- Will ketamine infusions help me if I have treatment resistant depression?
- How many ketamine infusions will I receive?
- What happens after my series of ketamine infusions?
- If ketamine therapy works for me, how soon will I begin to feel better?
- Will I require ketamine therapy for the rest of my life?
- What should I expect during my ketamine treatments?
- Are there any other side effects I should be concerned about?
- Do ketamine treatments cause bladder damage?
- I am bi-polar, will ketamine infusion therapy make me hypomanic?
- What medical conditions could keep me from receiving IV ketamine infusions?
- Is ketamine infusion therapy addictive?
- Do I need to bring someone with me to my ketamine treatments?
- Can I eat or drink before my appointment?
- I don’t have a psychiatrist, is that a problem?
- Where is the treatment performed?
- Will my current medications interfere with my ketamine infusions?
- What kind of payment do you accept?
- Will my insurance company pay for ketamine therapy?
- How soon can I be seen?
- Is there an age requirement to have IV ketamine infusions?
Dr. Mandel has personally administered well over 2,000 IV Ketamine Infusions since we opened in 2014 and over 80% of our patients have received significant relief. Although cannot guarantee any particular result as everyone is different, our past experience has been very encouraging. Many clinical trials have shown that Ketamine Infusions produce results for 70% of those involved. Our treatment is tailored, in terms of frequency and dosage, to each person. We believe it offers your best possible chance of success at over 80%.
For our mood disorder patients, that will depend on your response. We begin with two (or, in some cases, three) infusions 48-96 hours apart to see if Ketamine Infusions are effective for you. Most of our patients who respond see some improvement the day of or after their 2nd infusion. If not, we may attempt a longer and/or higher dose infusion. If there is still no response, we generally stop further treatment. If ketamine does improve your mood, outlook, and functionality, we suggest that you receive 4 additional infusions over the next two weeks to maximize ketamine’s brain-repairing abilities. That is a total of 6 infusions for one full series. For our CRPS/RSD or other pain condition patients, we provide five 4-hour long infusions, generally done on five consecutive days. Because pain conditions require more substantial dosing, we cannot determine whether or not a patient is responding after their 2nd infusion. Results can be seen very quickly, in as little as one treatment, but are often not seen until after the full course of treatment is complete.
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 it with an extensive aftercare plan at no additional cost to our patients. We offer Nuedexta, the only NMDA antagonist, FDA approved, oral agent, to those who are approved, to significantly extend the extraordinary benefits our patients are getting from IV Ketamine. We also prescribe ketamine lozenges, also known as troches, to select patients. Through Dr. Mandel’s experience prescribing, administering, and researching the various routes of administration of ketamine (IV, oral, nasal, IM, dermal) he has found the ketamine lozenges to be the most effective for aftercare. Intravenous ketamine is the gold standard and most effective ROA for relieving depression, other mood disorders, and pain. We have found ketamine troches to be most effective for maintenance therapy because they are sub-lingual and can bypass first-pass metabolism. We also offer free counseling, develop personalized aftercare plans, and follow up with our patients regularly. Some patients are more receptive to conventional oral anti-depressants after treatment and most are encouraged to be involved in talking 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. Following the initial series of infusions, some patients begin an infusion maintenance program; returning for additional infusions as needed. In most cases, 1-2 boosters is all that is necessary to restore patients and significantly extend their results. The interval between maintenance infusions will vary from patient to patient. Some patients may have a booster once per month starting 3 months post treatment while others have gone over a year before needing to come back. There is no way to predict if or how often you will require booster infusions. The level of involvement with the above listed aftercare plan may impact the need and frequency of follow-up infusions.
For mood disorder patients, some will begin to feel better within 1 hour of their first infusion. Patients with thoughts of self-harm or suicidal ideation often notice those thoughts and feelings dissipate first, and almost immediately. There is often a dramatic relief of dread and hopelessness. Other patients may not notice any improvement in mood until the day after their 2nd infusion. Some patients will require a third infusion before feeling significantly better. It is important to note that the results of ketamine can be sudden and dramatic, but they are not always. It is more common for patients to see gradual, subtle improvement. Sometimes function improves before mood does. For pain patients, it is uncommon to see substantial relief after 1-2 infusions. It is possible, and we do have patients leave the clinic pain free after one infusion, but that is uncommon. Most of the time, pain patients need to complete the full series of five infusions before they see substantial and lasting relief.
No. Some patients achieve long-term relief after one series of infusions. Others will find that infusions enhance the impact of antidepressants or provide initial relief that is then sustained by oral medicines, other therapies, and lifestyle choices. If ketamine therapy is the only solution for you, you may be able to space your infusions apart by 3-6 months. 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.
