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Ketamine Infusion Therapy: an Alternative Innovative Treatment for OCD

Ketamine Infusion Therapy: an Alternative Innovative Treatment for OCD

Treatment for OCD

Ketamine-Infusion-Therapy-an-Alternative-Innovative-Treatment-for-OCD-300x200 Ketamine Infusion Therapy: an Alternative Innovative Treatment for OCD Los Angeles Southern CaliforniaAll too often on TV or social media, the visible rituals associated with OCD are the stuff of jokes and mockery. Yet for individuals suffering from this debilitating mood disorder, it’s no joke. What may start as a simple coping mechanism for a specific trigger—a fear of getting sick leading to frequent cleaning, for example—can eventually take over an individual’s life to the point where they are unable to participate in or enjoy normal activities. As with all mental health problems, OCD is not something that the individual can simply rationalize away. It starts deep within the brain’s chemistry and usually requires medical intervention and a long-term, comprehensive treatment plan.

The key to successfully intervening in and treating OCD requires lifting the anxiety and panic at the root of OCD rituals and breaking the cycle of negative thinking and compulsive thought processes. An innovative treatment option—Ketamine Infusion Therapy—may offer a safe and effective alternative to many of the traditional pharmaceutical approaches utilized by psychiatrists and medical professionals. For many patients, Ketamine Infusion Therapy works quickly to reduce panic and depression while dramatically improving the patient’s mood, thus opening up a window of opportunity for the positive effects of talk therapy, cognitive behavioral therapy, and/or exposure therapy to “kick in”.

Understanding OCD

OCD, or obsessive-compulsive disorder, is a mental health concern in which an individual relies heavily on rituals, compulsions, and/or superstitions to cope with uncontrollable irrational thoughts, anxieties, or fears. With OCD, the brain is hypersensitive to certain triggers, launching a dramatic overreaction when exposed to those triggers, which in turn leads to extreme panic and anxiety. Simultaneously, the part of the brain responsible for signaling safety is slow and sluggish, so the brain is unable to counter the hypersensitivity. The result is intrusive and relentless irrational thoughts, feelings, and sensations.

In order to cope with and eliminate this negative cycle of thoughts, feelings, and sensations, the individual with OCD develops rituals or compulsions that artificially reduce the feelings of anxiety and induce the feeling of safety that the brain cannot do on its own. Unfortunately, over time, the rituals, compulsions and superstitions must become more elaborate, elongated, or involved to induce the same level of calm (similar to drug tolerance). Thus, what may start as a minor repetitive action—frequent washing of hands, counting, or praying, for instance—can become so extensive and invasive that they interfere with the individual’s ability to engage in everyday activities.

What Does Ketamine Infusion Therapy Involve for Patients with OCD?

Most patients with OCD start with a series of four to six ketamine treatments, followed by routine maintenance treatments. The exact schedule of treatments is unique for each patient, and depends on how each patient responds to the treatment over both the short and long term. Each treatment involves slowly delivering a low dose of ketamine directly into the bloodstream through an IV. At Ketamine Clinics of Los Angeles, we utilize specialized digital infusion pumps, which can be programmed with the exact dosage each patient requires, and can be titrated up or down depending on as well as monitored and altered quickly as necessary depending on the patient’s response. Every treatment is performed in the comfort of our AAAASF-certified clinic, and overseen by our skilled and caring staff to ensure both the safety and comfort of each and every patient.

At Ketamine Clinics of Los Angeles, we believe that a successful treatment plan for OCD requires focusing not only on each individual treatment, but on two additional elements as well:

  • Long term monitoring: Dr. Steven L. Mandel has developed a unique assessment methodology called Mood Monitor, a HIPPA-compliant encrypted assessment service via text messaging. Mood Monitor enables regular and routine communication and assessment with each client based on the PHQ-9 depression assessment tool. This tool enables Dr. Mandel and his team to tailor both the individual ketamine treatments and the overall treatment plan to help each patient achieve successful results.
  • A team approach: treating OCD and other mental health issues usually requires a team of medical specialists working together to develop a comprehensive treatment plan with multiple techniques. Ketamine Infusion Therapy can be highly effective when coupled with individual therapy and participation in support groups. With your permission, we will work closely with all of your medical specialists to ensure that our treatment complements and supports your comprehensive treatment plan.

Treating OCD is not, unfortunately, something that can be done in a day and it’s not something that can be done alone. Yet it can be done! If you or someone you love is suffering from OCD, we encourage you to contact us today to obtain more information about our alternative and innovative OCD treatment, Ketamine Infusion Therapy.


For more information about Ketamine Infusion Therapy treatments for depression, bipolar, anxiety, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), fibromyalgia, pain syndromes and other conditions contact us at Ketamine Clinics of Los Angeles in Southern California (Orange County) by clicking here or calling  310-270-0625.


Photo by Jeremy Bishop on Unsplash

Celebrate June – Exciting News from Harvard!


Hello, June! We have reached the mid-year mark and summer is upon us. It truly is the season of celebration. Many of you are, or know someone who is, graduating, getting married, participating in a Pride event, or officially going on a dream vacation. It’s finally the beginning of summer; the days are longer and the nights are warmer and more inviting. Despite the ailments that may hold us back from enjoying this mid-year transition, I invite you all to find ways to celebrate this summer.

At Ketamine Clinics Los Angeles (KCLA), we have numerous reasons to be excited and celebrate this month. We have three special birthday’s; two of our administrative ladies whom you may know from our front desk, Jada: Executive Assistant and Amanda: Patient Care Coordinator, and from our medical team, Shonda: Medical Assistant. These women have what it takes to get the job done! It is our company culture to make sure these special moments are celebrated. My team is always giving to our patients and it’s important that we give to one another too and take a moment to recognize one another. I wish them nothing but joy and prosperity in the year to come and can’t thank them enough for their contribution to this team.

