The Ketamine Augmentation Option
While controversial in academic settings, ketamine has emerged as a highly effective treatment in refractory depression. Multiple centers now exist in several countries to aid those with treatment-resistant depression. Dr. Henderson has a wealth of clinical experience after treating hundreds of patients with ketamine. Indeed, his clinic maintains a response rate of 72% and a remission rate of 42%, which far exceeds the national average. A recent meta-analysis of data from ketamine clinics nationwide found that the average response rate was 45% and the mean remission rate was 30% (Alnefeesi Y et al., J Psychiatr Res 151:693, 2022).
The Ketamine Secret
Why does ketamine work so well on depression? Because it activates BDNF and upregulates receptors for BDNF. Simply put, ketamine induces your brain to make more good stuff and more receptors for the good stuff. As a result, ketamine is a powerful inducer of neuroplasticity. Yet, the mechanism by which it induces neuroplasticity is different from that of infrared light. As a result, you get synergy!!
Adding ketamine augmentation to your infrared light protocol can powerfully activate neuroplasticity with a one-two punch. The result is more robust recovery for your patients.
Most ketamine clinics follow a lockstep protocol of administering IV ketamine infusions 3 times per week for 2 weeks. Every patient in these clinics gets 6 infusions in 2 weeks at a cost of between $2000 and $3000; however, many of these patients do not feel significantly better after 2 weeks of treatment.
Understanding how ketamine works is essential to appreciating why this approach often fails. Ketamine works by 2 major pathways Henderson, Neural Regen Res 11:195, 2016). The first is the glycogen synthase kinase-3 (GSK-3) pathway, which results in the rapid antidepressant and antisuicidal benefit of ketamine. However, the second pathway is actually much more important. Ketamine activates the production of brain-derived neurotrophic factor (BDNF), which is the brain’s own repair inducer. Not only does ketamine increase BDNF, but it also increases the number of receptors to which BDNF binds. As a result, over time, there is more repair factor and more receptors available to be activated by the repair factor. The outcome is that over a period of weeks, neuroplasticity and repair occur in the brain. This leads to reduction of depression, because depression is the result of the breakdown in circuits and damage to the brain.
As it takes weeks for this neuroplasticity to develop fully, it should not be surprising that people do not feel better at the end of 2 weeks of ketamine treatment. Moreover, if it takes weeks for BDNF-induced neuroplasticity to work, why should a person get 3 infusions in 1 week? That makes no sense. On average, with the method developed by Dr. Henderson, patients receive an average of 4.3 ketamine infusions over their entire treatment course of 5 to 7 weeks. Dr. Henderson’s method save time, medication exposure, and money, and yields a superior outcome. Indeed, if a patient is getting infusions 3 times per week at a typical ketamine clinic, they will quickly spend more time and more money in 2 weeks than most patients spend in their entire lifetime at clinics using Dr. Henderson’s method. Ketamine infusion clinics using the thismethod have been operating for more than 10 years and have treated in excess of 800 patients. Ketamine is safe, if safely administered. No evidence of addiction has been seen and only 5% of patients require more than 7 infusions using this enlightened approach to ketamine.
Why use the Neuro-Luminance Ketamine infusion method?
At Neuro-Luminance, we offer the option to have a psychiatrist oversee the care of every patient, an offering that is unique to our clinic. This option, called Elite Care , includes psychiatric assessment before, during, and after each infusion and ongoing assessment and fine-tuning of your individualized treatment strategy. With this option, you also save on the cost of the initial evaluation and any ancillary medications during the ketamine infusion.
Frequently Asked Questions
Is Ketamine safe?
Ketamine has been used for decades as an anesthetic and is commonly used in even children and the elderly. The dose given for anesthesia is ten times that of the dose we use to treat depression.
Do I need a referral from my doctor?
Yes, we do require a referral from your current doctor. If you do not currently have a referring clinician, you may schedule an appointment with Dr. Henderson.
Do patients need to stop the use of any current medications?
Patients can continue to take their current medications prior to ketamine infusion, with just a few exceptions. All antidepressant medications may be safely combined with Ketamine and all medications are reviewed during a pre-infusion patient evaluation.
Who is administering the Ketamine infusion?
Our Ketamine infusions are administered by a nurse anesthetist under the guidance of a psychiatrist. Patients are monitored with ECG, pulse oximetry, blood pressure monitoring and end-tidal CO2 monitoring (if indicated). Our clinic provides a safe, secure, and spa-like experience.
Are Ketamine infusions covered by insurance?
At this time, the ketamine infusion process is not covered by insurance companies. Financial assistance options are available.
Is the Neuro-Luminance Ketamine infusion protocol different from what other infusion sites are doing?
While many clinics subscribe to a three-infusion-per-week protocol, Neuro-Luminance Brain Health Centers utilizes its own research-based protocol and never does more than one infusion per week.
Ketamine powerfully activates Brain-Derived Neurotrophic Factor (BDNF) which induces neuroplasticity and brain repair. Since this neuroplasticity takes place over a period of weeks, there is little benefit to multiple infusions over a short time as other clinics recommend. On average, our patients receive 4.3 infusions in their lifetime.
Do patients need to stay on medications after Ketamine therapy?
Most patients will continue to take medications to maintain the level of improvement they experience after Ketamine therapy. While Ketamine repairs brain degeneration from depression, it does not change the fundamental genetics which lead to depression in the first place.
What is a common experience post-infusion?
Typically patients will feel a bit dizzy for about twenty minutes post-infusion. As part of our protocol, patients spend 30-40 minutes in our relaxation room for monitoring. It is important that patients do not drive following a Ketamine infusion.
Is there any preparation a patient should be doing for the Ketamine infusion?
- Do not have anything to eat or drink, other than water, for six hours prior to infusion
- Continue to take regular medications (as advised in your pre-infusion evaluation)
- Arrange for a ride home post-infusion
I’m coming from out of town. Are there accommodations nearby the clinic?
Yes, we can help with accommodation recommendations close to the clinic.
How many infusions am I going to need?
On average, patients receive four to six infusions (an average of 4.3 throughout their entire treatment course). This is less than what many patients will get within two weeks at other clinics. With an 85 percent response rate, Neuro-Luminance’s protocols save time, medication exposure, and money, yet yield a superior outcome.
Some patients experience dramatic results after just one infusion, but our experience with hundreds of patients indicates that lasting depression relief comes over time.
How much do Ketamine infusions cost?
Single infusions start at $435; packages are available for discounted rates.