By Cory Fowler, FNP
One of the most recent developments in psychiatry is the utilization of intravenous (IV) ketamine treatments for depression. While it has traditionally been used to provide anesthesia during major and minor surgeries, recent studies have brought forth a novel use as an effective, fast-acting antidepressant. It is possible to experience its effects within four hours, and they may endure for several weeks.
suicidal ideation – a breakthrough that has caused much anticipation throughout the industry of psychiatry.
The mechanism through which this occurs involves its action as an antagonist on NMDA receptor pathways; Necessary for controlling synapse’s capacity to increase or decrease in activity, excitotoxicity is regulated by this receptor type and linked to depressive states. Consequently, a blocking agent capable of preventing over-excitation can be clinically beneficial as a means of swift relief from depressed moods.
Adding to its desirability as a rapid-acting antidepressant is its profile of safety; This drug form is included in the World Health Organization’s list of Essential Medicines which accounts for those medicines providing effectiveness with expected levels of safety.
IV ketamine therapy for depression was once considered only a final option when more traditional FDA-approved treatments had been exhausted. However, its efficacy is becoming more widely accepted in psychiatry, aided by both positive anecdotal reports and rigorous clinical studies. The American Psychiatric Association unveiled its consensus statement on IV ketamine as a source of treatment for depressive illness.
What does the process of an infusion look like? It’s different from one provider to another, dependent upon components such as the setting (private clinic or academic practice), physician or healthcare assistant, and specialist field of expertise (anesthesiologist or psychiatrist). At NuLife Medical, it begins with a medical assessment with the physician associate to determine if ketamine would be beneficial based on individual requirements. Additionally, any potential risks and side effects are discussed along with other alternatives within the psychiatric medication. If it’s seen suitable to proceed then scheduled IV infusion treatments begin in specifically designed rooms set up to optimize patient comfort while maintaining safety measures.
Ketamine usually starts to take hold within five minutes and fully kicks in after around ten minutes before lasting 30 minutes more for a total of 40 minutes. Afterward, there’s typically a further 15-minute period before being discharged by the provider – unable to drive until the following morning due to long-term effects. Usually, an initial course consists of six IV administrations gradually increasing doses each time until both practitioner and patient decide if further application is necessary.
There has been a spectrum of feedback from those who have gone through IV ketamine for depression, from the positive to the negative. Most endure the process acceptably, some with pleasure and others finding it peculiar or intense. The only practical way to know is to try a session.
An issue with ketamine (or other psychological treatments) is that as soon as they stop, the benefits dwindle. NuLife Medical generally suggests renewing treatment sessions over an extended duration of time or opt for “maintenance infusions”, where single doses of ketamine are given every couple of weeks which has proven to be beneficial in preventing receding health benefits. Even though ketamine therapy might be a very effective distress cure, it is difficult to use particularly on complex illnesses like depression; this method can not always guarantee success in recovery. However, there are alternatives if it fails, we have worked on protocols that have had notable good results.
Is this revolutionary approach very costly? Astonishingly not so much; at NuLife infusion treatments cost anywhere between $325-$350 depending on various issues such as the phase of therapy etcetera but at present insurance does not cover it due to FDA non-endorsement for this application. Nevertheless perhaps someday insurance companies will recognize its cost-effectiveness and safety and include it in their list of covered expenses.
