What is Ketamine Infusion Therapy?
Ketamine is an anesthetic agent with powerful antidepressant properties. It was developed in the 1960’s by University of Michigan physicians as a safer option to provide comfortable sedation for procedures. Over the last several decades, studies have shown the potential for Ketamine as a therapeutic option for treatment-resistant depression. Ketamine is a safe option to provide relief from severe and persistent symptoms of depression and suicidal thinking, and can potentially provide relief of symptoms within hours to days after a single infusion.
What makes Ketamine Infusion Therapy different from other medications?
Ketamine infusions can provide rapid relief for symptoms of depression and suicidal thoughts. Traditionally, medications could take weeks before patients begin to experience relief of symptoms. With Ketamine infusions, patients often experience relief of symptoms within hours of infusion.
How do I know if I am eligible for Ketamine Infusions?
Patients must meet the following criteria:
- Age 18 or older
- Voluntarily consent to treatment
- Primary mental health diagnosis of Treatment Refractory Depression (unipolar or bipolar), verified by an assessment at Michigan Medicine Department of Psychiatry
- Commitment to undergo 3-6 infusions
- Other treatment options have not succeeded
- Ability to provide any medical records external to Michigan Medicine system
- Requires reliable transportation to infusions and accompaniment by a responsible adult
What are the side effects of Ketamine?
Most patients tolerate Ketamine infusions very well and report feeling sleepy and relaxed during infusions. Some may experience a higher blood pressure than what is normal for them during the infusion, however this typically resolves on its own once the infusion is complete. Some patients may experience nausea during the infusion which can be treated with medications. Visual changes may occur, such as double vision, illusion like experiences, or mild hallucinations. Some patients may experience discomfort with these vision changes.
Will my insurance cover Ketamine infusions?
At this time, IV Ketamine infusions for treatment-resistant depression are not covered by insurance providers, and are provided on a self-pay basis only. Patients must coordinate with Patient Financial Counselors and pay for treatment prior to receiving the first IV Ketamine infusion.
The initial provider consultation and all return outpatient visits with the provider will be conducted at the University of Michigan Rachel Upjohn Building and can be billed to your insurance plan(s). Any pathology, such as labs, ordered at the initial consult or return visits can also be billed to your insurance. You will be responsible for any deductible, co-pay, and/or co-insurance amounts.
How is Ketamine administered?
Ketamine will be delivered through an IV as an outpatient procedure at the Department of Psychiatry’s procedural unit at University of Michigan hospital. Ketamine infusion therapy is administered by our team of medical professionals specially trained in the delivery of Ketamine. Typically, a patient needs approximately 3 hours to participate in an infusion. A nurse will monitor your vital signs and provide support throughout the procedure.
What can I expect?
Prior to the infusion, you will need a referral from your current provider. You will then meet with a Michigan Medicine psychiatrist at the Rachel Upjohn Building to assess the appropriateness of Ketamine infusion therapy. If Ketamine is recommended, scheduling for infusions will then be determined.
On the day of infusions, you should not eat or drink before the procedure. You may take your medications as directed by our psychiatrists. You will be assisted by one of our skilled nurses to a comfortable position within our procedural unit, and an IV will be started. Your Ketamine dosage will be determined by our treating psychiatrist. You may feel drowsy during the infusion. The nurse will monitor you during the infusion, and will provide additional support as needed.
Once the infusion is complete, the nurse will continue to monitor you for an additional hour, after which you will be discharged into the care of a responsible adult. At that time, you may resume your normal diet and medication regimen. You will be advised not to drink alcohol, drive, or make any legal decisions for 24 hours after the infusion.
How many infusions will I need?
Patients receive 3 infusions to determine if Ketamine is an effective treatment option. After the initial 3 infusions have been completed, additional infusions may be scheduled. Most patients will receive between 3 and 6 infusions. Patients will then be reassessed by a psychiatrist to determine if they will have additional Ketamine infusions in a “maintenance phase” or if other treatment options should be considered.