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The Ketamine Story

The History of Ketamine

In 1962, ketamine was first synthesized by a chemistry professor at Wayne State University. It is a fast-acting, quickly metabolized, non-opioid anesthetic. It was approved by the FDA for this purpose in 1970. For decades, ketamine has been used in hospitals, by first responders and combat medics for safe, effective pain control. It is the most commonly used anesthetic in third world countries. For these reasons, The World Health Organization has judged ketamine to be an essential medication.

In the United States, ketamine is routinely administered (in much higher doses) by civilian and military first responders, emergency room physicians, and anesthesiologists for acute pain relief and anesthesia. In the last twenty years, low dose ketamine therapy has been studied as an innovative treatment for psychological disorders and chronic pain.

Biochemistry

Repeated scientific studies show that stress, both acute and chronic, adversely affect the number and functionality of certain brain cells called neurons. Events that produce fear or physical and/or emotional pain (stressors) stimulate chemical reactions that alter the communication between these cells.

The discomforts we identify as anxiety and depression are the results of the body’s attempt to adapt to stress. Over time, stress affects neurons; shrinking them in size and diminishing their function. The good news is the human brain exhibits “neuroplasticity,” which is the ability to alter routes by which thought, emotions, and memories are regulated. Ketamine enhances neuroplasticity, helping to repair cellular connections damaged by stress exposure.

The glutamatergic system (part of the brain affected by ketamine) appears to play a role in the development of migraines and several chronic pain syndromes as well. We provide treatments focused on facilitating relief from these debilitating conditions.

With your active participation, we will design an individualized treatment plan to address your specific issues and reduce the possibility of symptom recurrence. Summit Ketamine Innovations offers a safe, professional, open, and accepting environment to address the issues preventing wellness.

Treatment Modalities

Ketamine is administered in several forms. Oral, intranasal (nasal spray), intramuscular (injected into the muscle), sublingual (dissolved under the tongue) and intravenous (injected into a vein) have all been studied. Intravenous (IV), continues to be most effective, although other delivery methods have shown moderate success. At our clinic, depending upon each individual’s specific circumstance, we administer ketamine intravenously and orally. We also prescribe sublingual ketamine for self-administration between scheduled IV infusions. This regimen has proven effective at prolonging symptom resolution for certain patients. Summit Ketamine Innovations offers Oral Ketamine Group Therapy, a program designed to make ketamine treatment more affordable. We encourage you to contact us to discuss individualized options.

Intravenous (IV)

Infusion therapy is administered by a licensed physician, specialized in Anesthesia, who adheres to the American Society of Anesthesiologists (ASA) guidelines’ for moderate sedation. Anesthesia specialists are trained in administering, monitoring, and managing the dynamic continuum associated with IV sedation and treatment. At Summit Ketamine Innovations, patients are continuously monitored through the treatment process by our doctor and critical care trained, registered nurses. Vigilance and detailed attention to safety are the cornerstones of our practice.

Infusion therapy has advantages over other forms. IV administrations provide the highest bioavailability (amount of medication that can be used by the body). Research shows that 70-75% of patients respond with IV infusion. Other forms of administration have less predictable results. Infusion therapy is closely monitored to provide us the greatest opportunity to individualize treatment, based upon your body’s response and under the safest conditions possible.

Sublingual

Ketamine is administered as a dissolvable medication that is placed under the tongue. Response rates to sublingual administration are less than infusion, however, this route is relatively inexpensive and easy to manage. We integrate this formulation to increase the time between infusions, or to help maintain adequate symptom relief between scheduled infusions. Sublingual ketamine is also used for our maintenance program following our Group Oral Ketamine Therapy (GOKT).

Oral

Oral ketamine is widely used in Europe, primarily for cost savings. Similar to sublingual, response rates to oral ketamine are not as effective. For certain patients, oral ketamine may still be an effective treatment modality. We offer oral ketamine as part of a group therapy program. Learn More →

Intramuscular

Intramuscular injections are frequently used with decent response rates. Ketamine is ~95% bioavailable in this form. Patient discomfort and inability to modify dose during treatment are limiting factors for our practice. Doses can be adjusted between treatments, although it is not as precise as with intravenous administration.

Intranasal

Early in 2019, the FDA approved a new medication for treatment-resistant depression used in conjunction with an oral antidepressant. Spravato, or esketamine, is a close chemical relative of ketamine, administered as a nasal spray. Since Spravato’s approval, we have been in contact with Janssen (the manufacturer), Medicare, private insurers, and the members of the American Society of Ketamine Physicians to determine its potential role in treatment.

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