Frequently Asked Questions
FAQs
- Supervision by a cleveland clinic trained, triple board-certified psychiatrist, addictionologist and pain physician.
- Custom tailored ketamine dosing.
- Continuous vital signs monitoring.
- Preparation guidelines.
- Specially curated playlist delivered via wireless bluetooth headphones.
- Eyeshades and earplugs if needed.
- Any supplemental medications needed during treatments.
- Anti-nausea, blood pressure lowering, allergic reactions, etc.
- Ultrasound guided iv needle placement for “difficult sticks”.
- Conscious attention to optimal set and setting.
- Holistic framework using the bio-psycho-social-spiritual model of medicine.
Mental health: severe or treatment refractory depression, bipolar depression, PTSD, OCD, postpartum depression, anxiety, substance use disorders and addictions
Pain: chronic pain, spinal pain, fibromylagia, chronic regional pain syndrome (CRPS), reflex sympathetic dystrophy (RSD), neuropathic pain and neuralgia, migraine headaches, trigeminal neuralgia
More info: https://careclinicinfusions.com/conditions
Ketamine infusion therapy is the use of ketamine for the treatment of mood disorders and pain conditions, most commonly depression, suicidal ideation, post-traumatic stress disorder (PTSD), and complex regional pain syndrome (CRPS). For the treatment of mood disorders, ketamine therapy involves a series of six infusions at a ketamine infusion center spaced out over 2-3 weeks, with each infusion lasting about one hour. The dissociative effects of ketamine subside quite quickly, with most patients feeling comfortable enough to go home 20-30 minutes after the infusion is complete. For pain conditions, ketamine treatment involves a series of five, higher dose infusions at a ketamine infusion clinic over five days, with each infusion lasting about four hours.
Mood disorder patients often get rapid results from ketamine infusion. When given through an intravenous infusion in a slow, controlled, and constant rate, ketamine has many highly therapeutic effects on the brain. Among them is the ability to cause a physical growth in the brain’s prefrontal cortex, establishing new connections between neurons while repairing damaged cells. Ketamine causes an increase in neurotransmitters like glutamate that help to build new pathways in the brain, improving function in areas of mood, sleep, and more.
Pain patients often suffer from a process known as “central sensitization,” where pain signals increase in frequency and intensity over time. Ketamine acts to reset pain receptors and block signals of pain, restoring a healthier balance.
Ketamine, the medicine, was approved by the FDA as an anesthetic in 1970. Ketamine infusion therapy for the treatment of mood disorders and pain conditions is an off-label treatment. When evidence shows medicines to be helpful in treating conditions other than what they were originally approved for that use is considered off-label. This is a very common practice throughout the world. Almost one in four medications in the United States are used off-label and one in three psychiatric medications are. In early 2019, esketamine AKA Spravato, a nasal spray version of ketamine, was approved by the FDA for the treatment of depression.
Patients commonly feel tired or groggy after an infusion. This usually subsides completely after a full night of sleep. Some patients experience mild nausea after an infusion, especially those prone to motion sickness. If you are prone to nausea, we can administer anti-nausea medicine before the infusion to help prevent it. Additionally, patients who experience nausea after an infusion usually feel much better after we provide additional anti nausea medicine. Side effects usually dissipate within a few hours and are usually completely gone by the following day. There are no known long-term side effects of IV ketamine infusion therapy when administered by a responsible clinician in a medical setting.
We have administered thousands of IV ketamine infusions and 84.5% of our patients have received significant relief. Although we cannot guarantee any particular outcome, our past experience has been very encouraging. Many clinical trials have shown that ketamine infusions produce results for about 50-70% of those involved. Our treatment is personalized for each individual, in terms of frequency and dosage, and we believe it offers you the best possible chance of success at 84.5%.
Ketamine is most commonly administered through an intravenous (IV) for depression as it allows for exact dosing and can be easily adjusted if needed. Oral dissolvable tablets (aka sublingual troches) and intranasal administration (e.g., Spravato/esketamine) are alternative options, which may not provide as much medication to the bloodstream as the IV route but can be an effective way to maintain the positive effects of a ketamine infusion. We often continue patients on the sublingual troches depending on their response to the IV infusions. For those who are not good IV candidates, sublingual may be an option. Ultimately, the best method of administration may depend on the individual’s clinical presentation and personal preference, and it’s important to consult with one of our Board-Certified Physician’s trained in Ketamine to weigh the potential risks and benefits.
If you are experiencing the following: Uncontrolled high blood pressure (hypertension); unstable heart disease (arrhythmias, congestive heart failure, chest pain, etc.); untreated thyroid disease; active substance abuse; active manic phase of bipolar disorder; active delusions and hallucination symptoms (not on meds or while taking street drugs). If you have any of the above the day of your infusions, you unfortunately will not be able to receive your infusion.
