Benefits and Risk of Ketamine Infusion Therapy

The potential benefits of ketamine infusion is pain relief, possibly reduced swelling and often vast improvements in mood.  

The side effects of ketamine are numerous.  We spent more than a decade analyzing patients who had side effects from ketamine in order to develop a pharmacological regimen to vent or significantly diminish these side effects.  Side effects include: 

Post infusion medication is administered that usually significantly diminishes the headache.  

Nausea is a common side effect of ketamine that can be minimized by providing a variety of anti-nausea medicines.  There is one class of medications that is often used for chemotherapy patients that is found to be considerable effective.  If this medication is not effective there is a stronger medication from the same family that is more effective.  Sometimes, the nausea maybe caused by some dysequilibrium that temporarily is caused by the ketamine.  When this occurs, medications that are used for sea sickness either has a patch or a pill are used.  We note that patients who ride in a car for a considerable distance after ketamine infusions are more likely to have nausea so for this reason we do not recommend commuting from a great distance. 

Hallucinations have traditionally been a significant side effect for ketamine when used as an anesthetic in the operating room.  From a pharmacological standpoint, we have developed a regimen that we deliver before the ketamine infusion starts that significantly diminishes or eliminates hallucinations during the treatment.  

We prescribe medications before sleep for the 7 days after ketamine treatment.  In addition, we may provide some medication at the time of treatment that would minimize the possibility of nightmares.  Nightmares have not been a problem in our practice in many years. 

With the use of intermittent pressure to the legs, thrombus in the legs has been eliminated as a problem.  We also provide patients with one baby aspirin per treatment to help prevent blood clots from forming while lying still for the length of the time of the infusion.  

With the use of intermittent pressure to the legs, thrombus in the legs has been eliminated as a problem.  We also provide patients with one baby aspirin per treatment to help prevent blood clots from forming while lying still for the length of the time of the infusion.  

These are extremely rare and we monitor for this by drawing blood work to see if liver function tests have changed.  We have not had a significant case where it was necessary to discontinue treatment.

Ketamine infusion can leave a patient somewhat disoriented.  This can last up to a day or two after the 10th infusion.  The disorientation goes away by itself without the use of any medication.  There is only a small percentage of patients that experience this and it is a self limited phenomena.