Frequently Asked Questions

Ketamine is a dissociative anesthetic used for anesthesia and procedural sedation. First synthesized from phencyclidine (PCP) in 1962, it produces dream-like state that is dissociated from reality. In 2019, the intranasal form of ketamine, Esketamine (Spravato), received FDA approval for treating depression. Since then, both IV and intranasal ketamine has been used to treat a variety of mood disturbances and chronic pain.

Yes. The strongest evidence for ketamine in the treatment of mood disorder is for depression, for which an estimated 50-85% of patients show improvement in symptoms. For some, the effects can be seen within minutes of treatment. The maximum response for ketamine is within 1-3 days. Its benefits can last 1-2 weeks or longer.

Potentially. Ketamine works much faster than either traditional antidepressants or electroconvulsive therapy (ECT). It can reduce the symptoms of fatigue and ahedonism (lack or pleasure), problems considered resistant to typical antidepressants. Ketamine can help people with treatment-resistant depression, defined as depression despite the use of at least two medications. It can do so with fewer side effects that ECT. Most importantly, ketamine can rapidly treat suicidal ideation, a potential life-saving advantage compared to  traditional antidepressant medications. While effects of ketamine can be remarkable, it is not a substitute for counseling services from a qualified mental healthcare professional.

Yes, reports on ketamine use for conditions such as post-traumatic stress disorder, obsessive compulsive disorder, anxiety disorder, bipolar depression, substance abuse, ADHD, and chronic pain is rapidly accumulating and largely favors its use. The list of conditions for which ketamine can be applied continues to grow by the day. 

The number of treatments is variable. Some people respond with one treatment, sometimes within hours. Others may require several sessions, with higher doses. While an initial six sessions is recommended as an initial treatment plan for mood disorders, we personalize care based on the response of the individualize patient. Once a positive response has been achieved, subsequent maintenance therapy may be extended to one sessions every few weeks or months, depending on individual patient needs.

Yes, the typical dose of ketamine used for treating chronic pain conditions is higher and the duration of infusion longer (e.g., 4 hrs) than that for mood disorders. In some patients, pain reduction can begin within 48 hrs and may last 2 to 8 weeks, if not longer. Results may vary, and in others, multiple doses may be required before an effect is seen. 

People with chronic mood and pain disorders, especially if their symptoms are severe and resistant to other therapies. Examples of treatable mood disorders include depression, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), anxiety disorder, bipolar depression, and suicidal ideation. 

Examples of treatable pain conditions include fibromyalgia, migraine headache, TMJ syndrome, chronic back or musculoskeletal pain, neuralgia (eg, trigeminal), and complex regional pain syndrome (CRPS). Other conditions may also be amenable to ketamine. The decision to attempt to treat these disorders is made on a case-by-case basis.

Ketamine can increase heart rate and blood pressure. It should be used with extreme caution, if at all, for patients with severe cardiovascular disease or intracranial masses, aneurysms, and arteriovenous malformations. Ketamine can also cause delusions and hallucinations, so patients with schizophrenia, schizoaffective disorder, and mania should not be given ketamine therapy. The safety and efficacy of ketamine in children and pregnant or breastfeeding women is still unknown, making its use in such persons unwise. Ketamine should not be used to treat the minor ups and downs of everyday life. 

Yes, in the sub-ansthesthetic doses used at Catalyst Ketamine for mood disorders, ketamine seems safe. The most common side effects include nausea, headache, elevated blood pressure, elevated heart rate, dizziness, and a feeling of dissociation from reality. Most of these problems are mild, transient, treatable, and well-tolerated. 

The long-term side effects of ketamine are rare. While potential complications of chronic use include liver inflammation and dysfunction, gall bladder disease, urinary bladder dysfunction, such problems are are extremely unlikely. Memory impairment, trouble thinking, ketamine craving and dependency, and signs of schizophrenia are also extremely rare. In a recent survey of over 6,000 patients receiving IV ketamine for depression, the rate of long-term complications was very low. In fact, the need to discontinue treatment due to complications was only 0.7%, usually due to distress associated with treatments.  

Based on available information, ketamine addiction from the sub-anesthetic doses of ketamine used to treat depression is extremely unlikely. According to a recent study, the only time addiction occurred in patients taking IV ketamine was in patients who were also given intranasal ketamine for self-administration at home. At our treatment center, we only administer IV ketamine. Increasing doses are sometimes required to achieve the same effect, but that is not dependency. 