There are very few medications that have any known interaction with ketamine. Please inform us of any and all medications you are taking. We will disuss any necessary changes to your medications at the time of your consult.
In some cases, patients may benefit from reducing the dose or completely eliminating medications that don’t work or produce negative side effects. Ketamine can be helpful in this process, but you should not adjust your dose or frequency of use of any prescription medication without first consulting with your prescribing physician.
Go to www.careclinicinfusions.com/news and www.askp.org for more information.
For mood disorder patients, some will begin to feel better within 1 hour of their first (1st) infusion. Patients with thoughts of self-harm or suicidal ideation often notice those thoughts and feelings dissipate first, and almost completely. There is often dramatic relief of dread and hopelessness. Other patients may not notice any improvement in mood until after completing a full course of treatment, which is a series of six (6) infusions. Most patients see some improvement the day after their 3rd infusion. Some patients require more infusions and more time following their infusions before feeling significant relief. It is important to note that the results of ketamine can be sudden and dramatic, but they are often not. It is more common for patients to see gradual, subtle improvement that increases over time. Sometimes function improves before mood does.
For pain patients, it is uncommon to see substantial relief before completing a full course of treatment, which is a series of five (5) infusions.
Mood disorder patients receive a series of 6 infusions over 2-3 weeks. Afterwards, booster infusions may be provided on an as-needed basis for maintenance. Typically, booster infusions are two infusions, provided one to two days apart. On average, patients enjoy around three months of relief before needing boosters. Sometimes, the results of the initial series do not last as long and in other cases, they last much longer. It is not unusual for patients to enjoy six months of relief, or longer.
Pain patients receive a series of five, 4-hour long infusions, over five consecutive days. Afterwards, booster infusions may be provided on an as-needed basis for maintenance. Typically, booster infusions are 2 infusions, provided on consecutive days or sometimes one to two days apart. On average, patients enjoy around three months of relief before needing boosters. Sometimes, the results of the initial series do not last as long and in other cases, they last much longer. It is not unusual for patients to enjoy six months of relief, or longer.
For mood disorder patients, low-dose ketamine is administered for 50-55 minutes and patients are awake the entire time. During the infusion, most patients have a mild dissociative experience, with an increased sensitivity to light and sound and an altered perception of time. Most patients tolerate this without discomfort and many find the experience to be pleasant or interesting. In the rare case these side effects are considered unpleasant, other rapid-acting medications can be used to relieve or eliminate this discomfort. Once the infusion is complete, the dissociative effects rapidly dissipate and are often mostly gone within 20-30 minutes. There are no delayed “flashbacks” and patients generally leave the clinic within 20-30 minutes following an infusion.
For pain patients, ketamine is administered over a period of four hours. The amount given is higher than what mood disorder patients receive and can increase side effects such as dissociation. We use a number of adjuvants to decrease or eliminate the side effects that are associated with higher doses of ketamine. Patients generally take 60-90 minutes of rest following the infusion before they leave the clinic. There are no delayed “flashbacks” and aside from being tired or fatigued, most feel much like themselves. We require pain patients to be picked up inside our clinic by a responsible adult.
No. Ketamine can affect your ability to drive, so it is mandatory a trusted friend or family member picks you up from your appointments. We also recommend refraining from operating heavy machinery, caring for small children, participating in strenuous activities, or signing or entering into any legal contracts for at least a day after your infusion.
If you are unable to find a friend or family member to transport your home, we will allow for you to take a ridesharing service or taxi home. However, we require you to stay longer after your infusion and you may incur additional fees. Thus, it’s in your best interest to find a friend!
We ask that you not eat or drink anything four hours before your scheduled appointment; some water is okay. This decreases the chance of nausea and other complications.
Our commitment to you and your recovery remains long after your last infusion. We know how vital it is that ketamine therapy be part of a bigger treatment plan for our patients, and that’s why we combine our program with an extensive aftercare plan including: regular availability to you for any resources or referrals you may need, quick replies to your questions and concerns, a detailed list of lifestyle changes to support your recovery, regular follow up from our medical team, and more. Some patients are more receptive to conventional oral antidepressants after treatment and most are encouraged to be involved in talk therapy with a trusted, licensed, mental health professional. We also work with patients on modifying their lifestyle choices to help maintain their good results.
For pain patients, the aforementioned treatment plan applies as well. Physical therapy, exercise, and stretching are also beneficial in some cases, depending on what the cause of the pain is and the condition.
Some patients achieve long-term relief after one series of infusions. Others find that infusions enhance the impact of antidepressants or provide initial relief that is then sustained by oral medicines, other therapies, and lifestyle changes. After the initial series of infusions restores the brain to a healthy balance, it is generally easier to maintain that balance than it was to attain it in the first place. Follow-up or “booster” infusions are provided on an as-needed basis for maintenance and are typically two infusions, provided one to two days apart.
