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Ketamine Therapy
Ketamine Therapy: A True Game changer
Ketamine Therapy has seen exponential growth in the last several years in the US, UK, Canada and other countries simply because it is very fast acting and effective.
Cost of Ketamine therapy as it is not covered by Insurance is a deterrent for many patients. Our clinics have therefore kept this Cost more affordable than other clinics.
Dr. Tilak and his dedicated Team are ready to offer this novel therapy at either of our 2 locations: one at Jacksonville: 10175 Fortune Parkway Suite 401, Jacksonville 32256 & and the other at Middleburg/Orange park location: 430 College Drive, Suite 104-106, Middleburg, 32068: Same phone # for both locations: 904-298-1994
Indications for Ketamine Therapy : ( please see separate tabs for detailed description how Ketamine helps for each indication)
* Major Depressive Disorder or other types of Depression
*Generalized anxiety, Social anxiety or other Anxiety types
* PTSD (post traumatic stress disorder) or panic disorder
*Bipolar disorder
*Substance use disorder especially alcohol or opiates or marijuana
* Chronic pain disorders, Migraine headaches, Fibromyalgia, endometriosis, CRPS
Please note that we offer pain management services only at our Middleburg location as only this clinic is state registered as a pain management clinic.
What is Ketamine?
Ketamine was first approved by the FDA in 1970 to be used as Anesthetic. Yale School of Medicine first published a trial in 2000 showing its effectiveness against Depression. Many institutions then conducted several other trials showing similar results. Hundreds of clinics in various countries including the US are currently offering Ketamine for above indications with good success for a variety of conditions as above. Ketamine discussions have taken place in multiple TV shows and media. with physicians and patients presenting their success stories.
Separate tab on Ketamine in the news is included on this website for those interested.
Mechanism of Action of Ketamine
Ketamine interacts with multiple receptors in the brain. The main receptor is the NMDA receptor. Its interaction with this releases Glutamate which explains some of its effect on mood disorders, as Glutamate release uplifts the mood and causes happiness. Ketamine's effect on AMPA receptors also causes glutamate release.
Another important action is on brain structure which probably explains its longer term effects. Studies pioneered at Yale by Neuroimaging showed that Ketamine creates new neural connections in various parts of the brain (anterior cingulate cortex, prefrontal cortex, limbic system) which were found suppressed by chronic stresses be it Mood disorders or Drug abuse or chronic pain. This is called Neuroplasticity: brain adaptability by changing its structure.Studies show that it probably does this by release of Neuronal vascular endothelial growth factor. Ketamine is also an opioid receptor agonist which explains its effect on pain conditions.
Benefits of Ketamine Therapy
* relief of sadness, stress, anxiety, and restoring mental balance and wellness and happiness
*Very quick results in hours or upto a day
* Ketamine therapy can be used in conjunction with prescription medications and psychotherapy
* With relief of fatigue and stress, patients feel energetic and blissful
*Ketamine enables the brain to develop new neural connections (synapses), a new treatment
* Excellent option for Treatment resistant conditions as above
* Longer term results over weeks to months with multiple infusions
What to Expect with Ketamine Infusion
Many patients notice distinct improvement within a few hours or upto a day of IM infusion. Some patients start to feel better with improvement in day to day functioning, before distinct improvement in mood lifting or pain relief. The duration of these positive effects from the first infusion typically depend on the severity of the underlying condition but may last from a few days to 1-2 weeks or longer. For longer lasting relief, weekly or biweekly treatments for 6 to 8 weeks is recommended. Booster injections may be given on a monthly basis or longer as needed.
Why IM Ketamine Infusion Therapy?
IV route is cumbersome. Many patients find it uncomfortable, and require more intense monitoring. It is associated with risk of fluid extravasation and infection.
Many studies have demonstrated no significant difference in results of IM and IV therapy, both short term and long term as bioavailability of IM route is about 95%. Thus minor dose adjustment will give the same amount of Ketamine as IV route.
IM Ketamine is more cost effective, more convenient thus patients can afford more treatments for long term results. IM therapy doses can be spaced out at 15-30 minute intervals depending on patient preference. We can also give a small dose of Benzodiazepine or anti nausea medication if needed.
Safety of Ketamine
Ketamine has been used as Anesthetic since 1970 and has a proven track record of being very safe even when it is given at much higher dose when used as Anesthetic for children and adults . You will also be closely monitored for about an hour after the Ketamine Infusion. Dr. Tilak is board certified in both Internal Medicine and Interventional Pain management with added training in taking care of patients undergoing complex procedures with moderate sedation. He has been practicing for over 30 years as a physician with a proven safety record.
Success rate of IM Ketamine therapy
With proper patient selection, many studies have reported success rates upwards of 70%, although the overall success rate of current studies is around 70%. Success rate is mainly calculated by patients feeling significantly better than before the treatment. In general the duration of relief has lasted from a few days to 1-2 weeks following a single infusion (sometimes longer), a series of infusions over 4-6 week period ( one to two infusions per week depending on the severity of the condition) can provide longer term relief for weeks to months. Booster injections may be needed once a month or longer if condition returns or as a proactive measure.
Side effects of Ketamine Therapy
Patients will be closely monitored during Ketamine therapy and psychological support will be provided to tackle the side effects should they arise. The beauty of Ketamine therapy lies in low risk of side effects and high success rate. Most side effects are mild and transient. Side effects are directly related to the dose of Ketamine administered. Many studies have indicated that smaller doses of Ketamine will have very similar results in improvement of the conditions than higher doses with much less side effects.
Our approach is to get patient preference for selecting the dosage.
Dissociation or out of body experience can be uncomfortable for some. Nausea and rarely vomiting can occur and will be treated with medications like Zofran as needed. Using Zofran prophylactically before the infusion is also an option.
Blood pressure or pulse may increase during treatment and this will be monitored. Hardly ever this needs additional treatment.
Transient hallucinations, transient difficulty in muscle coordination and cognition may occur, thus we require that patients not drive after treatment till next day or call ride services like Uber.
Headache if disabling can be treated with IM Toradol (strong anti-inflammatory like Motrin) in the clinic.
Please note that most patients will not get troublesome side effects.
Is consultation needed before 1st Ketamine Infusion Therapy?
Yes. Consultation is required so Dr. Tilak can perform a medical and mental health assessment to optimize therapy and to ensure patients will benefit from the therapy. Prior medical records if available will be reviewed. Alternatives to Ketamine therapy will also be discussed and patients will be educated about the process of Ketamine infusion, its side effects, expected benefits and duration of benefits will be discussed.
Cost of Ketamine Infusions
Our clinics have kept the cost most resonable compared to other clinics in the area who are doing Ketamine Infsusion, with a hope that more patients will be able to complete the recommended course of 6-8 infusions.
Cost of a single Infusion : $350
You can buy 3 to 5 infusions for a cost of $325/infusion
You can buy 6 to 8 infsions at the cost of $300/infusion
If your condition is severe, biweekly infusions are recommended
If your condition is less than severe then weekly Infusions are recommended.
Thank You for your interest in Ketamine.