KETAMINE

Ketamine


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. 
Safety and side effects:
Common side effects during IM ketamine include a dissociative experience (the ketamine “high”), a brief increase in blood pressure, dizziness and nausea. Patients are advised not to drive for 6 hours after each treatment. Patients should make the necessary arrangements for transportation after each treatment. There is extensive ketamine safety data when used sporadically for anesthesia. There is also good data on the safety of using it for several years for pain control, at doses comparable to those used for the treatment of psychiatric disorders. There is also significant evidence that long-term ketamine abusers develop serious side effects such as cystitis (a painful inflammation of the bladder) and cognitive problems. However, ketamine abusers typically use between 1,000-5,000 mg of ketamine several times a week. Psychiatric patients will rarely receive more than 75 mg a week.
During the initial evaluation, a thorough review of all potential side effects will be given, and questions about the treatment will be answered. 

 To schedule an evaluation

 Please call 314-222-5828  

Please note: ketamine is not for everyone, and not everyone responds to ketamine. Patients whose psychiatric condition is serious enough to consider ketamine treatments should be under regular psychiatric care. We expect our patients to have ongoing psychiatric care, and will gladly communicate with their psychiatrists while they undergo ketamine treatments. 

Luis Giuffra, MD,PhD

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