- Why choose Dr. Belnap as an Anesthesiologist to administer the ketamine?
Although Ketamine is a very safe drug, it is safest when it is being delivered by someone who has the highest level of training to administer drug infusions. As a board-certified Anesthesiologist, Dr. Belnap has the highest level of training and has been administering ketamine to patients for over a decade.
- How will Dr. Belnap be involved in my treatment?
Dr. Belnap will be involved with you directly throughout the entire treatment. He will perform the initial assessment and verify that you are a good candidate for the treatment. From starting your IV to monitoring your vital signs, Dr. Belnap will be with you throughout the treatment and make sure you are as comfortable as possible. Finally, Dr. Belnap will monitor your progress with the treatments and adjust the treatment schedule to meet your needs as much as he can.
- How does ketamine compare to alternatives?
Typical antidepressants take 4 to 6 weeks to work. There is no reliable way to know which of the many oral antidepressants will be effective and well-tolerated. Patients often become frustrated that they must tolerate the side effects of the medication for weeks without knowing whether the drug will even really help them. The common side effects are usually weight gain, sexual dysfunction, gastrointestinal disturbances, sleep disturbance, fatigue, and emotional blunting. Conversely, side effects from Ketamine occur during the infusion itself and typically resolve within 15 to 30 minutes after stopping the infusion. Patients don’t experience any significant side effects in between each treatment.
Before ketamine (and TMS), electroconvulsive therapy (ECT) was the only option for patients who either failed to have a positive response from oral antidepressants or could not tolerate the side effects. ECT is an invasive treatment which requires general anesthesia for each treatment and ECT treatments must be repeated several times. The most serious side effects from ECT are memory loss and the risks related to having general anesthesia (airway complications, heart problems, etc.).
- Is there potential for addiction?
There are no reported cases of any patients becoming addicted to Ketamine from receiving the low doses that are used clinically to treat mood disorders and pain disorders.
Most drugs prescribed in the US are listed on different “schedules” based on several criteria including their level of possible addiction. Illegal drugs such as LSD and Heroin are schedule class 1. Commonly prescribed pain medications such as morphine and dilaudid are a schedule class 2. Ketamine is a schedule 3 class medication which is described as having a low to moderate physical dependence.
The World Health Organization (WHO) believes Ketamine is an essential medicine used for anaesthesia and analgesia (pain relief) in adults and children, having been listed on the WHO Essential Medicines List since 1985. In 2015, the WHO Expert Committee on Drug Dependence reviewed the latest evidence on the potential harm to health and dependence- producing properties of ketamine and upheld its previous recommendations (of 2014, 2012 and 2006) that ketamine should not be a scheduled medication.
- Would it work the same if I took it intramuscularly (IM) orally or nasally?
No. Ketamine is absorbed very differently through the oral and nasal routes versus the intravenous route. Patients tend to experience more undesirable side effects and complications with the IM, oral and nasal routes. Clinical studies have reliably shown that the greatest results come from ketamine administered intravenously.
- How does Ketamine work?
Depression, anxiety, pain, and other forms of stress physically damage the part of the brain responsible for memory, learning, and higher-order thinking. It is currently believed that a metabolite, a breakdown product of ketamine and not the ketamine itself, is responsible for the physical healing to those parts of the brain damaged by the depression. Exactly how ketamine helps to repair the brain is currently unknown.
- What conditions respond well to ketamine treatments?
Major depression, the depressed phase of bipolar disorder (bipolar depression), postpartum depression, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), pain syndromes such as complex regional pain syndrome (CRPS)(formerly known as reflex sympathetic dystrophy (RSD)), migraine headaches, trigeminal neuralgia, phantom limb pain and addiction.
- Do I need a referral from a psychiatrist or therapist?
No. A referral is not required. Dr. Belnap will contact your licensed mental health professional with your written permission to confirm your diagnosis and update him/her on your progress with the treatments.
- Are there any medical conditions that will prevent a patient from receiving ketamine?
There are very few medical conditions that will prevent a patient from receiving ketamine. Please call 760-331-7735 to learn more.
- What are the risks?
The dose used for the treatment of mood disorders and pain is very low and safe. A patient’s blood pressure and heart rate may increase during the initial part of the infusion. This is monitored closely and other medications may be administered to counteract this effect if necessary. There is a risk of worsening depression if the treatment does not work for you.