Another meaningful celebration is the two-year work anniversary of our wonderful nurse, Denisse! Many of you have heard of her amazing experience with Ketamine Infusion Therapy and the benefit she received; there are not enough adjectives to describe what we have all witnessed on her journey. Denisse has blossomed over the years. When she started with us, she was suffering silently. She would wake up feeling suicidal, depressed and full of anxiety. She was diagnosed with Bipolar Disorder, and struggled since she was a child. She moved slowly and cautiously at work, saving all her energy for our team and our patients. She was worried daily about making a mistake. The day she asked me if she could receive treatment was a real turning point in all of our lives. She completed her series of six infusions, has scheduled boosters quarterly, and now over a year later, is still doing remarkably well. Giving someone a job is nice, but giving someone relief from depression with Ketamine Infusion Therapy feels so wonderful it’s indescribable. Now this is a reason to celebrate! Happy two year workversary, Denisse, we appreciate you! Read Denisse’s story

Lastly, I’d like to give a shout-out to all the Fathers. Being a Dad is the title I’m most proud of. My children are in my heart every minute of every day. I feel lucky to work alongside my son Sam, my COO, and I’m so glad I get to celebrate Father’s Day with my family.

Wishing you a fun-filled and memorable June.


Dr. Mandel


Denisse, we can’t thank you enough for your hard work and dedication to this clinic. Your pride in this work, compassion for our patients, and willingness to help with the team in all areas is truly remarkable. You are more than an employee, you are part of our Ketamine Clinics LA family. Happy two year!

unnamed Celebrate June - Exciting News from Harvard! Los Angeles Southern California


Thank you, Jada, Amanda, and Shonda for making our days brighter and offering hope and guidance to our patients. We appreciate all you do and wish you a terrific birthday and a fabulous year to come!

We spent the morning celebrating at the park. We fit in some fun/silly team pictures!

unnamed-1 Celebrate June - Exciting News from Harvard! Los Angeles Southern California

unnamed-2 Celebrate June - Exciting News from Harvard! Los Angeles Southern California

unnamed Celebrate June - Exciting News from Harvard! Los Angeles Southern California

Ketamine for major depression: New tool, new questions

“Ketamine was once used mainly as an anesthetic on battlefields and in operating rooms. Now this medication is gaining ground as a promising treatment for some cases of major depression, which is the leading cause of disability worldwide. In the US, recent estimates show 16 million adults had an episode of major depression in the course of a year. Suicide rates rose substantially between 1999 and 2016, increasing by more than 30% in 25 states. Because of its rapid action, ketamine could have a role to play in helping to prevent suicide.” Read more

In light of Fathers Day I feel it is important to address what signs to look for in our children. Depression, anxiety, and other mood disorders are often a passed down family trait. – Dr. Mandel

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Children Won’t Say They Have Anxiety, They Say ‘My Stomach Hurts!’
“Recent statistics have shown us that at least 1 out of every 8 children develops an anxiety disorder. If left untreated, the initial anxiety disorder can transpire into difficulty maintaining and developing connections with their peers, severe sleep disturbance, and substance dependency.” Read More

unnamed-1 Celebrate June - Exciting News from Harvard! Los Angeles Southern California5-STAR REVIEWS

As employees at Ketamine Clinics Los Angeles, we know how amazing IV Ketamine Infusion Therapy is, we witness success stories every day. For future patients on the fence about treatment, let me remind you that it is truly the heartfelt words in these reviews that help encourage those considering this treatment to make the tough decision to move forward. This month, I want to thank Brandon and his wife, Carla, for sharing a great experience with us in their review from over a year ago, as well as recently updating their review to share even more appreciation. Many thanks for recognizing our staff for their continued kindness, and for giving us a shout-out on how beautiful our new facility is; we are glad you enjoy it as much as we do.

If you would like to leave kudos for us, or read the experiences of others, view our Yelp page now. – Dr. Mandel

Follow Us on Instagram

Follow our Instagram page and join the conversation. We post lots of personal content, new original photos, videos, and plenty of ketamine/healthcare news; visit us here!

Wishing all Dad’s a fabulous Father’s Day!

unnamed-2 Celebrate June - Exciting News from Harvard! Los Angeles Southern California

Ketamine Clinics of LA: Postpartum Depression signs and treatment

What is Postpartum Depression?

th-anh-789902-unsplash-221x300 Ketamine Clinics of LA: Postpartum Depression signs and treatment Los Angeles Southern CaliforniaThe first few days, weeks, and even months after childbirth can be a joyous time for new mothers and new families; it can also be extremely challenging, exhausting, and even stressful: coping with sleep deprivation and an infant who needs constant attention, learning the ins and outs of parenting, and balancing care for a newborn, care for other family members, and self-care as well. Many new mothers find themselves overwhelmed, depressed, and moody, especially as the body copes with yet more hormonal changes after childbirth. In fact, it’s pretty normal for all new mothers to have the so-called “baby blues”.

For most new mothers, the “baby blues” occur within a week or two of childbirth and then reside as the body’s hormones return to normal and life with a newborn becomes more routine (or as “routine” as it can be with a growing family). Postpartum depression (PPD) is not the same as the “baby blues”, and medical professionals now believe that up to 20% of new mothers may suffer from this serious medical condition (according to the Centers for Disease Control). PPD is a serious form of depression that manifests with symptoms that more closely resemble other mood disorders and will not simply “go away” on its own after a few weeks.

Symptoms of postpartum depression can include:

  • Feelings of being overwhelmed or trapped
  • Inability to cope with everyday tasks
  • Feelings of sadness, irritability, “moodiness”, and anger that persist for most of the day, for many days together
  • Worry, anxiety, and panic attacks
  • Significant bouts of crying
  • Withdrawal from family and friends
  • Loss of interest in normal activities
  • Lack of appetite
  • Persistent fatigue and exhaustion
  • Feelings of rejection and/or guilt
  • Feelings of inadequacy
  • Lack of interest in the infant or overwhelming anxiety about the baby’s health

If you or someone you love is suffering from one or more of these symptoms, it’s so important to talk about it! Unfortunately, the symptoms of PTSD themselves augment feelings of shame and inadequacy, making it easy for a new mother to blame herself for “not getting over it” and making it extremely difficult to discuss openly. For many mothers suffering from PPD, professional intervention and medical treatment may be required.

