Question 1

Are any of your services covered by insurance?

Accepted Answer

Ketamine infusions are typically not covered by insurance because for mood disorders it is considered an 'off-label' usage of this medication, & for pain disorders it isn't a common or mainstream treatment.  We can provide you with a 'super bill' that you can submit to your insurance company for possible reimbursement. 
 
Because ketamine is an FDA-approved medication for analgesia, patients receiving ketamine for any pain diagnosis may have a better chance of receiving reimbursement for their infusions than those for mood disorders.
 
We encourage you to contact your insurance company & speak with a representative who can authoritatively guide you in seeking reimbursement.

Question 2

Are Ketamine Infusions safe?

Accepted Answer

Absolutely!  Our infusions are meant to bring you to an improved place of wellness, both physically & mentally.  Ketamine is FDA-approved as an anesthetic/analgesic & has been safely utilized, both in the U.S & worldwide, for 50 years. 
 
As an anesthesia practitioner, our CRNA/owner is highly qualified to deliver your ketamine infusion, monitor your safety, & provide any interventions you may need during your infusion.  
 
Sensitivities or allergies to any of the medications we use are rare, but we have the appropriate interventions if this happens.  Both our CRNA & RNs monitor you throughout your treatment to ensure your safety. Your well-being is our top priority.

Question 3

What is ketamine?

Accepted Answer

Ketamine is a general anesthetic agent that's been used for 50 years with a proven record of safety. It is used during operations & procedures around the world every day.  It is used for pediatric patients, adults, geriatric patients, & in veterinary medicine. Ketamine works at the glutamate receptor in the brain (NMDA receptor), rather than the serotonin or norepinephrine site like most traditional antidepressants. It also stimulates the healing & regrowth of the synaptic connections in the brain (1).  Ketamine is on the World Health Organization's List of Essential Medications (2).

Question 4

Am I a good candidate for ketamine infusions?

Accepted Answer

Ketamine therapy is NOT a first-line treatment for either mood disorders or chronic pain. Many people can get relief from their symptoms with medication prescribed by their primary care provider, pain specialist, or mental health specialist. However, some do not experience relief of their symptoms & are considered "treatment-resistant"....these are the people who may be good candidates for ketamine infusions. Some medical conditions may exclude you as a good candidate, such as pregnancy, or schizophrenia. Some conditions need to be optimized before initiating ketamine infusions, such as hypertension, sleep apnea, or seizure disorders. If you have a condition called Interstitial Cystitis (IC) we ask that you consult your urologist prior to initiating ketamine therapy; they may wish to optimize your bladder health, perhaps to include a cystoscopy, to establish a baseline & optimize your bladder health prior to ketamine treatments.  Anyone with chronic liver disease will need to have labwork both before & after ketamine infusions to monitor your liver function.  A consultation with our Certified Registered Nurse Anesthesiologist can help determine if you are a good candidate to receive ketamine therapy.

Question 5

It is true that ketamine infusion therapy begins with a 'series' of infusions?

Accepted Answer

Yes. Studies have shown that, even if one feels some relief of symptoms after one infusion, the best way to build up longer-lasting effects of ketamine is through a series of infusions.  For mood disorders, there is a series of six (6) 40-minute treatments given over a 2 week period.  For chronic pain, the infusions last 2-4 hours each, and you will receive 5 infusions in a 1-2 week period. Additionally, a large percentage of recipients are considered 'late responders' & may not sense positive changes until the series of infusions is completed. 
 
After the series is done, you will then enter the 'maintenance' phase. Because everyone is different, how often you will need a maintenance infusion will vary. For some people it may be once a month, for some it may be once every 2 months, or even longer. We will work with you so that you understand how best to self-monitor your symptoms to make a determination when to come back in for a maintenance infusion.

Question 6

What can I expect during my visit?

Accepted Answer

You will be in one of our private infusion rooms for your treatment; our Nurse Anesthesiologist or Registered Nurse will be with you & monitor you at all times.  You will be connected to monitors during the entire infusion, and for 15-20 minutes after it's completion.  Initially, we ask family members or friends to remain outside of the infusion area until your treatment is completed; once we become familiar with your response to the infusion, you are welcome to invite a family member or friend to remain during the infusion, if you choose.  Additionally, if you have a therapist who would like to conduct a therapy session during a ketamine infusion, we will gladly accommodate that for you, & do, in fact, encourage it.  (Talk therapy during infusions has been found to render significant breakthroughs for some patients.) We aim to treat each of our patients as if they were a family member, and our goal is for you to feel safe & supported.

Question 7

How quickly can I begin ketamine therapy?

Accepted Answer

In general, it takes 1-2 weeks to receive your paperwork from your provider, have our initial consultation, & set up a schedule. 
 
