Ketamine is a medication that has been used for many years as an intravenous general anesthetic and for providing pain relief and sedation. Ketamine induces a trance-like state. In addition to providing general anesthesia, Ketamine has been used for sedation in intensive care units and in chronic pain management.
In subanesthetic doses, Ketamine has been used quite effectively in the management of treatment-resistant major depressive disorders, bipolar disorder, and as well in emergencies during periods of severe major depression with suicidal ideations. Ketamine has been available since the 1960s, but more recently is used in the management of treatment-resistant depressive disorders, and has been of considerable interest to mental healthcare professionals. Ketamine is provided to these patients in the form of an intravenous infusion at subanesthetic doses, it produces a fairly rapid and sustained response, and researchers believe that it works by blocking NMDA receptors for glutamate. The mechanism of action of Ketamine in treating depression therefore is different from other medications that are used in the treatment of these disorders.
Prior to the treatment, the patient is evaluated by the physician and if the patient is deemed to be an appropriate candidate, the procedure is conducted on an outpatient basis. Patients receive an intravenous infusion which contains a calculated dose of Ketamine. The drug is infused over a period of approximately 30-45 minutes. This procedure is conducted in a relaxed setting. During the infusion, the patient may experience minor dissociative symptoms, and if these symptoms are bothersome, the infusion can be discontinued. Patients may feel somewhat lightheaded after the procedure, and it’s required an adult drive the patient home following discharge.
Patients with severe major depressive disorders, including chronic and severe anxiety states, severe bipolar, bipolar depression and postpartum depression would be ideal candidates for Ketamine infusion therapy when other forms of treatment such as medications, inpatient or outpatient therapy, ECT, TMS, etc., have failed to provide relief. In addition, patients with severe depression and who suffer from bouts of suicidal ideations, and who need immediate therapy, will benefit from Ketamine infusion therapy. In other words, patients who appear to suffer from treatment-resistant severe depression are probably ideal candidates for Ketamine infusion therapy.
Ketamine is useful in treating migraines, with and without aura, as well as other types of primary headaches, such as cluster headaches, chronic daily headache, paroxysmal hemicrania and migraines with face pain/headaches. The use of Ketamine may be considered when these conditions do not respond to regular forms of treatments, including medications. The treatment consists of an initial clinical evaluation, and if the patient is deemed to be a suitable candidate, Ketamine is administered in the form of an intravenous infusion at a pre-calculated dose, over a period of 45-60 minutes. Side-effects are minimal, such as “feeling a bit spaced out” and occasionally very mild agitation. These side-effects are short-lasting and without any long-term effects.
Patients who suffer from the following can benefit from Ketamine infusions for pain relief:
