Other things to keep in mind about ketamine infusions.

Ketamine is not a cure, it will not cure your chronic pain, it will not cure your depression, it will not heal your underlying traumas, it will not cure any other illnesses. It is a tool to help, just like other medications & treatments. But like other treatments, you will need to keep utilizing it to continue receiving the benefits that it brings you.

It is a myth that ketamine will make a depressed person happy.  In reality, ketamine treatments will make you feel more resilient. The stressors don’t change… what changes is your ability to cope & your willingness to engage in other treatments, both for mental health & physical health.

One infusion will not do much, even if you feel a positive result. Ketamine needs to build up in your system in order for the effects to be longer-lasting. It needs time to reset the NMDA receptors & help your synapses heal. Don’t give up early… trust the process.

What dose is best for my “XYZ” diagnosis? Because every person is different, it is difficult to know what your best dose will be. But there are guidelines for starting points & we can go up or down from there, based on your feedback. So being honest with your provider is important. A good clinic & provider will be willing to adjust up or down as needed.

Whether you’re getting ketamine for chronic pain or mood disorders (or both), it’s very common that you’ll still have good days & bad days.  Some people even get a little worse after an infusion before they begin to feel better overall; it’s called a post-infusion flare. Utilize all of the tools that you know to manage your times of down-swing. And know that it will get better!

Do some people develop a tolerance to ketamine? Yes, it is possible. Just like with many medications, there doesn’t seem to be a way to prevent it. Communicate with us if your infusions aren’t helping as they used to. We have a protocol where we can increase your dose by 10% if your dose seems to start to lose it’s effectiveness. From what we’ve observed & heard from other providers, this may happen to long-term ketamine users about once a year. That’s why it can be important to start at the lowest dose that’s effective for you.

I’ve heard that some people are able to come off of their antidepressants… is that true?  In some cases, with the supervision of their mental health provider, some people have been able to reduce or eliminate their antidepressants, mood stabilizers, &/or anti-anxiety medicines. However, most people do continue to utilize antidepressants in combination with ketamine; they find that the ketamine seems to cause the anti-depressants to work more effectively.

If you develop pain that feels like it’s in the location of your bladder, it’s possible that the ketamine is causing this pain. It’s rare with lower doses for mood disorders, but with higher doses for pain, the ketamine being metabolized by your body can irritate your bladder. Let us know… we have a list of OTC medications that can help. Also, if you’ve been diagnosed with Interstitial Cystitis, it’s important that we know… we will have you take those same OTC medications from the start.

Remember to visit the bathroom before each infusion!

Wherever you receive your ketamine infusions, that clinic should be willing to share with you what dose you are receiving, over how much time, & what other medications you will receive along with the ketamine. Many clinics are using IV magnesium to work synergistically with ketamine & may also need to give you medicine to treat elevated blood pressures or nausea.  You should always be told what you are being given; if any place doesn’t want to tell you, consider avoiding them.

We enroll you in Mood Monitor, an app that helps you track daily how you’re feeling.  Mood Monitor also has an application for pain patients.  You can also try keeping a journal of your daily mood or pain as a way to track your progress. This is especially helpful if your changes happen more slowly. However, if you have OCD, keeping a journal may not be a good idea as it may cause you to obsess over it. Your entries don’t need to be very long, just meaningful to you. Maybe even give your mood or pain a number… something that you can use to quantify your current status. When you read back over several days or a week of entries, you’ll be surprised at your progress!

And finally, if you don’t think ketamine will work, then it won’t work. You must tell yourself that the ketamine is making changes in your body, it’s healing your synapses that have become damaged through stress over time. Sometimes the changes are subtle & you may not pick up on those small clues that things are improving.

The improvements have been described by some as “sliding a dimmer switch” rather than “flipping a switch”… things may brighten slowly!

Part of the process is knowing that the ketamine truly is healing your body; the other part of the process is becoming aware of those subtle changes. You will not go from 0-60 overnight, & if you’re convinced that it isn’t working, then it won’t, & you’ll be back too square one with yourself. As you are trusting the process, do small things that bring you pleasure.