Question 1

Will ketamine therapy help my treatment resistant depression?

Accepted Answer

Based on a landmark study conducted by the National Institute of Mental Health, up to 70% of all patients can expect significant relief after a series of six ketamine infusions. We have found that by curating the patient experience, providing an exceptional level of support, and setting realistic expectations, we consistently see outcome metrics that outperform the NIMH study.  It is important to understand that it is impossible to predict an outcome for a specific patient. Thankfully, owing to the ease and accessibility of treatment and the absence of known side-effects, it is possible to explore the benefits of therapy without risk.

Question 2

Do I need a referral to begin therapy?

Accepted Answer

No. If you are not currently a patient of Dr. Applegate’s, he will meet with you to discuss your diagnosis prior to beginning treatment. Patients who are already seeing Dr. Applegate will work with him to determine readiness during a pre-infusion consultation.

Question 3

Where is the treatment performed?

Accepted Answer

All treatments are performed, on an outpatient basis, in Dr. Applegate’s relaxing and comfortable treatment room.

Question 4

How many ketamine infusions will I receive?

Accepted Answer

Initially, all patients receive a series of six infusions spaced over two or three weeks. This follows the protocol developed during the NIMH trial and is the best predictor of efficacy.

Question 5

Will I require ketamine infusions for the rest of my life?

Accepted Answer

Some patients seem to achieve long-term relief after the initial series of six infusions and others require additional infusions at varying frequencies to maintain relief. Aftercare is an important part of ketamine therapy and Dr. Applegate will work with you to determine the best approach for you to achieve lasting relief.

Question 6

If ketamine therapy works for me how soon will I begin to feel better?

Accepted Answer

A very small percentage of patients begin to feel better within hours of the first infusion. Patients with thoughts of self-harm often notice those thoughts dissipating first with a dramatic relief of dread and hopelessness. Many patients do not notice a significant mood improvement until they’ve had several infusions. Almost all patients who will respond feel measurably better after the series of six infusions.

Question 7

Are there any long-term side effects with ketamine therapy?

Accepted Answer

IV Ketamine therapy following the NIMH protocol results in no known long-term side effects.

Question 8

Is oral, nasal, or IM ketamine a viable alternative to IV therapy?"

Accepted Answer

The bioavailability of ketamine delivered intravenously is far superior to any other form of administration. This means that a much smaller dosage yields a superior result.Other forms of ketamine are significantly less effective and likely to produce side effects.

Question 9

What medical conditions could keep me from receiving ketamine?

Accepted Answer

There are very few. Dr. Applegate will discuss contraindications with you before you receive your first infusion.

Question 10

Are ketamine infusions addictive?

Accepted Answer

No. The dosage and frequency of infusions are such that addiction is not possible. In contrast, patients using oral or nasal ketamine often develop a tolerance, addiction, and side effects.

Question 11

What should I expect during ketamine therapy?

Accepted Answer

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 a waking dream-like state or mild euphoria. Most find the treatment very pleasant. Patient generally leave the office within a few minutes following the infusion and feel quite normal. It is important not to drive, operate any dangerous machinery, or make any important decisions until the day after a ketamine infusion, as reaction times can be significantly diminished immediately following the infusion.

Question 12

Do I need to stop taking any of my current medications before I begin ketamine therapy?

Accepted Answer

No. You should not make any adjustments in your current medications without specific approval from the prescriber. It is important to note that while there is some speculation related to benzodiazepine and lamotrigine and their effect on ketamine infusions, there is no actual evidence to support adjustments in either in advance of therapy.  While these medications may reduce the dissociative effects of ketamine during an infusion, our experience suggests that they have no negative impact on outcomes.

Question 13

Will my insurance company pay for ketamine therapy?

Accepted Answer

No. Because IV ketamine therapy for mood and anxiety disorders is off-label, insurance companies do not provide reimbursement. Thankfully, IV ketamine therapy is not only the most effective treatment, it is also the least expensive.

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