Chicagoans are about to experience wellness on a whole new level with the debut of IV Solution’s first Ketamine Center (712 N. Dearborn St., 844-948-6337), which offers intravenous ketamine therapies that help alleviate depression, chronic pain, and other ailments. To learn more about how the treatment works and what to expect, we caught up with chief medical officer Dr. Bal Nandra M.D. to ask him all of our pressing questions.
What are some of the benefits that ketamine infusions provide?
BAL NANDRA M.D.: Most of the benefits of ketamine that have been studied are in the relief of chronic depression and other mental illnesses such as PTSD, OCD, bipolar depression, and suicidal thoughts. It is very effective in treating all of these. In fact, multiple clinical studies over the past 10 years have shown ketamine to be up to 80% effective in treating refractory or treatment-resistant depression. It is also effective in treating chronic nerve pain and fibromyalgia. One benefit is that ketamine will allow some patients to get off or reduce their antidepressant medications, and hence hopefully eliminate the undesired side effects that these carry, which include weight gain, fatigue, sexual dysfunction, GI disturbances, and emotional/cognitive dulling. In chronic pain patients, ketamine can reduce the requirement for opioids and reduce tolerance to these addictive drugs.
How do ketamine intravenous infusions work and what makes them so effective?
BN: Ketamine is a drug that was developed in the 1960s and used from the 1970s as an anesthetic medication. It is a blocker of the cellular NMDA receptor, and this action is what makes it effective in treating depression and pain. In fact, ketamine also has the ability to stimulate neurogenesis and synaptogenesis, which can essentially “rewire” the pathways in the brain and nerves. Hence, we see the long-term results that can be obtained with a series of stabilization infusions.
Walk us through the process. What should a first-time visitor expect?
BN: After your initial inquiry and enrolling in the treatment protocol, we will ask you to complete a few questionnaires for health and medication screening. You will also complete a standard depression score assessment if applicable. If there are certain medications that can affect the ketamine infusion’s response, we will ask your prescribing physician to review your history and advise on managing those. You will be asked to arrive to the center with a prearranged ride home because of the potentially lingering effects for a few hours after the infusion. You should not have any solid food for at least four hours before the infusion and no liquids for two hours. You can bring headphones and music, and we recommend calming music.
Upon arrival, you will check in and then be taken back to the private infusion room. There, a nurse or the anesthesiologist will start your IV and start the infusion. You may get a medication for nausea in the IV. You will be comfortably reclining or laying down for the 45-minute duration of the infusion (for depression) and we will have a blood pressure cuff and other standard monitors on you that we will watch closely. For chronic pain treatment, the infusion can last up to 4 hours.
After the infusion starts, you will almost immediately feel a little drowsy and will start feeling “free” or “floating.” You will most likely not sleep and we will adjust dosing if you feel any untoward feelings, although this is rare. Once the infusion is over, the effects may last for a few more minutes. We will have you recover for around 30-45 minutes and you will then be free to take your ride home.
Are there any side effects?
BN: The side effects of ketamine are minimal at the very low doses used to treat depression. Patients can experience drowsiness, nausea, and increased blood pressure. We often administer a medication before starting to prevent nausea. Since it is a dissociative drug, patients may experience a floating or free state with vivid dreams. These are usually well tolerated and the effects all dissipate within 30 minutes of the treatment. This relaxed and free feeling has been postulated to potentially be beneficial in patients with depression.
How soon before you feel relief from the chronic pain?
BN: The clinical effects such as relief of pain may be seen as early as after the very first infusion, but this may only last a few days. The subsequent infusions will provide a longer period of relief and this is why we do a series of infusions. For depression, most responders will see improvement in symptoms as early as after the first and definitely by the third treatment, which is after the first week. The length of depression symptom relief is maximized with the six stabilization infusions over two weeks. Then patients only need to have a maintenance infusion as needed after that.
May 21, 2018