Based on searches of major medical centers over the past 15 years, and in our experience, up to 70% of all patients can expect significant, and fast, relief. Of course, we cannot predict any individual's results. Our treatment is tailored in terms of frequency and dosage to each person.
If you are not currently a patient of Dr. St John's, she will meet with you to discuss your diagnosis prior to beginning treatment. She may want to obtain medical records or discuss your diagnosis and treatment to date with other doctors who have been seeing you. Patients who are already seeing Dr. St John will work with her to determine readiness.
Dr. St John is a Neuragain specialist. All treatments is outpatient are performed in a relaxing and comfortable location within her existing outpatient offices.
That will depend on your response. Most responsive patients receive a series of six infusions. Dr. St John will work with you to customize your treatment plan for the best chance of success.
No. Some patients seem to achieve long-term relief after a series of infusions.
Some patients will begin to feel better within hours of the first infusion. Patients with thoughts of self-harm often notice those thoughts dissipating first. There can be a dramatic relief of dread and hopelessness. Other patients may not notice any mood improvement until the next day. Some patients will require a second (or even a third) infusion before feeling better.
Traditional medications often produce side effects such as sexual dysfunction and weight gain. However, ketamine therapy results in no known long-term side effects.
Hypomania has not been reported following ketamine therapy.
There are very few. Dr. St John will discuss contraindications with you before you receive your first infusion.
Anti-depressant medications (SSRIs, SNRIs, MAOIs, and TCAs) do not interfere with ketamine, and there is no need to stop them. Ketamine infusions can provide relief during the time it takes antidepressant medications to begin working. Important: You should not decrease or stop taking any prescribed medication without first consulting your prescribing physician.
Ketamine is administered over a period of 40 minutes. The dose is determined by your weight. The amount of ketamine administered is not enough to cause a loss of consciousness, so you will remain awake. During the infusion some patients experience odd perceptions—like seeing bright colors. Some report what is referred to as a "dissociative" or "out of body" experience. These are side effects of ketamine that may be important for ketamine's ultimate effectiveness. Most patients tolerate the experiences with no trouble, and many people find them pleasant. Once the infusion is complete, the dissociative effects of the drug rapidly dissipate. There are no delayed "flashbacks," and patients generally leave the office within 30 minutes of the infusion feeling quite normal.
Occasionally patients experience some nausea following an infusion. More rarely, a patient may experience a transient headache. Patients can expect to be tired following the infusion. Very, very rarely patients already at risk for seizure have reportedly experienced one. If you have a seizure disorder please be sure to share that information with Dr. St John prior to receiving ketamine therapy.
You do not need to have someone bring you or accompany you during the infusion, but we request that you have someone drive you home. We advise you not to drive a car until the following morning.
You cannot eat for the 4 hours prior to your scheduled appointment. You may have clear liquids up until 2 hours before your appointment.
Following the initial series of infusions, most patients will work with Dr. St John to begin a maintenance program, returning for single infusions intermittently. The interval between maintenance infusions varies from patient to patient.
Because ketamine therapy for mood and anxiety disorders is recent and still viewed as experimental, insurance companies DO NOT provide reimbursement.