Feel better quickly with intranasal or IV ketamine!
- Complex Regional Pain Syndrome
Ketamine works by stimulating AMPA, which increases brain derived growth factor to stimulate the formation of new nerve connections. Another mechanism of action by which ketamine works is through blocking NDMA receptors to decrease glutamate and restore the balance between glutamate and GABA. Suicidal thoughts can subside in 4-24 hours for quick relief, with 70% of patients with depression noting a positive response.
Ketamine Nasal Spray
In March 2019, the FDA approved Spravato (esketamine) nasal spray for the treatment-resistant depression. Depression that is treatment-resistant means that there has been no response after trying at least two different antidepressant treatments at adequate doses for adequate durations.
The American Journal of Psychiatry published a meta-analysis in February 2018 reviewing the effect of a single dose of IV ketamine on depression. Ketamine was found to quickly decrease suicidal thoughts, within 1 day and for up to 1 week in depressed patients with suicidal ideation.*
*Am J Psychiatry. 2018 Feb 1;175(2):150-158. doi: 10.1176/appi.ajp.2017.
In May 2019, the American Journal of Psychiatry published a study comparing ketamine regimens, and found that repeated ketamine infusions have cumulative and sustained antidepressant effects.*
Am J Psychiatry. 2019 May 1;176(5):401-409. doi: 10.1176/appi.ajp.2018.18070834. Epub 2019 Mar 29.
Ketamine infusion can be very beneficial for improving mood and pain. Ketamine IV can be used occasionally as needed, though a common regimen for the infusion is three times a week for 2 weeks. Some people may require additional boosters once every 1-3 months to sustain the benefits. Appointments take approximately 2 hours. Weekend appointments are also available.
Intranasal ketamine spray can be used in conjunction with complementary therapies.
Common side effects, greater than 1% and less than 10%:
- nausea and vomiting
- vivid dreams and nightmares
- increased saliva production
- blurred vision
- increased heart rate and blood pressure during the infusion
- out of body experience during the infusion
- change in motor skills
Will there be a consultation before the IV starts? Yes. There will be a full history and exam before the IV begins.
Can I eat before coming? Yes. Please be well hydrated. Can I drive myself home? Yes, 45 minutes after the end of the IV once any dizziness has subsided.
Will I have to do a urine drug screen? Yes.
Is ketamine addicting? No. However, it is a controlled substance that is tightly regulated.
How safe is it? Very safe. Vitals will be monitored.
Can I stop my medications for depression and anxiety? No. After you are feeling better, you can discuss weaning off with your prescribing doctor.
How soon will I see changes? Usually people report feeling better within 3 days. Some feel better after 3 sessions.
How long will the effects last?Patients with severe depression or anxiety, usually report feeling better for 2-3 days. Those with moderate symptoms report 1-2 weeks. Those with mild symptoms usually report 1 month.
Testimonials on YELP
“Dr. Shirley has a new FDA-approved ketamine nasal spray called Spravato to treat depression. I was worried about whether or not it was safe and I was pleasantly surprised that it make my feel so much better without the side effects from a typical antidepressant. I was looking for something more long lasting so she tried V ketamine which was the most helpful of everything I’ve tried.
During the infusion I was dizzy for about 10 minutes. After that, I did not feel like I was under the influence of any drugs yet it helped so much with anxiety and depression. It’s like fog lifted.
It did not dim my joy or numb me like traditional anti-depressants have done. I did not have any side effects.
I feel that this is a revolutionary new treatment to help people struggling with anxiety and depression and I highly recommend it! It’s so much better than antidepressants or other serious drugs that come with serious side effects.
Dr. Shirley was the most affordable physician I found to provide this in orange county. She was very professional and personable.”
“Great doctor. Patient and kind. Really listens and she explains what is happening with your body better than any doctor I have ever had. She is treating me with ketamine for major depressive disorder that I have struggled with for years. I am off all other medication and the fog has lifted. It is expensive but the joy I feel for the first time in years is worth it.”
“She has helped me incredibly with my depression and suicidal ideation. Ketamine helped my treatment resistant depression significantly. Continuing treatment with her has helped maintain my mental health. I recommend her as she has helped save my life.”
IV Packages available:
First visit: $650
Other visits: $450
Package of 3: save 10%
Package of 6: save 15%
Add-on before ketamine IV: NAD IV 100 mg $200 each
Nasal Spray: $200 for visit
*prescription $0-$150, depending on insurance