Are infusions done as outpatient?
Yes. All infusions are administered in our private office.
How do I know if Ketamine Infusions will help my pain?
While treating some types of chronic pain with Ketamine Infusions have been more studied and found more effective than treating others, there is no guarantee that Ketamine Infusions will help your pain.
How will you determine how many Ketamine Infusions I will need?
By experience with your type of pain, and observing your response to the first two infusions. You will receive a minimum of two and a maximum of ten infusions depending on your response.
How frequently are infusions scheduled?
The best results are achieved when infusions are administered on successive days.
Will someone need to come with me?
You may arrive alone and undergo the infusion without a friend or relative present. Our staff will be watching you closely. However, all patients must be accompanied by a responsible adult at time of discharge.
What about eating and drinking the day of my procedure?
Patients in the morning session must have no food or liquids after midnight the night before. A sip of water with medications is OK. Afternoon patients may have clear liquids until 8:00 am, then nothing other than medication with a sip of water.
I heard that Ketamine can cause hallucinations?
If given alone, Ketamine can cause hallucinations. To limit the occurrence of this side effect we administer midazolam, a benzodiazepine that is very effective. Only rarely will a patient have to stop treatment because of any of Ketamine’s side effects.
How will I feel after the Ketamine Infusion?
Your thinking may be a bit cloudy and your walk unsteady for an hour or two after treatment. There will be a few more hours of tiredness. But, hopefully there will be a noticeable improvement in the pre-treatment level of your pain as well.
What is the goal of Ketamine Infusion therapy?
What we want to achieve is a significant improvement in the level of your pain. With a decrease in pain you can expect to increase your activity level and improve your overall quality of life.
How long will my pain relief last?
Following a series of infusions we want to see a prolonged period of significant pain relief measured in weeks to months. Most patients will need to return from time to time for a booster infusion to maintain that level of relief.
Is the office handicap accessible?
The Pittsburgh office is wheelchair accessible. The New York office and the bathrooms are handicap accessible.
Does the office have WiFi?
Yes, we have WiFi and those accompanying you are welcome to bring any laptops, iPads, iPods and cell phones that they wish. During the infusion you will be sedated and need to rest without distraction.
What is the cost?
The cost of each infusion is $750-$800, depending on location. This fee is inclusive with no additional or hidden charges. We accept cash, checks and all major credit cards.
Introduction | The Science of Ketamine | Outcomes
The NMDA Receptor
The dorsal horn of the spinal cord is important for the transmission and modulation of pain signals arising in the periphery. An important receptor in the dorsal horn is the NMDA receptor. Peripheral pain causes the release of glutamate which binds to this receptor. This results in an opening of the NMDA receptor channel allowing the influx of ions which leads to a cascade of neurochemical events ending with pain perception by the brain. With prolonged stimulation of these receptors, a central sensitization occurs. Ketamine blocks the NMDA receptor and stops the transmission of peripheral pain signals to the brain. With prolonged blockage during Ketamine Infusion Therapy, the brain “reboots” and stops interpreting peripheral stimulation as pain.
Chrinic Pain ReliefKetamine is not a new drug. It has been used for five decades in human and veterinarian medicine. Most commonly it has been used as a general anesthetic agent. In anesthetic doses it results in a complete loss of consciousness while preserving certain protective reflexes. That has made it attractive to anesthesiologists in selective patients. While it does stimulate opiate receptors, much like morphine, its action in subanesthetic doses as an NMDA receptor antagonist is much more important in the treatment of chronic pain. By blocking the receptor and closing the channel to ion transport, pain signal transmission is interrupted giving central pain centers a chance to “reboot”. One or a series of low dose ketamine infusions in awake patients can dramatically alter or even eliminate their chronic pain. Ketamine infusions have been most often used when other treatment modalities have been less effective. Certain types of pain considered to be “neuropathic” in origin have been most studied and are considered to be most responsive to ketamine therapy. However, other types of chronic pain such as chronic temporal mandibular joint (TMJ) pain, some headaches, and musculoskeletal pain may also benefit from ketamine infusions. The list of chronic pain syndromes that benefit from ketamine therapy continues to grow.
Ketamine Side Effects
Ketamine infusions are generally well tolerated, and few patients need to terminate treatment because of side effects. Still, ketamine is a derivative of phencyclidine (PCP) a known psychedelic and if not combined with sedation can cause hallucinations in many patients. You will be given a benzodiazepine to control this dysphoria. Other possible side effects include nausea and rarely a headache. These side effects also can be treated during the infusion. Following treatment patients will be tired for several hours and need to be accompanied home by a responsible adult. There are no long term side effects associated with Ketamine in the relatively low doses used to treat chronic pain. There is no chance of addiction to Ketamine.