Ketamine Infusion Therapy: An Innovative and Effective Treatment Option for PPD

For new mothers suffering from the “baby blues”, taking the time to focus on your “lifestyle” can help counter the mood swings of the first weeks of motherhood. Focusing on getting plenty of rest and healthy meals, asking for and accepting help from friends and family, taking time during the day for self-care, and getting outside for a brisk walk are all excellent pieces of advice. Unfortunately, for women suffering from postpartum depression, offering “helpful” suggestions about lifestyle changes only places the onus for “curing” their PPD back onto the mother’s shoulders. As with other types of depression, postpartum depression is a serious medical condition that requires medical intervention.

Successful intervention is possible and can be highly effective. The standard treatments for postpartum depression are two-fold. First, talk therapy can be extremely effective, whether through a support group, individual counseling, and/or cognitive behavioral therapy (or some mix of the three). Second, some women may benefit from antidepressants known as SSRIs such as Prozac, Zoloft, or Lexapro to name just a few. Unfortunately, for women suffering from PPD, these types of antidepressants can have several drawbacks.

SSRIs often require several weeks before they “kick in”, which may simply be too long if PPD is interfering with a mother’s ability to care for her family. It can also take time to find the right SSRI; every individual reacts differently to each type of medication, and finding the one that works for you may require some trial and error, which takes even more time. Finally, and perhaps most critically, SSRIs can be transmitted through breastmilk to the infant, so they may not be appropriate for nursing mothers.

An innovative new treatment option in the form of Ketamine Infusion Therapy may offer a better solution for new mothers with PPD. Ketamine therapy involves extremely low dosages of ketamine delivered slowly into the bloodstream through an IV. Ketamine is extremely safe—in fact, it is still used as an anesthetic for children in some surgical situations—and does not pass through breastmilk. Moreover, it has the benefit of being fast-acting; most patients who try Ketamine Infusion Therapy experience a rapid improvement in depressive symptoms quickly.

Postpartum depression is a serious medical issue that, in most cases, requires the intervention of a medical professional. If you suspect that you, or someone you love, is suffering from more than just the “baby blues”, we encourage you to seek help immediately. Effective treatments such as Ketamine Infusion Therapy can offer lasting and effective relief.

For more information about Ketamine Infusion Therapy treatments for depression, bipolar, anxiety, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), fibromyalgia, pain syndromes and other conditions contact us at Ketamine Clinics of Los Angeles in Southern California (Orange County) by clicking here or calling  310-270-0625.


Photo by Thư Anh on Unsplash

Ketamine Clinics of LA: How to tell if someone has PTSD and treatment options

How to Recognize if Someone You Love Suffers from PTSD

Ketamine-Clinics-of-LA-How-to-tell-if-someone-has-PTSD-and-treatment-options-300x200 Ketamine Clinics of LA: How to tell if someone has PTSD and treatment options Los Angeles Southern CaliforniaToday, we tend to think of PTSD, or Post Traumatic Stress Disorder, as an issue for combat veterans returning from military deployment. In fact, PTSD can happen to anyone who has been involved in any type of traumatic event, including, but not limited to,  traffic accidents, natural disasters, sexual or other assault, or any other terrifying, dangerous, or tragic event. Most people who experience trauma do not develop the type of emotional reaction that leads to PTSD, but for those who do, PTSD can be a serious, debilitating, and even life-threatening medical condition that requires immediate, professional intervention.

Cognitively, psychologists categorize the symptoms of PTSD into four general groups:

  • Reminders or triggers: emotional reactions linked to specific memories, flashbacks, reminders, or nightmares of the traumatic event.
  • Withdrawal or avoidance: loss of interest in normal activities and social interactions in order to avoid potential triggers.
  • Negative thinking and/or mood swings: may include persistent feelings of guilt, fear, shame, anxiety, depression, and/or anger.
  • Hyper-arousal: the need to be “on guard” at all times, potentially manifesting as irritability, reckless behavior, trouble concentrating, and/or difficulty sleeping.

Yet, while these broad groupings are useful from a clinical perspective, they are perhaps less helpful when trying to identify whether a family member or friend may be suffering from PTSD. What specific signs or symptoms should you look for? In general, eight of the most common indicators of PTSD are:

  1. Uncontrollable thoughts or memories of the event, or uncontrolled reliving of the trauma
  2. Intense fear or feeling that one cannot now or ever again be safe, even if no danger is present
  3. Chronic anxiety coupled with a need to be “on guard” and unable to unwind or relax
  4. Persistent feelings of depression and/or hopelessness
  5. Inability to connect emotionally with loved ones
  6. Difficulty sleeping, including problems falling asleep, difficulty staying asleep, or persistent nightmares
  7. Irritability and frequent episodes of uncontrollable outbursts of anger
  8. Suicidal ideation or thoughts of suicide, either active (making a specific plan of action) or passive (such as thoughts like “you would be better off without me around”)

Individuals with PTSD may also begin to demonstrate specific behavioral changes relating to and stemming from the symptoms listed above, such as:

  • Difficulty maintaining personal relationships due to increased interpersonal conflict, issues with trust and intimacy, and withdrawal from normal familial/social relationships
  • Decrease in self-esteem, potentially coupled with a reduction in self-care, an increase in self-harming behaviors, and/or suicidal ideation
  • Compromised work performance or decline in an ability to perform normal tasks and activities
  • Avoidance of people, activities, and/or hobbies that used to be enjoyable
  • Inappropriate and/or ineffective coping mechanisms such as an increase in alcohol or drug use

Of course, not all PTSD sufferers demonstrate all of these symptoms; the ways in which PTSD manifest vary greatly from individual to individual. However, if someone you love has been through a traumatic event and you are seeing even just one of these symptoms begin to undermine their emotional health and ability to function, it is important that you encourage them to seek medical help immediately.

