Are Ketamine Infusions Safe?

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Today, the use of ketamine has an ever-expanding role in treating patients with conditions that are often considered difficult-to-treat. These conditions include, but are not limited to, depression, chronic pain disorders, PTSD, and chronic headache/migraine disorders. In fact, the FDA recently approved the use of ketamine in treatment-resistant depression. Since Mullica Hill Advanced Therapies offers ketamine infusion therapy for all of these conditions, one of the first questions we get from patients prior to getting a ketamine infusion is “are ketamine infusions safe?”

It is understandable why these questions arise. Patients who are contemplating ketamine infusion therapy are typically stepping outside of traditional healthcare norms and processes. These patients are often looking for alternative therapies for their untreated conditions and arrive at ketamine infusion on their own, whether it be through Google, word of mouth, etc. The act of finding a treatment and then simply receiving it can understandably generate a significant amount of reservation or cautiousness. The familiar stepwise approach of seeing your physician/specialist, discussing your condition, having a treatment recommended or prescribed, and then finally taking the medication is largely eliminated. Also eliminated is the opportunity to discuss the risks and benefits of ketamine treatment. Lastly, patients are used to taking medications in pill form, and the thought of receiving a medication through an IV can also be daunting.

The end of this article will discuss recommendations for patients on how they should proceed if they are considering ketamine infusion, however we will first answer the question “are ketamine infusions safe?”

While many patients have never heard of ketamine before, some have at least some knowledge of the medication. However that knowledge is usually limited to simply identifying ketamine as a drug used in hospitals, a drug used on animals, or a street drug. In fact, this is all true. While ketamine can be abused recreationally and is used as a sedative in veterinary medicine, the most widespread use of ketamine is within hospitals. Ketamine is considered a dissociative anesthetic, which means it causes sedation at high doses. This is how the drug is used in the hospital, primarily in operating rooms and emergency departments. At much lower doses, it works as an analgesic medication, which means it relieves pain. Because of the way ketamine works on the brain, there has been new and ongoing research showing ketamine to be effective against depression, chronic pain disorders, PTSD, and chronic headaches at these similar lower doses.

Nearly all patients receiving ketamine infusions tolerate these experiences without discomfort and many people find the experience therapeutic and pleasant. When a patient receives a ketamine infusion at Mullica Hill Advanced Therapies, the patient relaxes in a comfortable chair and the medication is slowly infused over a period of 45-60 minutes. Once the infusion is complete, the drug is rapidly metabolized by the body within 20-30 minutes. There are no delayed side effects and patients are generally safe to leave our clinic within 30 minutes following the infusion. Most patients receiving infusions will not experience any significant symptoms during the infusion. Due to the slow rate of infusion as well as the low dose of medication, patients will not become sedated or lose consciousness. The most common side effect is very mild fatigue.

Rarely, patients have a mild “dissociative” experience, which can include an increased sensitivity to light and sound or an altered perception of time and color. Patients typically do not find these experiences troubling and they only last for a short period of time. In the rare case these side effects are considered unpleasant, other rapid acting medications will be used to resolve these symptoms.

Finally, it should be noted that there is only a small population of doctors who have experience using ketamine, are knowledgeable of the medication’s effects and dosing, and are completely comfortable administering the medication. These doctors are typically limited to emergency medicine physicians, anesthesiologists and pain management physicians trained in anesthesia. In addition, emergency medicine physicians are especially suited for this type of treatment because they are trained to manage and treat a wide range of conditions ranging from minor to serious. Patients coming to Mullica Hill Advanced Therapies should be comforted to know that there will be two emergency medicine physicians present at the time of any patient’s ketamine infusion.

If patient’s are considering receiving a ketamine infusion and have questions, they should discuss this treatment option with their primary care physician or specialist physician. If they are unable to have this important conversation or would like to discuss ketamine infusion therapy further, the physicians at Mullica Hill Advanced Therapy are happy to offer a free consultation in their office.

Joseph Cesarine, MD Joseph Cesarine, MD Joseph Cesarine, MD is a practicing emergency medicine physician in the South Jersey and Philadelphia region. In addition, Dr. Cesarine is one of the physicians/owners of Mullica Hill Advanced Therapies, an Integrative Wellness Medicine and Interventional Pain Management clinic.

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