- Do I have to stop my other medications?
Patients cannot take MAOI medications within 2 weeks of an infusion. Some common brand names are Isocarboxazid (Marplan), Phenelzine (Nardil), Selegiline (Emsam), and Tranylcypromine (Parnate). If you are taking one of these medications, you must consult with your prescribing physician before either decreasing or stopping your medication.
Lamictal (Lamotrigine) is a medication that should not be taken for at least 12 hours prior to the start of a ketamine infusion. Patients should wait at least 6 hours after their infusion before resuming lamictal. Before making any changes to their dosing of lamictal, the patient must consult with their prescribing physician.
Benzodiazepines taken in large doses or frequently prior to a ketamine infusion will reduce the effectiveness of the ketamine. You may be asked to skip a dose 24 hours before the start of your infusion and wait until 6 hours after before resuming your benzodiazepine. Some common brand names of benzodiazepines are Xanax (Alprazolam), Ativan (Lorazepam), Valium (Diazepam), and Klonopin (Clonazepam).
There are currently two other medications, which are known to significantly interfere or block the response to ketamine, and these are risperidone (Risperdal) and olanzapine (Zyprexa). They are “relative contraindications” to therapy and may need to be reduced or discontinued prior to treatment.
- What am I likely to experience during a ketamine infusion?
The medicine is given very slowly over 40 to 50 minutes while you relax in a soft recliner chair. Patients may notice some blurring of vision or double vision, a feeling of “lightness,” “floating,” or intoxication. Other common feelings include euphoria, talkativeness, a feeling of being “disconnected” or in a dream, heightened perceptions (background noise may seem louder, colors or lights may be more intense) and a feeling that people often describe as “weird, odd, different, or interesting”. Less commonly, people may experience some anxiety and headache, nausea, or sweating. The infusion may be stopped temporarily or slowed down if any of these side effects become uncomfortable. Once the infusion is complete, the main side effects resolve in approximately 15 to 20 minutes. Patients may experience more minimal side effects (i.e. fatigue) for the next 3 to 4 hours.
- Will I be awake?
Yes. You will not lose consciousness from the effects of the Ketamine. If you are already sleepy and are feeling very calm and relaxed during the treatment, you might drift off for a short nap as you relax in a soft recliner chair.
- What should I do during the infusion?
We will provide a relaxing atmosphere where you will be reclining in a soft comfortable chair that you can adjust using the automatic settings. Calming music will be provided and you may choose to relax and listen to the music or we can add calming nature scenes on a large screen high resolution TV. Our goal is to make you as comfortable as possible.
- How do I know if it worked/what should I expect?
Most patients experience positive effects in approximately 2 to 4 hours after the infusion and up to 24 hours after the infusion. The positive effects one may feel include feeling more hopeful, less sad, decreased thoughts of suicide, increased calmness, “weight” of depression lifted, or more inclined to engage with people. For the longest lasting results, one must complete the 2-week course treatment with 6 infusions.
- How long will the results last?
The positive effects from a single infusion typically last anywhere from a couple of days up to 1 week. A series of 6 infusions may last anywhere from one month to several months. When the positive effects begin to wear off, a single booster infusion is often all that is needed to extend the positive effects for another month or longer.
- How do I maximize the benefits?
Ketamine treatments allow patients to participate more effectively in talk therapy with their trusted, licensed mental health professional. Patients are better able to perform those tasks that were too monumental for them as they struggled with depression. They have more energy and motivation to take care of themselves, exercise, manage their weight, and establish a better sleep schedule. Maintaining a healthy lifestyle along with the occasional booster infusion can ensure that the patient maintains the benefits attained through the ketamine treatments.
- What are the success rates?
Approximately 70% of people respond positively to ketamine infusions.
- Are there any age limits?
There are no formal age limits.
- Will my insurance cover this?
Unfortunately, ketamine infusions are not covered by insurance.
- What kind of payment do you accept?
We accept cash and all major credit cards.
- Do you offer interest free financing?
Yes, we have partnered with Advance Care to help patients obtain up to 12 months of interest free financing. The process is quick and easy as outlined below.
How to apply:
- Click on www.advancecarecard.com
- Select “Apply Now”
- Choose current credit status from: Excellent, Good and Fair
- You will be directed to the product which best matches your credit situation
- Complete and submit the secure on-line application
- Receive an instant credit decision!