Ketamine Infusion Therapy and Other Treatment Options for PTSD

The traditional treatment for PTSD is a combination of talk therapy and, if necessary, a class of medications known as antidepressants. At Ketamine Clinics of Los Angeles, we offer an alternative approach: Ketamine Infusion Therapy. This alternative therapy, especially when coupled with traditional talk therapy, may offer some patients coping with PTSD a safe and effective medical alternative to antidepressants. More critically, Ketamine Infusion Therapy may prove an especially important option for patients who:

  • Have treatment-resistant PTSD and have not found relief from currentlyavailable antidepressants; and/or
  • Are coping with suicidal ideation and do not have the luxury of the time needed to wait for antidepressants to take effect.

Because Ketamine Infusion Therapy works differently on the brain’s chemistry than antidepressants, it can take effect more quickly; many patients find that their negative thoughts decrease, and their mood elevates also immediately after treatment, without the negative side effects associated with antidepressants. In fact, research studies and anecdotal evidence alike are beginning to demonstrate that ketamine has, for many patients, an immediate anti-depressive impact, delivering rapid relief that can quickly break through the cycle of PTSD, anxiety, depression, negative thought patterns, and suicidal ideation.


For more information about Ketamine Infusion Therapy treatments for depression, bipolar, anxiety, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), fibromyalgia, pain syndromes and other conditions contact us at Ketamine Clinics of Los Angeles in Southern California (Orange County) by clicking here or calling  310-270-0625.

An Alternative—and Innovative—Treatment for Chronic Pain: Ketamine Infusion Therapy

Ketamine Clinics of LA: Alternative innovative chronic pain treatment

aaron-blanco-tejedor-768029-unsplash-300x199 An Alternative—and Innovative—Treatment for Chronic Pain: Ketamine Infusion Therapy Los Angeles Southern CaliforniaWe all experience pain at times in our lives: maybe the occasional headache or aching muscles due to too much physical activity, or acute pain due to an accident or serious injury. In most of these cases, an over-the-counter pain reliever is all that is needed, or for more serious acute pain, a trip to the doctor can help us identify the cause of the pain and treat it accordingly. Chronic pain, however, is different. Generally defined as pain that lasts longer than 12 weeks, in reality chronic pain is persistent and limiting. It can limit an individual’s ability to move easily and reduce strength, flexibility, and stamina. At worst, it can make it nearly impossible to carry out simple, daily tasks and participate in enjoyable activities with friends and family.

Chronic pain stems from several a number of different causes, some of which are easily identifiable while others fight an easy medical diagnosis. For instance, chronic pain can begin with an acute injury that is not treated or not treated properly, or one that resists treatment; chronic back pain often falls into this category. Chronic pain may also be a symptom of any one of a large number of illnesses or “conditions” such as Complex Regional Pain Syndrome (CRPS), fibromyalgia, rheumatoid arthritis, multiple sclerosis, or lupus, for instance. It may be the result of a long-term illness, as in the case of refractory pain due to cancer. Finally, and most unfortunately for some individuals, their chronic pain may not have a clearly identifiable cause.

Since the early 1990s, the medical community has relied primarily on opioid-based pain medication for individuals suffering from chronic pain (if the source of the pain itself cannot be identified and/or treated). This class of drugs, including codeine, OxyContin, Percocet, Vicodin, and morphine to name a few, has the benefit of being highly effective in treating pain for most, although not for all, patients. However, opioids have also several serious drawbacks, the two most critical of which are opioid tolerance and of course addiction.

As the medical community continues to search for effective treatment options for individuals suffering from chronic pain—options without the serious drawbacks of opioids, especially for individuals already coping with tolerance and/or addiction due to past use of opioids—an “old” solution is presenting itself again as an alternative, and highly innovative, treatment: Ketamine Infusion Therapy. Ketamine has been available as an FDA-approved anesthetic since the 1970s and, when administered in sub-anesthetic doses, has been shown to be highly effective in fighting neuropathic chronic pain.

How Ketamine Infusion Therapy Works Against Chronic Pain

Although the mechanisms by which ketamine works with the brain’s chemistry to fight pain are still not entirely clear, researchers currently believe that ketamine modulates and reduces pain by impacting the effectiveness of a chemical reactor known as an N-methyl-D-aspartate (NMDA); as an NMDA antagonist, ketamine may actually calm the nerves within the central nervous system, increasing the threshold required to send pain signals to the brain and thereby reducing the level of pain perceived by the brain. Moreover, by impacting the brain’s chemistry differently than opioid-based pain medications, ketamine appears to work, for many patients, without the long-term risk of either tolerance or addiction. Thus, there are very real indications that Ketamine Infusion Therapy could present a highly effective—and extremely safe—alternative for patients suffering from chronic pain. Ketamine infusions also resets the pain receptors in the brain.

For patients coping with chronic pain, Ketamine Infusion Therapy generally involves a series of low dose ketamine infusions administered by the highly skilled and qualified staff at Ketamine Clinics of Los Angeles, a state-of-the-art clinic accredited by AAAASF. Dr. Steven L. Mandel utilizes specialized digital infusion pumps that deliver individually-tailored dosages that can be quickly changed to meet the needs of each patient. Each treatment plan and individual infusion is specifically tailored to meet the individual needs of every patient, depending on their specific diagnosis, other medical treatments, and overall health.

For more information about Ketamine Infusion Therapy treatments for depression, bipolar, anxiety, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), fibromyalgia, pain syndromes and other conditions contact us at Ketamine Clinics of Los Angeles in Southern California (Orange County) by clicking here or calling  310-270-0625.


Photo by Aarón Blanco Tejedor on Unsplash

Innovative PPD (Postpartum depression) treatment

What is PPD (Postpartum depression) ?

Postpartum depression (PPD) is a major form of depression and is less common than postpartum blues. PPD includes all the symptoms of depression but occurs only following childbirth. It can begin any time after delivery and can last up to a year. PPD is estimated to occur in approximately 10 to 20 percent of new mothers.