For mood disorder patients, ketamine is administered over a period of 50 minutes. The amount given will not cause you to lose consciousness. During the infusion, most patients have a mild dissociative experience, with an increased sensitivity to light and sound and an altered perception of time and color. Most patients tolerate these experiences without discomfort and many people find them to be pleasant. 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 of the drug rapidly dissipate and are often mostly gone within 20-30 minutes. There are no delayed “flashbacks” and patients generally leave our clinic within 30 minutes following the infusion and aside from mild fatigue, feel much like themselves. For pain patients, ketamine is administered over a period of 4 hours. The amount given is significant and can increase side effects like dissociation. Dr. Mandel uses a number of adjuvants to decrease or eliminate the negative side effects that are associated with higher doses of ketamine. Patients generally take 60-90 minutes of rest following the infusion before they feel comfortable leaving our 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.
Patients commonly feel tired following an infusion. On rare occasion, some patients experience nausea after an infusion. If so, we have medication that will relieve this. If you are prone to nausea, Dr. Mandel can administer a prophylactic before the infusion to help prevent it. Side effects usually dissipate within a few hours and are completely gone by the following day. There are zero long-term or permanent side effects of IV Ketamine Infusion Therapy.
Although hypomania is possible, we have not seen one single case in over 600+ patients.
There are very few. Call now to discuss your other medical conditions: 310-270-0625.
No. Not one of our patients has displayed or reported any symptoms of addiction.
You do not need to have someone bring you or remain with you during the infusion, but someone must bring you home. We advise you not to drive a car, operate heavy/dangerous machinery, sign any contracts, or partake in other potentially risky activities until the following morning.
You cannot eat 4 hours prior to your scheduled appointment. You may have clear liquids up to two hours before your appointment.
You do not need a referral from a psychiatrist or therapist but we do require pre and post treatment evaluations by a mental health professional in order to verify the efficacy of the treatment for you, monitor your progress, and ensure a successful treatment plan.
All ketamine infusions administered by Ketamine Clinics of Los Angeles are outpatient procedures and are provided in our state of the art facility in Brentwood, California. Our address is: 11645 Wilshire Blvd Suite 852 Los Angeles, CA 90025
Please inform us of any and all medications you are taking. We are particularly interested in learning if you are taking:
- Lamictal (generic name Lamotrigine). Patients should allow 12 hours between taking lamictal and the start of their infusion. They should wait 6 hours after their infusion before resuming lamictal.
- Any MAOIs. Some common brand names are Isocarboxazid (Marplan), Phenelzine (Nardil), Selegiline (Emsam), and Tranylcypromine (Parnate). Patients cannot take any MAOIs within 2 weeks of an infusion.
- Patients taking large doses of benzodiazepines will have a reduced response to ketamine. This does not mean you can’t receive ketamine treatment while taking benzodiazepines. It is perfectly safe, we just want to ensure the best possible chances for your success. We may ask you to skip a dose 24 hours before the start of your infusion and wait until 6 hours after before resuming your benzodiazepine. Some common brand names are Xanax (Alprazolam), Ativan (Lorazepam), Valium (Diazepam), and Klonopin (Clonazepam).
- SSRIs and tricyclics do not interfere with ketamine. There is no need to stop them.
- If you are taking opiates, muscle relaxers, or anti-inflammatories, there is no need to adjust your dose.
We can assist you in reducing or tapering off of any medications that are contraindicated, cause a reduced response to ketamine, or that you would like to stop taking due to negative side effects, ineffectiveness, or price. You should not adjust your dose or frequency of use of any prescribed medication without first consulting with your prescribing physician.
We accept all major credit cards, and cash. Interest-free financing is available to those who qualify through CareCredit. We’ve joined their network to make it easier for you to get the care you want and need for yourself or for your family. CareCredit is the nation’s leader in patient healthcare financing. You can conveniently pay over 12 months with no interest or over a longer-term for a reasonable rate. Copy and paste the following link into your browser for the fastest application process: https://www.carecredit.com/apply/confirm.html?encm=BWQCO1U3VjMMMAdjUmYJYFVvBGZUNgc4BGgHNARpBDY You can also call them at (800) 677-0718
Reimbursement policies vary widely among insurance companies. Some providers offer reimbursement for ketamine therapy. We can assist you in finding out whether or not your provider is one of them prior to your having treatment. We will provide you with the necessary documents to submit to your insurer for reimbursement. We require payment at the time of treatment. Interest-free financing is available for those who qualify. Copy and paste the following link into your browser for the fastest application process: https://www.carecredit.com/apply/confirm.html?encm=BWQCO1U3VjMMMAdjUmYJYFVvBGZUNgc4BGgHNARpBDY
It is our goal for you to begin treatment within a few days of your call. Most patients are seen within one week of contact.
There are no formal age limitations.