Common Questions About Ketamine

HOW DOES KETAMINE DIFFER FROM OTHER ANTIDEPRESSANT MEDICATION?

Ketamine is unique in that it typically works very rapidly (over hours), unlike many other medications for depression, which can take weeks to have full effects. It also appears to work on very different brain chemicals and brain systems than typical antidepressants.  Though ketamine has been subjected to rigorous study (see KETAMINE RESEARCH), it is not approved by the FDA for treatment of depression.

The duration of benefit from ketamine varies from person to person, from hours to days to weeks.  Sometimes, with repeated treatments and other additional measures (i.e. other traditional antidepressant medication) the benefits can persist for longer periods.

HOW IS KETAMINE GIVEN AT DR. MACDONALD’S PRACTICE?

Ketamine, due to its unique molecular structure, can be administered in a variety of ways: 1. via a ketamine infusion in a vein (IV); 2. via an intramuscular injection (IM); 3. intranasally (via nasal spray); 4. under the tongue (sublingually), or even 5. orally.  

All of these methods have published studies describing and supporting their benefit and safety in treating depression (see KETAMINE RESEARCH). The IV administration method has far and away the most published research supporting its use.

Dr. MacDonald, for reasons of cost, safety and patient comfort, prefers a “gentler” approach to ketamine treatment, so often starts with sublingual (under the tongue) treatment, and progresses to intramuscular (shot) treatment if needed.  

The sublingual approach allows patients to take a more active role in their treatment, and dramatically reduces the overall cost of ketamine treatment.

HOW EXPENSIVE IS KETAMINE ? DOES INSURANCE PAY FOR IT?

The sublingual form of ketamine (Dr. MacDonald’s preferred delivery system) is not covered by insurance, but is quite affordable, compared to IV treatment.  

IS KETAMINE ADDICTIVE?

There have been case reports of patients who initially started using ketamine recreationally and became addicted.  Professionals who use low-dose ketamine for depression report this side effect rarely if ever, especially with careful screening and education.  Dr. MacDonald has extensive experience assessing and treating addiction, and will monitor for this very rare side effect.

WHAT ARE THE RISKS OF KETAMINE?

On the short-term, ketamine not uncommonly causes altered states of consciousness (which are sometimes disconcerting), visual changes, nausea and increases in blood pressure.  

Other risks–most commonly observed in chronic, higher-dose users–include potential cognitive changes and effects on the bladder.  Careful monitoring for these side effects is part of treatment.

HOW CAN I GET MORE INFORMATION ABOUT KETAMINE?

In the age of the internet, one can find is all kinds of information about ANYTHING on the web, including ketamine.  This information varies in quality.

The most scientifically accurate information about medical treatments is from peer-reviewed studies (see KETAMINE RESEARCH tab), which have built-in methods to control for bias.

Popular news stories (see KETAMINE IN THE NEWS tab) also often give interesting, readable, personalized stories about treatments, and attempt to present a balanced view.  They often lack rigor in terms of accurate presentation of facts.

A final, critical source of information is from your personal physician, who has training in reviewing different kinds of research, clinical experience with real-world use of treatments, and a unique focus on the details of your particular clinical situation.  

It is often helpful to do your own research using the above sources, and bring your individual questions to Dr. MacDonald for a personal discussion.