What are the symptoms of PPD?

innovative-postpartum-depression-PPD-treatment-ketamine-300x225 Innovative PPD (Postpartum depression) treatment Los Angeles Southern CaliforniaSymptoms of postpartum depression (PPD) are not the same for every woman.

Sadness is only one symptom of PPD. Some women may be more aware of an increase in anxiety and irritability. Only your healthcare provider can determine if you have PPD.

If you experience any of the following symptoms, tell your doctor right away:

  • Feeling sad, hopeless, empty, or overwhelmed
  • Crying more often than usual
  • Worrying or feeling overly anxious
  • Feeling moody, irritable, or restless
  • Oversleeping or being unable to sleep when your baby is asleep
  • Having trouble concentrating and making decisions
  • Frequent feelings of anger or rage
  • Losing interest in activities that are usually enjoyable
  • Suffering from physical aches and pains
  • Eating too little or too much
  • Avoiding friends and family
  • Having trouble bonding with your baby
  • Persistently doubting your ability to care for your baby
  • Thinking about harming yourself or your baby

Postpartum psychosis

With postpartum psychosis — a rare condition that typically develops within the first week after delivery — the signs and symptoms are severe. Signs and symptoms may include:

  • Confusion and disorientation
  • Obsessive thoughts about your baby
  • Hallucinations and delusions
  • Sleep disturbances
  • Excessive energy and agitation
  • Paranoia
  • Attempts to harm yourself or your baby

Postpartum psychosis may lead to life-threatening thoughts or behaviors and requires immediate treatment.

PPD Causes & Risk Factors


There’s no single cause of postpartum depression, but physical and emotional issues may play a role.

Physical changes. After childbirth, a dramatic drop in hormones (estrogen and progesterone) in your body may contribute to postpartum depression. Other hormones produced by your thyroid gland also may drop sharply — which can leave you feeling tired, sluggish and depressed.

Emotional issues. When you’re sleep deprived and overwhelmed, you may have trouble handling even minor problems. You may be anxious about your ability to care for a newborn. You may feel less attractive, struggle with your sense of identity or feel that you’ve lost control over your life. Any of these issues can contribute to postpartum depression.

Risk factors

Any new mom can experience postpartum depression and it can develop after the birth of any child, not just the first. However, your risk increases if:

  • You have a history of depression, either during pregnancy or at other times
  • You have bipolar disorder
  • You had postpartum depression after a previous pregnancy
  • You have family members who’ve had depression or other mood disorders
  • You’ve experienced stressful events during the past year, such as pregnancy complications, illness or job loss
  • Your baby has health problems or other special needs
  • You have twins, triplets or other multiple births
  • You have difficulty breast-feeding
  • You’re having problems in your relationship with your spouse or significant other
  • You have a weak support system
  • You have financial problems
  • The pregnancy was unplanned or unwanted


Treatment and recovery time vary, depending on the severity of your depression and your individual needs. If you have an underactive thyroid or an underlying illness, your doctor may treat those conditions or refer you to the appropriate specialist. Your doctor may also refer you to a mental health professional.

Innovative PPD (Postpartum depression) Treatment with Ketamine

A traditional course of treatment for mothers diagnosed with postpartum depression is antidepressant medications. The biggest limitation of antidepressants such as Selective Serotonin Reuptake Inhibitors (SSRIs) is that the drug can enter the breast milk when breastfeeding. Furthermore, it can take one to two months for the medications to take full effect and may result in various unpleasant side effects.

Looking at these drawbacks, physicians are increasingly turning to Ketamine Infusion Therapy as a promising alternative to conventional treatments for postpartum depression. Ketamine Therapy has proven to have a high success rate treating mood disorders and it is fast-acting with little to no risk to the child. The symptoms of postpartum depression can be eliminated within a matter of days instead of weeks.

Furthermore, the mother does not have to become dependent on a drug to maintain a stable mood. In many cases, the patient may only require as few as six infusions of Ketamine Therapy to achieve sustainable relief for several months. That provides her with plenty of time to develop a healthy bond with the newborn and reassess her long-term treatment options, if required.

In many cases, while Ketamine Infusion Therapy works to address the postpartum depression symptoms, the mother’s hormones and other PPD contributing factors would have stabilized. Therefore, they would not require any further treatment.

For more information about Ketamine Infusion Therapy treatments for depression, bipolar, anxiety, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), fibromyalgia, pain syndromes and other conditions contact us at Ketamine Clinics of Los Angeles in Southern California (Orange County) by clicking here or calling  310-270-0625.

Ketamine Infusion Therapy: an Innovative and Effective Treatment for Suicidal Ideation

Ketamine Treatments

Ketamine-300x200 Ketamine Infusion Therapy: an Innovative and Effective Treatment for Suicidal Ideation Los Angeles Southern CaliforniaDeath by suicide is a serious and rising concern in the United States today. While suicide has not gotten as much “press” as opioid overdoses, for example, or violent homicide, suicide is the 10th leading cause of death in the United States, with approximately 45,000 people dying from suicide each year. Statistically, that’s twice as many suicides as homicides, and equates to about 113 suicides each day, or 1 every 13 minutes. [1] Moreover, the statistics clearly show that some groups are at significantly higher risk: suicide is the second leading cause of death for young people between the ages of 10 and 34, while according to the VA, veterans have a suicide rate 50% higher than the rest of the population.[2] Clearly, as these statistics demonstrate, we need to take serious and real steps to improve our ability to recognize individuals at risk of suicide and offer them timely and effective assistance.

According to the same CDC data, each year more than 9 million adults in the United States confess that they have experienced suicidal ideation, again with a higher percentage among adults 18 to 25. Suicidal ideation is defined as thinking about and/or planning suicide, ranging from only a brief or fleeting thought to developing a detailed plan for suicide. Of course, most people who experience suicidal ideation do not act on these thoughts, yet clearly the medical community is—as it should be—focused on developing a variety of methods of providing effective and fast-acting relief from suicidal ideation before suicidal thoughts can develop into suicidal action.

