Charlene could not remember a time when she wasn’t depressed. A series of tragedies in her family along with psychiatric disorders in her relatives, all seemed to lead to her own depression. Antidepressants she’d taken for years seemed to do very little. Regardless of dosage or ration, she’d long ago lost hope that she’d every be better. Some people just had to live a life of wasted dreams. Dull. Flat. Empty. 

That’s how she felt.

She’d tried to go to college, but found she was too unstable.  She wanted to excel. But lack of motivation and dread seemed to have far more power over her than good intentions. She knew someone who went for IV ketamine maintenance infusions… but who knows? A lifetime of depression had tainted her, dulled her. She guessed the person she was must have become molded around the depression that had ruled her for so long. She hated herself, soaked herself in shame. Worth NOTHING. No education, no accomplishments, nada.

She wondered how she could ever be any different.

Now she had passed her 31st birthday, and she’d heard about ketamine treatment…she was thinking she might invest in it for a birthday present to herself. So she scoured the internet to learn what this treatment could do, and whether she should put hope in it.

The more she read, the more she learned, and her confidence and hope grew. So she called for an appointment. She wondered if ketamine infusions would work. And if she would need IV ketamine maintenance infusions.

She wanted an expert who really knew what they were doing. She wanted someone who would know what to do with severe symptoms. Symptoms that resisted everything. And everyone’s effort. She really wanted to find someone who was an expert in treating what she’d been told she had: treatment-resistant depression.

To find a psychiatrist who emphasized treating each patient individually, with remission as the hopeful goal.

She felt blamed. Like SHE was resistant. But she wasn’t. She did everything, took everything, tried to meditate in the morning, walked outside everyday, posted stickies on her mirror. Which she thought was stupid. And pointless.

Because none of it worked.

So was she just going to end up going to someone who would say, yeah, year, oh sure. ketamine? yes, you should do that …

She wasn’t born yesterday. Nor was she an idiot. She didn’t need a yes-man or a yes-woman, or a yes-doctor, for Pete’s sake. Who would just plop her down and promise her the world.

Here’s what she found: a place where she met a doctor who really wanted a ton of background information. Who took the time to collect it and read it and spent an hour with her before even getting to ketamine. (Not someone who did a phone screen. Nor someone who accepted someone else’s word for what she had. And not someone who interviewed her in a treatment chair.) Someone who wanted to know her story and her backstory. Who asked her questions that weren’t checklists. And someone who told her she was looking for all the factors that might indicate that ketamine could be helpful to her AND…all the things that she had working against her, that might make ketamine NOT work so well for her.

She was bowled over.

What if this actually worked? And if it did, was she going to need IV Ketamine Maintenance Infusions?

A Plan for Charlene

Lots of talk. Lots of tears.

And then the treatment started. Charlene received a series of infusions over a couple of weeks. Six to be exact. And she could feel some change — but not enough. Then, she was hospitalized and in the ICU for 9 days…  The severity of her condition, the stress of it on her body and mind, resulted in her losing the improvement she thought she felt after the sixth infusion.

She called the psychiatrist. Why would it fade so fast? Did that mean it wasn’t working? That it was never going to work? That it would be like every other thing she had tried?

She was encouraged to have two more infusions. Here is where she got a migraine. She wasn’t sure it was worth it …the money! She wasn’t sure SHE was worth it.

But she got 2 more infusions. She didn’t know if 2 more were considered IV Ketamine Maintenance Infusions or not. Still, she began to improve dramatically, but was under pressure to move to a new place. The extreme stress of moving under pressure with the earliest hints of remission blooming was too much.  

Once again, the benefits of the ketamine treatment seemed to lapse. So she went in about 2 months later, and had another infusion. In all of them, her dose and rate were titrated to support dissociation.

The goal was to get well — sustainedly well — and stay well.

That’s what she wanted. That’s what her doctor wanted.

(Isn’t that what everyone wants?)

The next morning, Charlene reported learning a new song in her dream. She sang it for her family.  Someone told a little dad joke, and she exploded into laughter…with her eyes shining. 

This never happened with her.

Her family told her she used to sing for them when she was a preschooler.

Early Signs of Remission

That was just the beginning. Over the next couple of months she became more and more lighthearted, hopeful and joyful. She began building the friendships that had lapsed during her depressed years.

It was as if the real person she was…the one that emerged from infancy… had replaced that person she thought was irrevocably tainted by depression.

About four months later, she was sick and in the ICU again. But once she recovered, her remission remained solid. A year ago she had to go through a massive move involving her mother’s abandoned belongings, and years of her own belongings that had stacked up during her depression. 

And her resilience stood strong.

Feeling well was her goal. STAYING well was her goal. It’s called REMISSION.

