Our physician network prescribes two types of ketamine administration which are ideal for home-based therapy and achieving sustained relief.
Oral Ketamine (ODT)
Oral ketamine medication, referred also as Ketamine ODT (Oral Dissolving Tablet) is the easiest and least complicated way to self-administer your at-home dose. The bioavailability of ketamine through an oral dose is approximately 17%. The psychoactive experience for the patient lasts between forty-five (45) to ninety (90) minutes, when ketamine is administered via oral tablet.
The ketamine-based nasal spray we prescribe is a mixture of R-ketamine and S-ketamine (esketamine). When administered by nasal spray, prescription ketamine reaches a bioavailability of 50%. Until your appointment, the intranasal ketamine spray must be stored between 68°F and 77°F. Patients use the entire dose provided according to their physician's guidance. A dose of intranasal ketamine can create a sedative effect that impacts the central nervous system. Patients taking CNS depressants (like benzodiazepines, opioids or alcohol) should discuss conflicts of medication.
Preparing for Treatment
Make sure that you discuss if you have had any allergic reactions to prescription medications or preparations with your doctor. Or if you have allergies to certain foods, preservatives, or other ingredients. Patients should also disclose if they are currently pregnant or thinking about becoming pregnant while treatments are ongoing. The supervising practitioner will also review the current prescription medications you are taking to make sure that ketamine is not contraindicated. Ketamine is generally well tolerated but there are some prescription medications that can conflict with ketamine.
Side-Effects and Reactions
Why isn’t ketamine used more often for therapies? One of the reasons or drawbacks, is that ketamine can cause emergence reactions. That is the hallucinations that can occur from ketamine. Sensations like hallucinations, vivid dreams, sense of floating, delirium or out of body experiences are moderated by providing a low dose of ketamine. Research indicates that the hallucinations, although disturbing to some patients, are actually a predictor that the Ketamine is beginning to work and make changes. To help with these side effects, patients are instructed to engage in their telemedicine therapy in a calm environment with minimal stimulus.
Staying in an environment where there are few pictures, colors, sounds or smells may help reduce some of the ketamine hallucinations that can occur. Patients are provided with additional instructions to create a suitable and safe at-home environment. Because ketamine and the therapeutic experience can cause drowsiness, patients are reminded not to drive a vehicle or operate heavy equipment following their treatment.
Ketamine May Not Be Right for You
If you have other health concerns, ketamine may not be the best or safest therapy for you. That is why before ketamine is prescribed, a physician will review your health history. That review also includes discussing lifestyle habits, including alcohol or tobacco use.
If you have been diagnosed with any of the following symptoms or health conditions you may not be approved by the physician for ketamine therapy:
- History or allergy to ketamine
- Aneurysmal vascular disease
- Arteriovenous malformation
- Intracerebral hemorrhage
- Cardiovascular problems or stroke
- Cerebrovascular disease
- Psychosis or schizophrenia
- High blood pressure
- Hypertensive encephalopathy
- Liver disease
Ketamine can cause temporary drowsiness, and confusion. That is temporary mental changes that can make it difficult to remember time, place, or personal identity. Patients who undergo ketamine therapy can experience ulcerative or interstitial cystitis and other bladder problems. Report any changes in your urine (cloudy or presence of blood), or if urination is painful, or causes a burning sensation. Consult with your physician before taking any over-the-counter (OTC) medications following your ketamine treatment.