With the FDA’s quite recent approval of a ketamine-derivative called esketamine (marketed as SPRAVATO™) as a fast-acting and effective treatment for depression, attention is once again focused on the potential of ketamine as an innovative treatment option for other mood disorders. The key lies in the words “fast acting”. When administered directly into the blood stream through an IV—a treatment known as Ketamine Infusion Therapy—ketamine appears to deliver, for many patients, a rapid improvement in mood and decrease in suicidal ideation. Thus, by reducing suicidal ideation quickly, the ketamine treatments may, in effect, “buy time” for other interventions to succeed.

Why is this treatment innovative? Traditionally (or at least since the late 1980s), the medical community has relied on a class of drugs known as antidepressants, such as Prozac, Zoloft, or Wellbutrin, for instance, to relieve depressive symptoms, anxiety, PTSD, and other mood disorders believed (in most cases) to underlie suicidal ideation. Unfortunately, antidepressants take a long time to “take effect”, up to several weeks, in most cases. Moreover, many patients must try different types of antidepressants to find one that offers relief with fewer side effects, while for a large number of patients, antidepressants actually do not work at all. Yet a patient who may be actively contemplating suicide doesn’t have the time to wait, experiment, and see what works. He or she needs something that works right away. Intervention with Ketamine Infusion Therapy may be able to eliminate the “risk period” before these traditional treatments “kick in”.

Two Recent Studies Demonstrate Ketamine’s Potential as a Treatment Option for Suicidal Ideation

Ketamine as an innovative treatment option for suicidal ideation is supported by two recently-published studies.

The first study, published online in late 2017 in the Journal of American Psychiatry, compared patient responses to two different treatment approaches: one group received low dose ketamine infusions while a second group received a low dose of a sedative called midazolam.[3] Conducted by researchers at Columbia University Medical Center, the study included 80 adults with major depressive symptoms and suicidal ideation. While both groups responded positively to treatment within 24 hours, the group that received ketamine saw a statistically greater reduction in suicidal ideation than the group that received midazolam. Specifically, 55% of the ketamine group was assessed at experiencing a 50% or greater reduction in suicidal ideation, while only 30% of the midazolam group experienced a similar reduction. Moreover, researchers noted that the impact of the ketamine infusion treatments lasted for up to six weeks after the study began.

The second, published in 2018 in the Journal of Affective Disorders, looked at data from five clinical trials involving ketamine infusions as treatment for treatment-resistant major depressive disorder or bipolar depression. [4] As suicidal ideation was one of the evaluation markers, the researchers in this compilation study were able to determine that nearly all of the individuals in the study experienced some decline in suicidal ideation after ketamine infusions. The study divided the patients into 3 distinct subgroups: remitters, responders, and nonresponders. After day 1 of treatment, 71% of remitters, 39% of responders, and 12% of nonresponders showed a significant decline in suicidal ideation, while by day 2, remitters actually had zero suicidal ideation. Thus, the researchers concluded that for many, although not

For more information about Ketamine Infusion Therapy treatments for depression, bipolar, anxiety, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), fibromyalgia, pain syndromes and other conditions contact us at Ketamine Clinics of Los Angeles in Southern California (Orange County) by clicking here or calling  310-270-0625.




[3] Michael F. Grunebaum, et al. Ketamine for Rapid Reduction of Suicidal Thoughts in Major Depression: A Midazolam-Controlled Randomized Clinical TrialAmerican Journal of Psychiatry, 2018; 175:4; pages 327-335. Published Online: 5 Dec 2017.

[4] Ballard ED, Yarrington JS, Farmer CA, et al. Characterizing the course of suicidal ideation response to ketamineJ Affect Disord. 2018; 241:86-93. doi: 10.1016/j.jad.2018.07.077.

What is SPRAVATO (esketamine)?

SPRAVATO – FDA Approves Esketamine Nasal Spray For Hard-To-Treat Depression

SPRAVATO-FDA-Approves-Esketamine-Nasal-Spray-For-Hard-To-Treat-Depression-1024x896 What is SPRAVATO (esketamine)? Los Angeles Southern California

According to the National Institute of Mental Health, depression is one of the most common mental health disorders among adults in the United States today, and a leading cause of both prescription drug usage and disability claims. An estimated 17 million adults have at least one significant depressive episode every year, over 7% of the population of the United States. The percentage increases to over 13% when the age range narrows to adults aged 18-25. (Source:

For nearly three decades (since the late 1980s), individuals with significant depressive symptoms or clinical depression have been treated with a class of prescription drugs commonly called “antidepressants”. In fact, there are a number of different types of antidepressants such as SSRIs (Prozac and Zoloft), SNRIs (Cymbalta and Effexor XR), MAOIs (Nardil and Marplan), and others such as Wellbutrin and Tofranil, to name just a few. Yet while the wide range of different types and formulations of antidepressants enable some patients to find one that works for them, antidepressants have significant limitations for many patients, including the length of time it takes for antidepressants to “kick in” as well as a long list of negative side effects. Most problematic, however, is that for many patients, antidepressants simply don’t work.

SPRAVATO™ Ketamine offers new hope to patients who have not found relief from depression from traditional antidepressants. The first ketamine-based treatment for depression to be approved by the FDA, SPRAVATO™ is a nasal spray composed of esketamine, a derivative of ketamine, a well-known, powerful, and highly effective anesthetic. It is designed for patients with treatment-resistant depression, in other words, for patients who have tried two or more different antidepressants (in appropriate dosages and durations) without positive results.

I suffer from clinical depression. Should I try SPRAVATO™?       

If you suffer from a major depressive disorder and have tried at least two different types of traditional antidepressants without relief from depressive symptoms, SPRAVATO™ may offer a more effective treatment option. Spravato is an option for patients, however, the success rates are not as high as Ketamine Infusion Therapy since it’s a nasal spray. This nasel treatment is designed to be administered two times per week for a period of four weeks, then one time per week for an additional four weeks. If effective, SPRAVATO™ can then be taken once a week or once every two weeks, depending on effectiveness. According to manufacturer specifications, it should be taken along with a daily oral antidepressant.

