Ketamine can be administered in several different ways: by an intravenous infusion, an intramuscular injection, intranasally, sublingually, and orally.
INTRAMUSCULAR AND IT’S BENEFITS
All different routes of ketamine administration come with a higher or lower bioavailability; in practice intravenous and intramuscular administration allows the most ketamine to affect the body, while the other routes result in lower effective doses due to metabolism and other factors. Pharmacokinetic data suggest an intramuscular injection results in active drug levels very similar to a forty minute long infusion, and empirical studies have shown equivalent efficacy (or benefit) with intramuscular administration. It is unlikely that intravenous ketamine infusions are more effective than other routes of administration, but this certainly results in greater patient discomfort, greater resource utilization, and ultimately higher cost.
TREATMENT PROCESS
Ketamine works best when used as part of a broader treatment strategy. During your consultation, your provider helps you create a personalized treatment plan. They let you know when you can expect to see results.
After your injections, our team observes you carefully. They ask how you’re feeling and make sure you’re responding well. The team also helps you adjust your dosage or plan for your next treatment.
All Zen Psychiatric Services clients treated with ketamine or esketamine, regardless of means of administration, are required to have a driver to and from treatment. Clients must take no oral food for at least two hours prior to treatment. They remain under close observation of Zen Psychiatric staff for approximately 120 minutes, during which time they have their vital signs checked at least three times: before, once during, and then after treatment. The most common reported (but infrequent) side-effects during treatment are nausea, transient increases in blood pressure, and dissociation. Supportive medications to manage those side-effects are available on site and will be administered as needed by trained staff, without any extra cost to the client. (The need for observation and possible management of side-effects is the primary driver behind the cost of treatment with ketamine, and a very significant factor in the cost of treatment with esketamine. Neither ketamine or esketamine are available for unsupervised self-administration.
The treatments are administered in recliners stationed in visually private treatment bays. The treatment bays are all equipped with a small nightstand, on which there are cell phone charging cords, white noise machines, and a lamp. Blankets are available on request. There is WiFi guest access. Towards the end of the session clients receive a small snack and something to drink. No last names or identifying information are ever spoken out loud in the clinic. (There is an opportunity for fully private sessions, potentially in the presence of the client’s therapist, in one of two offices on premises. Such inquiries are welcome!)
