What Is Ketamine Infusion Therapy?

Ketamine works by promoting regrowth of broken neural pathways in the brain that are a result from intense stress in individuals with depression and other mental illnesses. This enables better communication between parts of the brain, and can shift patients out of negative mental states. Ketamine infusion therapy involves the use of this medication in the form of intravenous (IV) administration. The onset is quick, within three to four minutes, resulting in the entire ketamine infusion therapy experience typically lasting about forty minutes.

How does ketamine infusion therapy differ from other forms of ketamine?

Bioavailability

Refers to the rate and extent to which a drug is absorbed into the body and reaches circulation. IV ketamine is 100% bioavailable, which is different from other forms of administration, such as oral and intranasal. The bioavailability is far less for oral (~20%) and intranasal (~40%) forms of ketamine, which even varies more due to uncontrollable factors such as the absorption of the medication in the nose or oral digestive tract. This means that IV doses are superior to the other forms that have lower bioavailability.

Control

IV ketamine infusion therapy allows for precise dosing, ensuring the attainment of the necessary threshold blood levels of the medication for to create an appropriate antidepressant effect. This proves to be a challenge with nasal and oral forms of ketamine due to the variation in absorption and the inability to guarantee the requisite blood levels.

Furthermore, in cases where patients experience nausea, or require immediate treatment for changes in blood pressure and or heart rate, the close monitoring of patients with an IV makes it easy to provide swift intervention. With an IV in place, other medications to counteract side effects can be administered intravenously, leading to rapid relief. Additionally, intravenous ketamine can be paused or stopped at any time, which is not possible with intramuscular, oral, or nasal forms of the medicine.

Setting

IV ketamine is administered within a highly controlled and closely monitored environment. In contrast, there is a growing trend in the use of oral and nasal forms of ketamine at home. However, I would advise caution, especially for individuals less familiar with this medication.

The practice of at-home use has led to an increased potential for recreational and abusive consumption. Surveys indicate that over 50% of patients who opt for at-home ketamine use use it inappropriately, often exceeding recommended dosages or frequency. While severe side effects are exceptionally rare, those who choose at-home ketamine use risk experiencing adverse reactions without immediate access to medical care.

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How do you prepare for ketamine infusion therapy?

Talk with your primary provider

Determining whether ketamine is a suitable option for you should involve a collaborative decision-making process with your current healthcare providers. Ketamine is likely to enhance the effectiveness of your ongoing psychotherapy and antidepressant medication. It should be utilized as a tool to support the healing process, rather than being considered the sole solution for your mental health condition.

Set intentions

Intentions, or the goals you aspire to achieve through therapy, can encompass various aims. For instance, you may desire to tackle a particular internal issue or confront a challenging past memory. However, it is essential to understand that these focusing on these intentions should not be perceived as mandatory for a "successful" therapy session. Rest assured that no specific expectations are placed on you, and this time is exclusively yours to engage with your thoughts and feelings and embark on your unique healing journey in any manner you see fit.

Relax

You have taken the initiative to make changes and take your mental health seriously. This can be the hardest part. Be proud that you have chosen to start the healing process and are open to making positive changes in your life. Know that at Innerbloom you are safe and in good hands.

Conclusion

The ketamine infusion process is a unique and powerful option for the treatment of various mental illnesses. It is rapid, safe, and highly effective. The infusion process differs from other forms for many reasons, although intravenous ketamine is the preferred route of administration at Innerbloom Ketamine Therapy. IV ketamine given in the clinical setting allows for maximal predictability, control, and safety. IV ketamine allows for use of lower doses and the ability to stop, or adjust doses based on your response. The preparation for a ketamine infusion includes discussing this option for treatment with your current providers, setting intentions, and lastly, taking a deep breath and trusting the process to guide you on your path to healing.

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About the Author

Dr. Ray Rivas, a former general and trauma surgeon with over a decade of experience utilizing ketamine, became a ketamine therapy specialist to treat mental health and pain after witnessing its profound impact on his hospital trauma patients and his own mental health. As the founder and medical director of Innerbloom Ketamine Therapy in San Luis Obispo, California, Dr. Rivas applies his extensive medical expertise to provide safe, evidence-based ketamine treatments for mood disorders, including depression, anxiety, PTSD, and chronic pain. His passion lies in helping patients find relief and rediscover hope through personalized, compassionate care.