Ketamine is a medication, developed in 1962 as a dissociative anesthetic that creates a feeling of disconnection from one’s self and reality. It has been used widely as an anesthetic in emergency medicine, in veterinary medicine, and in operating rooms and wound clinics around the world on a daily basis. It is often used for the most vulnerable patients, including children and the elderly, because of its safety profile. Ketamine has been increasingly used for the treatment of pain conditions and mood disorders since the year 2000 because of research studies

Significant research and clinical results show that ketamine may be effective for: Depression Suicidal/self harm ideation PTSD Anxiety disorders Bipolar disorder Drug rehabilitation Neuropathic pain CRPS or RSD Cancer pain syndromes Phantom limb pain Some research and clinical results show that ketamine may even be effective for: Fibromyalgia Trigeminal neuralgia OCD Post-herpetic neuralgia Diabetic neuropathy Central pain syndromes related to stroke or trauma Chronic migraine headaches

The use of ketamine for treatment of mental illness and pain are considered off-label drug uses, which means the drugs have been approved by the FDA but not for the specific conditions which we use these medications to treat. Many drugs are routinely used off-label – it is entirely legal and extremely common.

Ketamine is an anesthetic drug that has been used extensively for anesthesia every day. They have been used safely in millions of patients for many decades. Ketamine and adjunct medicines used at Las Vegas Ketamine are all considered safe when administered by trained professionals. However, like all medicines, they have the possibility of side effects including: hallucinations, drug reactions, anxiety, elevated blood pressures, elevated heart rate, and cardiac arrhythmias. Las Vegas Ketamine is prepared and trained to treat each of these side effects. Ketamine is the anesthesia of choice in emergency rooms worldwide because unlike other anesthetics, it does not decrease the respiratory drive.

The occasional side effects that we see from low dose ketamine treatments usually resolve shortly after treatment. We may use supplemental medications to treat nausea, anxiety, hallucinations, and/or blood pressure changes.

Insurance companies claim that ketamine treatments are experimental and that they are not required to pay for them despite the large amount of research and demonstrated efficacy in clinical use by medical professionals. We do not accept insurance because the insurance companies have decided not to cover the treatment.

A small dose of Ketamine increases glutamate, a neurotransmitter and chemical messenger, which stimulates alternate neurons to build new reaction pathways in the brain. This process, called synaptogenesis, has a positive effect on mood, thoughts, and cognition. In short, these new pathways, created through Ketamine, replace the old pathways that contain the problematic issues and they become the new primary pathways.

Infusion therapy means that the medications are administered through an IV directly into a patient’s bloodstream. IV Infusion is the most effective administration method because it allows us to manage more precisely how much Ketamine is absorbed.

As anesthesiologists, we are intimately familiar with the usage of ketamine in the operating room environment. We are more comfortable using ketamine at the higher doses that help us achieve our exceptional success rates. Anesthesiologists are also trained in the handling and treatment of potential emergent situations in the unlikely event that they occur.

For appropriate conditions ketamine can be an exceptionally effective option, often helping when other treatments have been exhausted. For depression, including severe and treatment-resistant symptoms, studies show up to 80% of patients receive effective relief of negative symptoms. Many patients know whether the treatments are a good option for them after the first few infusions. In some cases where a patient is unsure, we suggest proceeding through the 6-8 infusions before a decision to continue or stop treatments, as it can be difficult to notice or acknowledge positive changes after years or decades of severe depression. Some patients experience relief after one infusion, some experience relief after multiple infusions, and it is possible for patients to receive infusions without obtaining any relief. Each individual has their own separate diagnosis and the outcome of their infusion treatment plan may not match the results that are found in the studies.

Sometimes the positive effects can be seen after the 1st treatment, but the large majority of patients see marked improvement between the 3rd and 4th infusions. It is important to follow the induction protocol (6 treatments within 3 weeks) because the infusions build upon each other to gain the most efficacy and longevity. Occasionally it can take the full 6-8 initial treatment series to recognize the positive results after years or decades of depression. Friends and family members may notice changes in mood and behavior before the patient.