Ketamine is an NMDA antagonist, which means it blocks the neurotransmitter glutamate at the N-methyl-D-aspartate (NMDA) receptor on the surfaces of nerve cells (neurons) in the brain. How that leads to less depression and pain is  complex and incompletely understood. 

According to one popular theory, even though ketamine blocks glutamate binding in some neurons, this may paradoxically stimulate glutamate release. This excess glutamate can bind to another neuronal protein, the AMPA receptor, initiating a complex cascade of biochemical steps that leads to the production of BDNF, brain derived neurotrophic factor. 

Within minutes to hours of exposure to BDNF, tiny branches known as dendritic spines begin to sprout from neurons. These outgrowths strengthen the function of and communication between neurons (connectivity), restoring their normal function. Thus, ketamine actually changes both the structure and function of the brain, a process known as synaptic plasticity.

Ketamine has a multitude of actions that some suggest may play a role in treating depression. For instance, besides blocking glutamate, ketamine may activate other receptors potentially involved in depression (eg, opioid, serotonin, acetylcholine). It may also decrease inflammation, which may play a role in causing depression. 

Ketamine can also interrupt the default mode network (DMN), the background communication between different parts of the brain that may be responsible for the underlying negative ruminations of depression. It may help restore normal circadian rhythms and healthy sleep cycles. Some believe it is not only ketamine but its metabolites that produce its antidepressive effects. 

In chronic pain, ketamine may also work by blocking NMDA receptors. This may prevent sensitization of pain neurons in the brain. It may also lead to descending signals from the brain that block pain impulses traveling through the spinal cord. Many  possible mechanisms exist, all working in concert. 

Potentially. Benzodiazepines (eg, Xanax, Ativan, and Klonipin for anxiety), lamotrigine (ie, Lamictal for seizures), and certain dopamine blocking drugs (eg, haloperiodol, resperidol) may limit ketamine's effectiveness. The continued use of these agents during ketamine treatment may need to be discussed with the prescribing physician. 

Possibly. According to a recent high-quality study (meta-analysis) reviewing 24 trials that compared intravenous (IV) ketamine to inhaled ketamine (esketamine, or Spravato), IV ketamine was approximately twice as effective for treating depression. This is the reason we administer IV ketamine over intranasal. 

Perhaps not alone, but it can provide an important jump start. Ketamine is a powerful catalyst for change. By providing rapid relief from pain and suffering, it offers hope when all else has failed. But its effects are often only temporary. To achieve a sustained benefit, the underlying roots of the problem needs to be addressed. Such issues include a stressful environment, unhealthy lifestyle, poor sleep hygeine, deficient coping skills, or physical ailment. At Catalyst Ketamine, advocate and promote a holistic, whole-person approach to long-term health and happiness.

Ideally, yes. A note from a physician or qualified healthcare provider helps us better understand your condition to provide more personalized care. But we also understand that such a referral can be difficult to obtain. When pain and suffering are severe and treatment can't wait, we are willing to proceed with ketamine therapy without referral as long as the treatment is indicated, safe, and in the best interests of the patient.  

We only turn someone down for ketamine therapy if we believe it is not indicated or unsafe. Before initiating treatment, we always perform a thorough history, including a careful risk-benefits analysis. Only when the potential benefits of ketamine outweigh its potential risks do we use the drug. 

Our fee for a 1-2-hour low-dose ketamine session used to treat mood disorders is $425. For a 4-hour high-dose session used to treat pain conditions, it is $1,350.  The fee for six 1-2 hr session is $2,350. Discounts are provide to military veterans and first responders.  We also are also willing to negotiation prices based on your individual needs. 

Each intravenous (IV) treatment session at Catalyst Ketamine is administered by Dr. Michael Ho, a physician anesthesiologist with over 30 years of experience administering ketamine. IV administration allows use personalize each session to achieve your personalized level of dissociation and mood enhancement. This allows faster symptom relief and more sustained remissions. Our treatment settings are safe, secure, and spa-like. We cultivate a mindset in which patients are calm, aware, and hopeful. Everyone receive the most personalized, professional, and compassionate care available.  Let us help you rediscover peace, happiness, and the best in you.