Clinical studies involving SPRAVATO™ are now showing what many physicians and psychiatrists have believed for quite some time: that low dose ketamine, or esketamine in the SPRAVATO™ formulation, offers fast-acting and highly effective relief from depressive symptoms. At four weeks, patients utilizing STRAVATO™ demonstrated fewer depressive symptoms than those patients who utilized a placebo (both in conjunction with the use of a daily oral antidepressant). Moreover, while SPRAVATO™ does carry a risk of side effects, like all medications, those side effects were—generally speaking—less severe and disruptive than some potential side effects of antidepressants. In order to continue managing known and potential side effects of SPRAVATO™, all patients seeking to start treatment will be enrolled in a Risk Evaluation and Mitigation Study (REMS), required by the FDA.

While the nasal spray is self-administered, it must be administered while in the clinic and while under the close supervision of a healthcare professional. Once you administer the spray, a healthcare professional will monitor you closely for two hours to watch for any negative side effects. It is important to note that you will need to plan transportation to and from each SPRAVATO™ treatment, as you cannot drive or operate machinery until the next day. During your initial consultation, your healthcare professional will help you understand what to expect during a typical treatment session and how to prepare; it’s important at this time to inform your provider about all medications—including any over-the-counter medications—that you are currently taking.

If you are suffering from depression and are among the 30% of individuals who have not found relief from traditional antidepressants, ketamine-based treatment options may be the right solution for you. We encourage you to contact us for more information.

For more information about Ketamine Infusion Therapy treatments for depression, bipolar, anxiety, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), fibromyalgia, pain syndromes and other conditions contact us at Ketamine Clinics of Los Angeles in Southern California (Orange County) by clicking here or calling  310-270-0625.

FDA Approves SPRAVATO™: What’s Next for Ketamine Therapy?

Ketamine is FDA approved to treat depression – Now what?

Ketamine-Drug-History-300x200 FDA Approves SPRAVATO™: What’s Next for Ketamine Therapy? Los Angeles Southern CaliforniaThis past March, the FDA took a huge step forward in the fight against depression by approving a new drug called SPRAVATO™, literally the first time in decades that the FDA has approved a medication for depression that works in a radically different way than traditional antidepressants. Why is SPRAVATO™ different than other depression medications? SPRAVATO™ is different from antidepressants because it is formulated from the same chemical compound as ketamine, an effective and well-known anesthetic the medical benefits of which have, unfortunately, been tainted by ketamine’s reputation as a party drug.

Does this mean that ketamine been approved by the FDA for the treatment of depression? The straight answer is…“sort of”. Healthcare professionals have been successfully utilizing Ketamine Infusion Therapy, delivered in low doses directly into the blood stream via IV, for a decade or more in the treatment of mood disorders such as depression and anxiety. Because ketamine is approved by the FDA as an anesthetic, this use is perfectly legal but considered “off-label”.

By approving SPRAVATO™, the FDA has approved the use of a ketamine derivative, esketamine, for the treatment of depression. Chemically speaking, esketamine is one-half of the ketamine molecule. By isolating and patenting esketamine, the makers of SPRAVATO™—Janssen Pharmaceutical—have effectively figured out how to monetize a chemical compound that was already FDA approved, widely-used, and not covered by a patent.

How is SPRAVATO™ different than IV Ketamine Therapy?

Healthcare specialists focusing on the treatment of depression and other mental health disorders are applauding the FDA’s long-overdue approval of a ketamine-based treatment option. SPRAVATO™ has a number of benefits. Because it is a self-administered nasal spray (although only in a clinical setting under close supervision), some patients may find it easier to use and more comfortable than Ketamine Therapy, which is administered by a healthcare professional through an IV directly into the bloodstream. Additionally, because SPRAVATO™ is an FDA-approved drug, health insurance may help defray some of the cost of the treatment.

However, experts caution that there are differences between SPRAVATO™ and Ketamine Therapy. Most importantly, SPRAVATO™ may not be as effective. As a nasal spray, it is difficult to vary the dosage or to verify how much of the drug reaches the bloodstream; for example, some of the spray may drift uselessly down the throat. Ketamine Therapy, on the other hand, involves a administering a low dose of ketamine (not esketamine) through an IV. This means that the dosage can be carefully controlled, with the entire dosage going directly into the body. Moreover, the dosage can be altered if necessary during treatment to maximize effectiveness while minimizing potential side effects.

Cost may also be a factor as well. SPRAVATO™ is likely to be more expensive than Ketamine Therapy. Ketamine is, as noted above, widely available, not covered by a patent, and relatively inexpensive. The cost of Ketamine Infusion Therapy stems primarily from the cost of administering the drug: maintaining the clinic and covering the time of the healthcare professionals who administer the drug and monitor the patient before, during, and after treatment. SPRAVATO™, on the other hand, is itself extremely expensive because Janssen discovered a way to create a patent-able drug, in addition to the cost of the clinic and healthcare professionals. Thus, even if insurance covers some of the treatment, it may still prove more costly than Ketamine Therapy.

What’s next for ketamine?

Despite the continued benefits of Ketamine Therapy over SPRAVATO™, most healthcare professionals are excited by the FDA approval and many clinics that specialize in Ketamine Infusion Therapy either already are or plan to become certified SPRAVATO™ providers. The fact is that in either formulation, ketamine and esketamine both have the potential to deliver powerful and highly effective relief to patients suffering from treatment-resistant depression. At the very least, FDA approval of SPRAVATO™ legitimizes ketamine as an effective treatment option and in the best case scenario, this is simply the first step in making this powerful treatment widely available to the millions of Americans who may benefit from it.

For more information about Ketamine Infusion Therapy treatments for depression, bipolar, anxiety, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), fibromyalgia, pain syndromes and other conditions contact us at Ketamine Clinics of Los Angeles in Southern California (Orange County) by clicking here or calling  310-270-0625.