Following the initial series of 6-8 treatments, we expect to see significant improvement that lasts from a few weeks to several months. Typically a “booster” ketamine infusion treatment is required after that time period to maintain relief of symptoms.

Ketamine can work well for neuropathic conditions, even when other treatments do not. In cases where pain is caused by a musculoskeletal injury, ketamine may not be a good treatment option. For instance, ketamine may not be a good treatment option for many instances of back pain caused by active impingement of nerves. In these cases, ketamine infusions may temporarily decrease the pain but the injury may cause the pain to come back quickly. Patients who have neuropathic pain are good candidates for ketamine infusions. Pelvic pain may respond very well to the ketamine, however, it can be difficult to know whether you will respond well, until you try a treatment, especially if the reason for the pain is undiagnosed. All the information that we have from studies and clinical results indicate that ketamine works at the level of neurons – improving their healthy function. If pain is based in the neurons themselves then ketamine can help.

During the infusion, some patients report changes in their vision, speech, and thought processes. They often describe feelings of dissociation from their body. It can feel like a sedated or dreamlike state. If unpleasant hallucinations or other sensations occur, we may decrease the infusion rate and/or administer medications to minimize these experiences.

Patients usually recover from the effects of the infusion within 20-30 minutes. There may be residual cloudiness and mild difficulty walking for a few hours. You may also feel fatigued for the remainder of the day. We recommend the patient have a low impact and relaxing remainder of their day following the infusion.

A series of infusions close together followed by maintenance treatments provides greater and longer-lasting relief. For the treatment of psychiatric symptoms, we start with a series of 6-8 infusions over several weeks followed by maintenance treatments as needed. Maintenance treatments are typically every 3 to 5 weeks at first. Most patients can “feel” a drop in their mood that will help them know when they need to come back for a treatment. For chronic pain conditions, we often see patients for one or more four-hour infusions on an as-needed basis. Treatment regimes can vary, but a common course of treatments may be approximately two treatments every six to eight weeks to manage symptoms. We work with patients to extend the time between treatments when possible. The number and frequency of treatments are variable from patient to patient.

You will be asked to not eat or drink in the 6 hours prior to your arrival time at the clinic. You can wear your comfortable street clothes the entire time. Once you have arrived at our office, our staff works hard to make sure that you are taken care of. We are highly experienced at IV start ups and use small-gauge needles. A friend may accompany you, although they should expect to sit quietly and shouldn’t interact with you much during the procedure. The room will be quiet and restful. Immediately following the infusion you will be monitored, usually for at least 30 minutes but as needed before being allowed to return home.

Ketamine produces a physical and mental state that makes it unsafe for you to drive for the remainder of the day after your infusion. It is mandatory that a trusted friend or family member accompany you or transport you home from all your appointments. If a friend or family member is unable to transport you home, we may allow you to take a taxi or ridesharing service home. However, we will require you to stay an additional 30-60 minutes.

Our treatments are administered or supervised by our Anesthesiologist who meets with the patient, places the IV, administers the infusion including reviewing the continuous monitoring, and releases the patient to leave at the end of the appointment.

We recognize that moving forward with these treatments represents a significant commitment of time and money. And for many people, the decision to pursue yet another treatment requires a significant commitment. We work hard to keep prices low for our patients, including working with our patients to balance the competing interests of good results against the time and commitment of the treatments. We offer the best-value treatment in Las Vegas

There is a movement to push the FDA for approval for the treatment of depression. However, without adequate backing, it will be difficult to finance the trials and bureaucratic navigation required to gain FDA approval for treatment of depression and chronic pain.

Patients should continue to take ALL prescribed medications. This includes any mental health medications. If you are using benzodiazepines (e.g. Ativan, Xanax, Valium), contact the office for a doctor consultation on how to get the best Ketamine effect. Patients on MAOi’s should not take ketamine. Always consult with your prescribing doctor prior to stopping any medication.