Ketamine Infusion for Depression & Pain Management in Torrance CA, Southbay, Westside
Ketamine is an anesthetic medication that has pain relieving properties and can be used at lower doses for Pain Management. Ketamine can be useful in relieving neuropathic pain that do not respond to other pain medications. This is because Ketamine works in a different way compared to other pain-relieving medication. Ketamine may also provide pain relief for a period of time after the infusion is complete and you have been discharged home. This may be because Ketamine helps your body to reset the way it receives pain messages.
For patients suffering from pain due to damage to the nerve fibers, tissues or nervous system (neuropathic pain), the options for treatment or pain relief are limited. Neropathic pain is characterized by burning, which may include a numbing or tingling sensation.
Ketamine Infusion Procedure
A Ketamine Infusion is an intravenous drip that contains Ketamine, which runs variable periods of time depending on the reason you require it. An initial dose is given, and then additional doses will need to be administered over a time period for the medication to have full effect.
Ketamine Infusion FAQ
Ketamine Infusions treat a variety of mental health and pain conditions. Ketamine Infusions treat chronic pain, severe anxiety, Reflex Sympathetic Dystrophy (RSD), Complex Regional Pain Syndrome (CRPS), Post-Traumatic Stress Disorder (PTSD), Obsessive-Compulsive Disorder (OCD), Bipolar Disorder and all forms of depression.
Depression is commonly treated with a combination of drug therapy (such as SSRI’s or SNRI’s) and psychotherapy. However, an intolerance to these medications necessitates the need for an alternative. Additionally, severe depression is often unresponsive to antidepressants and these medications take weeks to work. Ketamine offers rapid relief from a potentially devastating illness.
Ketamine works on a variety of receptors and pathways in the central nervous system (the brain and spinal cord, or CNS) to induce both an antidepressant and analgesic effect.
One of the primary mechanisms of action proposed is the antagonism (blockage) of NMDA receptors and the upregulation (increase) of AMPA receptors. These receptors are involved in the excitatory and inhibitory pathways in the CNS. Blocking the NMDA receptors in the CNS results in an interplay of glutamate (excitatory) and GABA (inhibitory) neurotransmission that ultimately leads to an increase in glutamate neurotransmission, or a net increase in excitatory signals in the brain (Kavalali and Monteggia, 2012). This pathway is involved in one of the brain areas affected in depressed and mentally ailing patients, the pre-frontal cortex (Browne and Lucki, 2013).
NMDA receptors are also involved in the propagation of pain signals to the brain. A state of chronic pain increases the activity of NMDA receptors, which leads to greater sensitivity to painful stimuli (Niesters et al., 2014). Blocking NMDA receptors reduces the perception of pain.
As mentioned earlier, ketamine is also an AMPA receptor agonist, meaning that it attaches to and activates AMPA receptors. An increase in AMPA receptor activation increases sensitivity to glutamate in the brain (Browne and Lucki, 2013). The result of ketamine’s effects is an increase in neuronal communication in the brain, a process lacking in individuals affected by depression and other disorders (Browne and Lucki, 2013).
Other than the glutamate/GABA pathways affected, ketamine has been found to affect the mTOR (mammalian target of rapamycin) pathway. Ketamine increases the phosphorylation (a type of activation) of mTOR, leading to the production of proteins responsible for the growth of neurons and the connections between them. One of these proteins is brain-derived neurotropic factor (BDNF), a protein that acts on TrkB and CREB receptors (Browne and Lucki, 2013). The mTOR pathway suffers from reduced signaling in individuals afflicted with depression (Browne and Lucki, 2013).
Furthermore, ketamine has been found to have an effect on mu and kappa opioid receptors, receptors involved in the inhibition of pain (Niesters et al., 2014). Ketamine additionally restores descending inhibition of pain signals in the body by activating the areas of the frontal cortex, insula and brainstem responsible for the phenomenon. (Niesters et al., 2014).
Due to ketamine’s mild physiological and mental side effects, patients who are not eligible to receive Ketamine Infusions are those with an unstable blood pressure or heart disease. Additionally, patients who are currently abusing other drugs or who suffer from illnesses such as schizophrenia are not eligible (Niesters et al., 2014).
In most cases, you do not need to stop using your current medication. In fact, it is encouraged to continue a regimen of antidepressants while you are receiving treatment to improve symptom relief even further if you are suffering from anxiety or depression.
If a patient responds well to an initial infusion, further infusions are administered rapidly (typically 6) in the next 2 weeks. However, the infusion regimen is variable and can be administered less frequently in accordance with a patient’s needs. After a sufficient amount of treatment, maintenance infusions or ‘boosters’ are given intermittently to maintain results.
Relief can be achieved within hours of receiving the first treatment. Some patients may even notice improvements within a few minutes following treatment. However, this varies from patient to patient.
Results from a single infusion typically last for 1-2 weeks, during which patients may feel an overall improvement in mood and functioning. After several treatments, results last for a much longer period of time. Long-term, ketamine lifts treatment resistant depression from responsive patients and provides relief from other ailing mental health and pain conditions.
Ketamine is administered very slowly over a 60 minute period. Patients remain in the office for 30-60 minutes following the procedure to allow for any side effects to subside and to ensure that the patient reacts well to the infusion. Overall, the entire process takes about 90 minutes to 2 hours and patients are able to return to regular activity the next day. An adult escort known to the patient is required to transport the patient home once the procedure is completed.
During the infusion, patients may experience mild hallucinations or dissociative feelings (feeling as if you are outside of your body). In addition, patients may experience dizziness, nausea, impaired vision and motor control, impaired short term memory, numbness in the extremities, feelings of being ‘high’ and increased sensitivity to the environment. Some patients may experience heightened anxiety. If uncomfortable, these can be treated during the procedure. Side effects resulting from the infusion subside after the procedure is over. Side effects between treatments are rare—they are typically present during the procedure and shortly after as the medication lingers in the body.
Ketamine produces a sympathetic (“fight-or-flight”) response within the body as it acts on the autonomic nervous system. Physical symptoms include increased blood pressure and heart rate. These can be treated through the use of benzodiazepines during the procedure.
Ketamine Infusion is considered an ‘off-label’ treatment and is currently not FDA approved for the treatment of depression and other disorders. Most insurances do not cover the procedure.
At Pacific Pain & Wellness Group, Ketamine Infusion is performed by pain specialist Dr. Kartik Ananth. Your pain specialist at Pacific Pain & Wellness Group can discuss options with you. Although extremely rare, risks of Ketamine Infusion may include adverse reaction to the medicine, infection or nerve damage.
Schedule a Consultation
If you are suffering from debilitating joint pain, knee pain, back and neck pain in Torrance, Southbay, Westside and want to know if Ketamine Infusion is right for you, please call us.
Call (424) 625-6600 for an Appointment