensure that they’re in good hands when receiving ketamine treatment at our clinics.

Ketamine Treatment Insurance Coverage

Insurance companies typically do not cover ketamine treatment, unlike Spravato, which is often covered, but coverage may vary from state to state. Before beginning a ketamine treatment plan, check with your insurance company about whether your treatment is covered. To find out more about insurance coverage for ketamine and whether or not your plan covers treatment, contact our Patient Services team by completing the Get Started form.

Ketamine vs. Spravato (Esketamine Nasal Spray)

There are a few significant differences between ketamine and Spravato.

Spravato, or esketamine nasal spray, is self-administered by a patient via intranasal spray under supervision of a medical care team. Ketamine is administered by a medical professional directly into the arm.

Spravato is also FDA-approved as a therapy for treatment-resistant depression. While FDA-approved only as an anesthetic, ketamine is widely used as an alternative intervention for patients with a range of mental health issues.

FAQ

How long is ketamine infusion therapy effective for?

Similar to Spravato treatments, ketamine therapy typically lasts three weeks for the initial onboarding phase. Patients receive treatments twice per week, and symptoms are closely tracked over this time. If patients respond after the initial series, a second 3-week phase of weekly treatments may help to maximize benefits and reduce risk of relapse.

People who respond to ketamine may receive regular maintenance treatments after their initial series. These maintenance injections will vary from person to person; generally, maintenance treatments are administered once or twice a month. Some people may find that their symptoms are manageable without ongoing ketamine after their initial sessions.

Is ketamine infusion therapy safe?

Yes. Ketamine therapy performed under medical supervision at Andala clinics is safe for patients. As with any medical procedure, there are some risk factors involved. Patients receiving ketamine therapy may experience a temporary increase in blood pressure. Patients may also experience some dizziness, fatigue or grogginess after treatment.

It is required that patients receiving ketamine be accompanied by someone who can drive them home after treatment. Patients should avoid driving, heavy machinery, hazardous activities or important decision-making until the day after their appointment.

Will I be asleep during treatment?

While some people may experience grogginess afterward, the treatment is not designed to make you sleep and most patients remain awake for its duration. Patients will be able to engage with those around them or just relax if they prefer.

Taking  a brief nap as needed is fine; however, it’s best to be well-rested prior to the appointment. There is anecdotal evidence that treatments are less beneficial for patients when they are sleep-deprived before a session.

Is ketamine FDA-approved for mental health?

Ketamine is FDA-approved for use as an anesthetic only. It is not yet approved by the FDA for mental health; however, eskatamine, a form of ketamine, is FDA-approved for treatment of treatment-resistant depression. This form of ketamine is administered via an intranasal spray.

While ketamine is not approved by the FDA for mental health, there is decades of clinical evidence that it has a positive impact on people with mental health conditions. All ketamine therapy performed at Andala clinics are done with medical supervision and are safe for patients