DUE IN LARGE PART TO UNFORESEEN EVENTS, CLINIC KETAMINE, P.C. WILL BE CLOSING
Major depressive disorder (MDD) has probably had the MOST clinical scientific research of all the recently (in the last 15 years) studied indications for IV ketamine infusions
post-traumatic stress disorder (PTSD)
You will need a formal diagnosis of depression and/or PTSD from a psychiatric or psychological mental health specialist to receive treatment from us with IV ketamine infusions. This does NOT mean that your mental health professional has to refer you to us for ketamine infusions or even agree that you need them or even know anything about ketamine. What is important is that you have been diagnosed with a major depressive disorder or PTSD that has been resistant or inadequately controlled using standard treatments like oral antidepressants. If you are still have suicidal thoughts, for example, even though you have tried many different oral antidepressants, it may be critical that you receive timely alternative treatment like ketamine infusions. Most oral antidepressants take two weeks or longer to become effective.
If you are not currently a chronic pain management patient, that's ok, you be fully assessed and evaluated by our provider(s) who will assess you for chronic pain and candidacy for an IV ketamine infusion. Not all types of chronic pain respond the same to IV ketamine infusions. If you have signs and symptoms of a condition known as central sensitization (wherein the brain becomes more sensitive to pain because you have had so much pain over time), and/or you are on high doses of opiates and still have not achieved manageable pain levels, a series of ketamine infusions may help you gain control over your pain. Multiple ketamine infusions may be required before this is achieved; and there is still no guarantee that your pain will become manageable; especially if a correctable pathological (diseased) state exists (e.g., a slipped disc or a disc herniation) which may require other interventions like cortisone injections or surgery to ameliorate or control.
Of the many types of chronic pain that IV ketamine has been proposed to treat, all types of neuropathic pain (numbness, tingling, burning, and/or pins and needles type pain) is the most responsive to ketamine infusions, along with complex regional pain syndrome (CPRS). Some experts suggest that ketamine infusions can reduce the symptoms of CPRS to the point of it being manageable and tolerable to nonexistent which is a huge accomplishment, even a huge triumph, for CPRS sufferers.
Fibromyalgia is another painful condition that has had limited effective treatments. There are still not enough randomized controlled trials (high quality scientific research) using ketamine infusions to determine definitively and qualitatively whether ketamine infusions treat fibromyalgia pain predictably. However, since fibromyalgia has so few effective alternative treatments, and since some of the treatments that do exist have such dramatic side effects in some sufferers, we believe ketamine infusions still present a viable option for fibromyalgia treatment with minimal risk versus the potential benefit. Additionally, since we know that most fibromyalgia patients have significant neuropathic-like pain (numbness, tingling, burning, and/or pins and needles type pain), and most of its sufferers certainly have central sensitization of pain due to having had so much pain diffusely over their bodies,
Again, there is a lack of definitive research regarding the treatment of the indication/condition of recurrent migraines or severe headaches and how well they are or not treated by ketamine infusions. However, recently there has been a breakthrough in migraine treatment: there are new medicines that use human monoclonal antibodies that bind to the calcitonin gene-related peptide (CGRP) receptor and antagonizes CGRP receptor function--this results in interruption of the cascade that leads to migraines or severe headaches. However, these medicines, namely Aimovig (R), Ajovy (R), and Emgality(R) are extremely expensive if not covered by the patient's health insurance. Therefore, again, on a risk versus benefit and cost basis, if ketamine infusions work to lessen the frequency, duration, and/or frequency of migraines, and are not required to be administered more than once per month, they may be more affordable than these new CGRP antagonist medications. If older and less expensive oral migraine treatment or preventative medication (e.g., acetazolamide, topiramate, amitriptyline, propranolol, divalproex sodium, imitrex, and etc) are effective, then the cost benefit may not exist for ketamine infusions.