The antidepressant effects of ketamine can vary in duration. The initial effects of ketamine are typically felt within a matter of minutes after administration and may last for a few hours. However, the long-term effects of ketamine can last for several days or even weeks.
Research has shown that a single dose of ketamine can lead to a rapid improvement in symptoms of depression, with effects being observed as early as 24 hours after administration. However, the duration of these effects can vary from person to person. Some people may experience a sustained improvement in symptoms for several days, while others may see a return of symptoms within a few days. Repeated administration of ketamine, either as a single dose or as part of a series of treatments, has been found to lead to longer-lasting antidepressant effects.
Studies have shown that a course of IV ketamine infusions can lead to sustained improvement in symptoms for up to 2-3 weeks. Ketamine is still an off-label treatment, and more research is needed to fully understand its long-term effects. It’s important to work with a healthcare professional to determine the best course of treatment and to weigh the potential risks and benefits. Ketamine is a medication that is used for various medical purposes, including as an antidepressant. It is administered in different ways, including intravenous (IV) infusion, intramuscular (IM) injection, sublingual tablets, or intranasal spray. IV infusion is the most common method of administering ketamine, and it is done by injecting the medication directly into the bloodstream. The effects of this method are felt almost immediately and can last for up to three hours. The duration of the effects depends on the half-life of ketamine, which is the time it takes for the medication to be processed in the body and leave the system.
IM injection is another method of administering ketamine, which is done by injecting the medication into a muscle, usually the shoulder or thigh. The onset of effects is typically 2-4 minutes, and the full duration ranges from 1-3 hours.
Sublingual tablets or troches are another way of receiving ketamine. These tablets are held in the mouth for direct oral absorption, and the effects are felt within 5-10 minutes. The dissociative effects last for around 30-60 minutes, with a return to physical baseline around 1-3 hours after treatment. If the tablets are swallowed, the half-life is increased, and the effects last for around 4-5 hours.
Intranasal (IN) spray is a newer method of administering ketamine. This method is done by administering the medication through the nose, and the effects are felt within 5-10 minutes. The full duration of the effects ranges from one to three hours.
It’s worth noting that the duration of the effects of ketamine can vary depending on the individual, and it’s always best to consult with a Board-Certified Physician trained in Ketamine before administering it.
No, because we have a psychiatrist on staff!
We do not require a referral or prescription from a psychiatrist or other physician. If you have a previous provider who treated you, we will ask for their records. This is to confirm your diagnosis, learn more about you, and personalize your treatment plan. Good news is that our physician is a psychiatrist himself and well versed in both mood disorders and pain.
As a general rule for all patients in this setting, we encourage you to engage in talk therapy and implement positive lifestyle changes.
All ketamine infusions administered by Care Clinic are outpatient procedures and are provided in our state-of-the-art facility in Fairfax, Virginia.
Our address is: 4017 Williamsburg Court, Suite 100, Fairfax, VA 22032.
How much does a ketamine infusion cost?
The pricing below includes your initial consult ($150); this amount will be applied towards your first infusion. If you chose not to proceed with Ketamine Treatment, the $150 will be applied towards your consult to account for your doctor’s time and efforts; therefore this fee is non-refundable.
We also offer a 10% discount for professionals and our military.
Please contact us to learn about our pricing and interest-free financing options. We can also provide you with a “superbill” of codes to provide to your insurance company which may offset the cost of some of your treatment (in this case, we reccomend first contacting your insurance company to verify this).
40 min, $397/each
1 free infusion with purchase of 5
Depression, Anxiety, PTSD, ADHD, Poor Concentration, Poor Energy, Insomnia.
3-4 Hours, $1,197/each
1 free infusion with purchase of 5
CRPS, Neuropathic Pain, Fibromyalgia, Chronic Back Pain, Chronic Headaches, Post-Amputation Pain/Phantom Limb Pain, Post-Herpetic Neuralgia, Traumatic Spinal Cord Injury, Peripheral Vascular Disease.
40 min, $397/each
1 free infusion with purchase of 5
Opioids, Cocaine, Alcohol, Methamphetamines.
We accept all major credit and debit cards, cash, and select interest-free financing options. We do not accept checks. Upon request, we can also provide you with a “superbill” for possible reimbursement to you from your insurance company.
Reimbursement varies widely among insurance companies and policies within companies. Some insurers offer policies with reimbursement for ketamine therapy. We can provide you with a sample billing statement (i.e. “superbill”) with the correct CPT codes so you can contact your insurance provider ahead of time and check whether they’ll reimburse you. Many PPO plans reimburse a portion of the cost after you’ve met your deductible. We require payment at the time of treatment. We also offer interest-free financing through Advance Care.
Yes we do!
10% off for Military and Professionals.
1 (one) free infusion with our package discount: purchase a series of 6 infusions for the price of 5.