Marvelous May – What is Esketamine/Spravato & Other News…


How is it already May? Time appears to be moving faster than usual lately. You may have noticed that we skipped our March and April newsletter; my apologies. It is my intention to publish this monthly to keep our ketamine community informed on the progress made in this field of medicine. As many of you have noticed, there has been a lot of buzz about ketamine in the last few months. I shall take this moment to get you all caught up.

In March, the FDA approved a new medication to administer to those who suffer from treatment-resistant depression. Spravato (Esketamine) was approved, and my team and I were shocked at how quickly the news spread. Our phone rang constantly for weeks with prospective patients eager to learn all about this new medicine, and existing patients who had questions on whether or not Spravato was a viable treatment option for them. There is much to understand about this new addition to the ketamine family. I’m very pleased that the FDA has approved this advancement in the treatment of depression.

Here is my take on the basics of Spravato:

  • Spravato is big pharma introducing an old drug in a new way so that they can obtain a patent. Rather than approve ketamine for depression and other mood disorders, they have created something “new” to give patients.
  • Ketamine, which has been around for over 50 years, consists of two molecules, an “R and S.” Johnson and Johnson (Janssen) patented the “S” molecule as a stand alone medication and named it Spravato. So technically Spravato consists of one isomer of the two which make up racemic ketamine.
  • To qualify for Spravato nasal spray, patients must currently be taking an antidepressant and be diagnosed as treatment resistant.
  • Patients require a two-hour office visit where the doctor supervises the patient’s administration of the nasal spray and monitors the patient. The minimum commitment for this treatment is two visits per week for 4 weeks, then once a week for 5-8 weeks, then every two weeks at 9 weeks until… there is no clear end date for this treatment.
  • The long-term benefit is still unknown, Spravato is a treatment not a cure.
  • The nasal spray has a limited bio-availability, with the route of administration being through the nose, the amount of medicine received will vary, it averages around 40%, which is also its “success rate.”
  • All patients are limited to a fixed dose of either 56mg or 84mg.
  • There is no long-term research on its success rate, Spravato’s research group was followed for one year only. No independent research was done.
  • Short term side-effects are similar to that of ketamine: dissociation, dizziness, nausea, sedation, vomiting, etc.
  • Long term side effects unknown.

This highlights some key items to note about the new drug, Spravato. Although we are an approved Spravato provider, we are not yet offering this treatment. In my opinion, IV Ketamine Infusion Therapy remains the gold standard. With decades worth of research, (my clinic alone having treated over 1,000 patients in the last five years), I know for a vast majority of patients, IV Ketamine Infusion Therapy works. Ketamine Therapy offers:

  • 100% bio-availability of the medication
  • Over an 80% success rate of relieving symptoms in patients
  • Less clinical visits needed to see results
  • Overall less expensive
  • Decades worth of non-biased research proves the benefit
  • No known long-term side effects
  • Long lasting relief in-between treatments (average of 3-4 months)
  • No requirement to be on an antidepressant in order to receive treatment
  • Dosing and treatment is personalized, larger doses may be administered

At Ketamine Clinics of Los Angeles, we believe ketamine is the best medicine for the treatment of depression and suicidality. We encourage you to do your research and educate yourself on your options. We are enthusiastic and pleased that the FDA has approved esketamine for the treatment of depression and mood disorders; it is a huge step forward in behavioral medicine.

Outside of this exciting news, in clinic we have all been busy at work, enjoying our new space and building our team so that we can continue to provide you with the excellent care that you have come to expect from the team at Ketamine Clinics of Los Angeles! We hope you are well, and we wish you a Marvelous May!
Dr. Mandel



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May 12th is International Nurses Day! We have some wonderful nurses at our clinic that make us extremely proud to celebrate this month. In celebration, we had sushi delivered for a team lunch. Find below our nurses: Nicki, Denisse & Stephanie.

unnamed-5-240x300 Marvelous May - What is Esketamine/Spravato & Other News... Los Angeles Southern California

unnamed-1-1-300x278 Marvelous May - What is Esketamine/Spravato & Other News... Los Angeles Southern CaliforniaStay-at-Home-Mom Depression Is Real and Women Are Finally Talking About
May is the month we celebrate and honor mothers for all the unconditional love they provide. Although many moms boast parenthood as their greatest joy, some moms really struggle. According to this article, 25% of mothers are stay at home moms (SAHM) and it is not as easy as one may think. Thank you Glamour for shedding light on the realities of this circumstance. Read more

unnamed-2-1-300x200 Marvelous May - What is Esketamine/Spravato & Other News... Los Angeles Southern CaliforniaExercise May Help to Fend Off Depression

Jogging for 15 minutes a day, or walking or gardening for somewhat longer, could help protect people against developing depression. Read more


unnamed-3-1 Marvelous May - What is Esketamine/Spravato & Other News... Los Angeles Southern California

We always have reasons to celebrate and fortunately our new office location has a Dave and Busters nearby. What a treat to get “almost” all of our team together for food, fun, and team bonding. The 6-minute virtual reality ride totally impressed us all. It was truly out of this world!

This particular team night was memorable and a little emotional. We officially said farewell to our nurse Mary, and hello to Conor (Physician’s Assistant), Nicki (Registered Nurse) and Jada (Administrative Assistant). (Keep an eye out for next month’s newsletter where we will share more on these fabulous new members!) So many feels for us all. We continue to be grateful to have a team with so much heart!

Mary, we thank you for your service. It’s been a wonderful 2+ years. You are a fantastic nurse and a great person. May this next chapter in your life bring you everything you could ask for! We miss you already!

Follow Us on Instagram

Follow our Instagram page and join the conversation. We post lots of personal content, new original photos, videos, and plenty of ketamine/healthcare news! Visit us here! Wishing all Mom’s a fabulous Mother’s Day!

unnamed-4 Marvelous May - What is Esketamine/Spravato & Other News... Los Angeles Southern California

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