What You Should Know About Ketamine Infusion Therapy

According to Mental Health America, 19.86% of American adults — about 50 million people — live with a mental illness, and 4.91% live with a severe mental illness.

In addition, the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report estimated that over 20% (more than 51 million people) experience chronic pain. The research, published in 2023 in the peer-reviewed journal JAMA Network Open, examined data from more than 10,000 participants to arrive at that conclusion.

Antidepressants are often prescribed as a first-line treatment not just for depression and related disorders, but also “off label” for conditions like chronic pain. The problem is, not everyone responds well to the medication, leaving a treatment gap that needs to be filled.

That’s where  board-certified anesthesiologist Michael Kullman, MD, in White Plains and Pleasant Valley, New York, comes in.  He and his staff offer ketamine infusion and home ketamine therapy to target the root of many mental health conditions, as well as chronic pain from a variety of sources. Since ketamine works differently than antidepressants, you have another treatment avenue open to you. Here’s what you need to know.

What are antidepressants, and how do they work?

Antidepressants target brain chemicals, such as serotonin and norepinephrine, that play a role in mood, emotion, and pain response. By adjusting the levels of these chemicals, the medications improve your mood and your pain. 

Some common classes of medication are:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants

If you take a conventional antidepressant, it may be 6-12 weeks before you can tell if it’s having any desired effect, during which you’re still experiencing symptoms.

Most antidepressants affect what are called the monoamine transmitters, such as dopamine, norepinephrine, and serotonin. However, over time, physicians realized that serotonin levels alone couldn’t fully explain depression because:

• More than a third of people are resistant to SSRIs
• Growing research demonstrated that serotonin and related transmitters make up less than 20% of transmitters in a person’s brain

Clearly, treatment had to be developed to target the other 80%.

What is ketamine, and how does it work?

The remaining 80% of neurotransmitters are composed of glutamate and GABA. Glutamate produces GABA, a calming neurotransmitter; low levels of glutamate and GABA can lead to depression.

Ketamine, a dissociative anesthetic, started as a veterinary tranquilizer in the 1960s, became a  battlefield anesthetic in the 1970s, made its way into operating rooms a decade later, and finally was discovered to serve as a calming agent for mental health disorders such as depression, anxiety, and PTSD.

Ketamine specifically targets glutamate, a transmitter known to process emotions and thoughts and form new neural connections (synapses). The transmitter affects how you learn, remember, and respond to new experiences.

Ketamine balances your levels of glutamate and GABA, essentially resetting your brain.

Research at Yale University confirmed that new neural connections were being formed with ketamine therapy, giving patients a means to develop more positive thoughts and behaviors. 

And ketamine can also reduce inflammation and inflammatory damage in the brain caused by long-term stress and stress hormones like cortisol. These hormones can themselves lead to depression.

And best of all? Ketamine takes just 24 hours to make the necessary changes in your brain that  let you feel more like yourself.

The ketamine infusion

We use an intravenous infusion to administer the ketamine directly into your bloodstream. All you need to do is lie back and relax. The process takes about 40-60 minutes.

Each person’s experience is unique to them. Some patients feel euphoria, others hallucinate, and some describe out-of-body experiences. Dr. Kullman supervises the entire procedure to ensure you remain comfortable and safe.

It may also help if you have someone with whom you can talk about the experience, such as a therapist or even a good friend. The treatment may help uncover some of the reasons that led to your mental health or chronic pain issues.

We generally recommend multiple sessions to maximize relief; Dr. Kullman will let you know how many at your initial consultation.

Home ketamine therapy

Ketamine may be safely taken in the comfort of your own home. Methods include capsule, rapidly dissolving tablet, or nasal spray. Treatment is individualized to each patient’s preference. 

If you’re experiencing mental health or pain issues that aren’t going away with traditional antidepressants, ketamine therapy may be right for you. Call Dr. Kullman’s office at 914-351-2313 to schedule a consultation, or book online with us today.