By Kelsey Casselbury
Depression is a leading cause of disability in the U.S., with chronic pain not too far behind. A new trend has emerged in treating these conditions: IV ketamine infusions. Most people don't havemuch experience with ketamine, an FDA-approved anesthetic; however, when other treatments don't work, these infusions could be the next step.
Ketamine has been used in the operating room as an injectable anesthetic since the 1960s, says Dr. Necole Fontenot, an anesthesiologist who co-owns Hydrafuse in Annapolis. In treating pain and depression, ketamine is administered in what Fontenot calls a “sub-anesthetic” dose, which is very low. She notes that when ketamine is used, the ain begins to create new ain connections. “It's like a hardware repair,” she says. It's not a cure, Fontenot is quick to note, but when patients have tried multiple types of medications and treatments, “a lot of patients come to us to try ketamine,” and often find success.
While research on the treatments is limited, a 2014 study published in the British Journal of Clinical Pharmacology concluded that, in clinical settings, ketamine is well-tolerated by patients. However, there can be side effects, such as nausea or hallucinations, and additional long-term research is needed. Fontenot notes that the ketamine administrators—who are all board-licensed anesthesiologists—have ways of dampening the side effects, such as Zofran for nausea or an anti-anxiety medication for any unpleasant mental issues. “Ketamine is a dissociative anesthetic,” Fontenot explains. “We warn patients that they might feel like they’re having an out-of-body experience. It feels like they’re in the Matrix—but most people find these feelings very pleasurable.”
For mood disorders, such as depression, PTSD, or OCD, treatment begins with two 40-minute injections. If they seem to be working, then four to six more infusions are scheduled. “Everybody's different; it depends on how severe their depression is,” Fontenot says. For chronic pain, such as fi omyalgia, infusions run much longer—approximately two to four hours—and it's recommended to schedule four to six consecutive sessions. Eventually, patients need to come back for “boosters” to keep up with the management—but that's up to each individual. “The patients are in control of when they come back,” says Fontenot, who co-owns Hydrafuse with Dr. Tonya Watson. “We don't tell them. Like I said, it's not a cure. It's a treatment.”
