Take the first BOLD step towards healing.
Ketamine treatment is providing
hope and relief to our patients in San Diego.
Ketamine injections have been shown to be a safe and effective treatment for depression.
Give us a call - (760)-503-4703
Fortunately, TRD has been the object of research efforts over many years, and we are currently benefiting from some of these efforts. The use of ketamine for treatment-resistant depression and PTSD probably represents the most powerful and unique treatment to be developed in many decades.
Ketamine is a medication that is widely used as an anesthetic, often for outpatient procedures or in emergency rooms due to its excellent safety profile. At doses well below those used for anesthesia, ketamine has powerful antidepressant and antianxiety effects.
Unlike conventional antidepressants, which can take weeks or months for benefits to fully develop, ketamine can produce robust benefits even with the first dose. A 2-3 week course of treatments is sufficient to make a solid judgment of the effectiveness of ketamine for an individual patient. The likelihood of responding to ketamine is more than 50%, even in the
setting of numerous failed prior medication trials. This places its efficacy well ahead of that of conventional antidepressants.
Unlike conventional antidepressants, which can take weeks or months for benefits to fully develop, ketamine can produce robust benefits even with the first dose.
What is Ketamine-Assisted Therapy?
Ketamine treatments, in and of themselves, can provide a robust antidepressant effect. Some individuals further enhance the benefit by engaging in Ketamine-Assisted Therapy (KAP.) KAP takes two main alternative forms. The first utilizes the acute therapeutic benefit of ketamine to improve the effects of conventional psychotherapy.
Sessions in this form of KAP are usually conducted right after a ketamine treatment when the acute alteration in the mental state has cleared (i.e., the “trip” is over,) while you are waiting to fully recover before leaving the clinic. This is a period of time when people can be much more psychologically open and able to engage in therapy. As a result, more rapid, deeper and sustained psychotherapeutic improvements can occur.
Another form of KAP focuses on the actual content and meaning of the experienced “trips” and involves preparatory therapy sessions and post-treatment integration sessions, usually on non-treatment days. This form of therapy is quite similar to that being studied at present in treatments using psychedelic agents and can incorporate both psychological and spiritual elements.
Unlike antidepressants, ketamine is a medication that is not
taken at home on a daily basis.
The ketamine treatment process differs greatly from that of conventional antidepressant treatments in multiple ways. Unlike antidepressants, ketamine is a medication that is not taken at home on a daily basis. Instead, individual treatments are given in an outpatient clinic setting on a frequency guided by clinical response. This treatment setting is required because ketamine typically induces a state of dissociation, which can be similar to the “trips” produced
by psychedelic medications.
The clinic setting allows us to provide for physical safety, medical supervision and emotional support by knowledgeable and caring providers and clinic staff. Other differences between ketamine and conventional antidepressants include the rapidity of treatment response, as noted above, and the relative lack of side effects that are frequent concomitants of antidepressant treatment (e.g., weight gain and sexual side effects.)
What occurs during a ketamine treatment?
Your ketamine treatments will be given in the ketamine treatment room at Bold Health. This is a quiet and private space where you will lay back in a comfortable recliner during the treatment. After having your vital signs taken and completing rating scales, you will receive the ketamine dose by intramuscular injection, most typically in your upper arm. After receiving the dose, people typically recline in the chair, close their eyes, and listen to pleasant and calming music on their headphones or earbuds. You should bring these with you and have saved appropriate music on your phone. Many people report that the right music can be very helpful in the treatment experience, and we can help you with music selection (there are also many “ketamine playlists” available from online sites.)
About five minutes after the injection, you will likely begin to feel the effects of the medication. These effects can vary and often include feelings of profound relaxation, dissociation and mood elevation. Many people also experience a “trip” very similar to – albeit much briefer than – the trips associated with psychedelic agents.
All of these states of mind tend to be experienced as very positive in nature but are quite transient. Within about 45 minutes, they should all fade, but should leave you feeling quite relaxed and with some improvement in mood. The mood benefit typically builds further over the next 24 hours. You should be fully able to go home at about 90 minutes after the start of the treatment but may need to wait longer if you have residual symptoms which haven’t yet cleared (e.g., feeling unsteady on your feet.)
Take the first BOLD step towards healing.
What disorders can ketamine be used to treat?
Ketamine is most commonly used in three situations:
- Treatment-resistant major depression or bipolar depression
- In acutely severe depression, particularly when suicidal thoughts are intense
- Hard-to-treat PTSD.
What is the definition of treatment resistance?
There is no universally agreed-upon definition for treatment resistance, and we take an individualized and patient-centered approach at Bold Health. Treatment resistance can be said to be reached when you feel that you no longer have the resilience to undergo additional medication trials and feel an urgent need to improve rapidly.
Could I experience a “bad trip?”
It is possible to have treatments in which an unpleasant altered state of mind (i.e., a “bad trip”) is induced by ketamine. Such an experience might include heightened anxiety and frightening trip content. These are rather infrequent experiences, but they do occur.
This is part of the reason why a caring and experienced staff member will be monitoring you at all times during your treatment. In addition to strategies for providing “grounding” and reassurance (developed to help people having “bad trips” from psychedelics,) we can also provide medications to rapidly reduce anxiety and distress.
How frequently would I receive treatments?
Although mood can improve significantly after a single treatment, research suggests that deeper and more sustained improvement can occur if a series of treatments are given over the course of several weeks.
Generally, these are done 2 to 3 times per week for a total of six treatments.
This may be the total number of treatments you if the therapy was undertaken to address acute suicidality or to provide rapid relief while waiting for a new antidepressant regimen to “kick in.”
For individuals with more chronic and treatment-resistant depression, the strategy is usually to provide additional treatments with ketamine at the minimum frequency needed to maintain response (usually once every one, two or three weeks) while also providing other pharmacologic or psychotherapeutic treatments to help you transition to a full and stable remission, thereby eliminating the need for additional ketamine treatments.
Are ketamine treatments covered by my insurance?
Unfortunately, up to the present, no insurance companies – and neither MediCal nor Medicare – cover ketamine treatments.
If you undertake ketamine assisted therapy, it is possible that the therapy component would be covered. Please call Bold Health for more details with regard to cost.
Do I need to follow any restrictions after having a treatment?
Because ketamine does produce a change in mental state, you do need to be careful after your treatment. You are required to commit to not operating a motor vehicle until after you have had a restorative night’s sleep. Therefore, you will need to arrange for a ride to take you home. Options can include a friend or family member, a ride service or taxi, or public transit. In addition, you should not return to work for the remainder of the day after a treatment and should not engage in other activities for which any residual alteration in mental state could be potentially risky (e.g., operating power tools, making major financial decisions, etc.)
What should I do if I have more questions
or which to be evaluated for ketamine treatment?
Please give us a call at (760) 503-4703.
Do you think you may be suffering from any of these conditions?
We’re here for you and are ready to help you walk through the process of self-discovery and healing. Give us a call at 760-503-4703 or contact us with any questions.