Ketamine is an anesthetic with remarkable psychiatric properties. Over the last 15 yrs, careful research studies have shown it to produce very fast and robust antidepressant effects in a significant number of patients with treatment-resistant depression, even among those that have failed electroconvulsive therapy (ECT). It can also be of help for patients with bipolar disorder, obsessive-compulsive disorder and other cases of severe anxiety.
Dr Luis Giuffra has been using ketamine on selected patients for over 7 years. He now administers it via the intramuscular route (IM) in the office. Using the IM route avoids using the expensive monitoring settings used for intravenous (IV) ketamine. IM is a safe, reliable, robust and fast-expanding route of administration that makes ketamine affordable to many patients. Dr Giuffra has personally administered or supervised over 500 IM ketamine administrations.
Typically, patients will receive 4-6 IM treatments over 2-3 weeks to establish a safe dose that results in at least one week of sustained improvement. Like any other psychiatric treatment, once patients stop receiving ketamine , their symptoms are very likely to reappear. Therefore, a maintenance schedule is often needed. Most patients need an IM dose every 1-4 weeks to maintain a positive response.