In true emergencies, with a psychiatric referral, we can typically get you started within a day or two.

Question 8

Is ketamine addictive?

Accepted Answer

Although ketamine can be abused, just like many other legally available medications, when you receive ketamine infusions for a legitimate medical reason with an experienced & licensed provider, addiction does not occur.  Ketamine has been safely used by anesthesia practitioners for five decades without those patients becoming addicted.  When used safely & appropriately, ketamine is not addictive.

Question 9

What if I have both chronic pain & depression? Which infusions will I receive?

Accepted Answer

Having both chronic pain & a mood disorder can be common.  The dose for mood disorders is much lower than the dose for chronic pain, and lower dose is just not enough medicine to properly treat chronic pain.  If you are diagnosed with both chronic pain & a mood disorder, we follow the protocol for chronic pain.

Question 10

What is the cost of ketamine therapy?

Accepted Answer

Ketamine therapy begins with a series of infusions in order to build up the medication in your body. 
 
For mood disorders the series is typically 6 infusions of 40 minutes each, every other day.
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For chronic pain the dose, duration, & number of infusions vary, depending on what type of pain you have, where your pain is located, & for how long you've had the pain.  If a series of infusions is recommended, they are ideally done on consecutive days.
 • Mood Disorders (45 min duration): $350 each infusion; series of 6 infusions;
 • Pain Disorders (2-4 hrs duration): $750 each infusion, 3-5 infusions;
 • IM Boosters - $40 each
If you've received ketamine infusions at another clinic, we are glad to provide your maintenance infusions at the same dose & length that you've previously received with positive results.  We just need documentation of your most recent infusion from that clinic.
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Although we do not bill private insurance, Medicare, or Medicaid, financing options may be available through Advance Care Card.(https://advancecarecard.com/)  Also, utilizing a health savings account (HSA) may be an option....check with your employer.
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We give a 10% discount to military (active or former) & police/fire/EMS personnel.

Question 11

Because ketamine is such an old drug, I've heard it's pretty cheap.  If that's so, then why does ketamine therapy seem so expensive?"

Accepted Answer

The cost of ketamine therapy doesn't lie in the price of the medication itself, as much as in the delivery of the medication.  Although ketamine can be purchased somewhat inexpensively, the things that contribute to the cost are: a knowledgeable provider with education & experience; a suitable & appropriate space; & the monitoring & delivery equipment that provides safe practice.
 
In fact, you will find that in many ketamine clinics, the owners are still working either full-time or part-time at a local hospital or facility, simply because their ketamine clinics couldn't possibly replace their regular income.  But that is also how passionate many ketamine clinic owners are about this life-changing therapy.  They are willing to work above & beyond their regular jobs in order to bring this therapy to their area.

Question 12

I've heard some people use ketamine nasal spray or lozenges to lengthen the time between maintenance infusions.  Do you prescribe those?

Accepted Answer

Due to the cost of ketamine infusions, some ketamine patients utilize nasal spray or lozenges (called 'troches') to lengthen the time between their maintenance IV infusions.  Although we do not write prescriptions for home ketamine use, we do offer 2 options: 1) you may come in for an intramuscular (IM) injection as a booster; or (2) you may ask your primary care provider (PCP) or psychiatrist for a prescription.  If your provider is hesitant to prescribe either nasal or lozenge use, we are happy to help provide information to your practitioner regarding dosing & common prescribing practice of this medication. If utilizing any of these techniques to lengthen the time between infusions, you must still continue to self-monitor your symptoms & be aware of when you need a maintenance IV infusion.

Question 13

I'm coming in for my first ketamine infusion.....what do i need to know?

Accepted Answer

Prior to any ketamine infusion we will have already had a consultation & have conducted an extensive review of your medical history. You must be accompanied by family or a friend because you will not be allowed to drive after an infusion or IM injection. 
 
 • Please do not eat solid food for 4 hours prior to your infusion.
 • You may have liquids up to 2 hours before your appointment. 
 • Dress comfortably in loose clothing so that you may relax during the infusion.
 • We will place you in one of our private infusion rooms in a comfortable recliner, take your vital signs & connect you to our monitors, start an IV, & begin your infusion.
 • You will not lose consciousness at all & will remain aware & relaxed throughout your infusion.
 • You may experience some dizziness, see 'bright colors', experience inner reflectivness, or possibly feel a floating feeling.
 • Most people do not find any of these effects distressing, & they may actually be pleasant.
 • These effects typically go away quickly after the infusion is completed.
 • You will not have "flashbacks".
 • Some may experience nausea or vomiting after an infusion; we have medications that can help.
 • Rarely some may have a headache after an infusion; we have medication that can help.
 • Most people are ready to be discharged within 30-60 minutes after the completion of an infusion.

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