And she got there with an approach that was not cookie cutter. It’s a wellness model, not a business model.

Her remission remained intact, and she maintained a light heart throughout the process of packing, throwing away old mementos of dear family members who’d died, and hauling off items she wanted to donate to charity. It was a gripping experience in addition to exhausting. But she felt resilient.

Her remission remained solid. 

Two years later she married a warm, loyal, and kind man her family loved. The stress of planning a wedding will bring many brides to their knees, but she remained strong and flexible through the process.   

She was so glad to be alive. And to be in love. She never took a single day for granted.

Somehow her physical health has also improved dramatically along with her emotional health. She had given up on antidepressants when she originally went in for ketamine treatment, and hasn’t looked back. It has been three years and she’s never had another booster or IV ketamine maintenance infusion.

Maintenance Infusions: Yes or No?

Each Person is Unique with Unique Needs for Treatment

Charlene is not like anyone else. Of course not. Every person is different. But the questions that came up for her after her series of infusions come up for lots of people. Do I need more? How do I know if it will be worth it? How frequently should I have them?

What’s the data really, about that?

Turns out there’s not a lot of data about maintenance treatment out there.

A recent retrospective chart review from Massachusetts General Hospital (my old stompin’ grounds!) looked at a group of 85 outpatients who received 2 ketamine infusions a week for 3 weeks starting at 0.5 mg/kg.

The study followed these patients naturalistically — that means their outpatient psychiatrists could change their medications and they could change their therapists or the therapy they were getting while they were going through their infusions.

Although the response to the first 6 infusions using was only modest, and the drop-out rates were high, about 47% of the patients went on to receive maintenance infusions and 33% continued maintenance.

The investigators attributed this to the patients perceiving benefit from continued treatment. They received an average of an additional 2.3 +/- 1.5 infusions during maintenance.

We applaud these efforts. Research is long, hard, and time-consuming. 

I think one of the things this study points out is that a one-size-fits-all approach to treatment doesn’t yield the most beneficial outcomes. Because one size doesn’t fit all. And just like with antidepressants, one strength doesn’t fit all. We need more research on dosing, titration, and schedules.

Each Doctor Chooses What He or She Believes is the Best Course

Medicine is both an art and a science. We’re deeply steeped in the science (from Wellesley, Hopkins, and Harvard …how could you not be?) — and we’re deeply committed to the art.

We bring the best of what we’ve learned, the best of what we know, and the best of who we are to you.

At Innovative Psychiatry, we just don’t use a one-size-fits-all approach to depression treatment. Or to ketamine treatment. We don’t now and we never have since the beginning. With each patient we tease apart symptoms and medical history, along with the patient’s experiences and descriptions to find what’s needed for that particular patient. We custom fit the infusion protocol and recommendations between visits to each individual patient.

See how that’s worked in a young woman with anorexia. Her anorexia has been in remission now for 10 months and counting.

It’s a wellness approach to treatment because we want to see our patients achieve remission in every case possible. 

It means doing our homework, staying up late and scouring the reading, to find out what other experts have experienced, learned, and tried. Going to conferences. (Well, staying at home and logging in to conferences now!) Then applying what we learn to each patient according to his or her specific needs.

Because it’s all a vital part of helping each patient achieve remission. Some patients may need maintenance infusions, and when they do, we make it part of our wellness approach to their ketamine treatment.

Overall, remission is the goal. We can’t promise it, but we do everything we can to make it possible.

We want you well.

Or as close to well as possible.

We want to see you enjoying your life, investing in your future, and in healthy, strong relationships… and the things you most like to do.

Give yourself the chance to live the best life you can live.

A 21st Century Approach to A Safe Ketamine Treatment Environment For You

We’re always on the leading edge. And we’ve taken your safety a step further as we lead the way in providing the safest possible clinical setting for ketamine treatments: IV, IM, IN, and ketamine-assisted psychotherapy. We’ve talked about the safety of IV and IM ketamine treatment. We’ve also talked about the ways we’re taking precautions to keep you safe during this pandemic when you come in for ketamine treatment. What you maybe didn’t know is that behind the scenes, we’ve been continually scrubbing the air you breathe to destroy viruses and bacteria, lifting pathogens from hard surfaces, and laying down protective microbarriers – with new plasma cell technology that destroys viruses. We’re innovators, always seeking the best possible solutions. So, true to form, we’re the first ketamine practice anywhere to offer this complete technological safety package for our patients. In fact, we’re leaps and bounds ahead because your safety and ours is of utmost importance.

We’re in this together.

Let me tell you about what we’re doing for you.

We’re on the side of science — not just about psychiatry, treatment-resistant depression, PTSD, BDNF, mechanisms of action, the lateral habenula, g-proteins. (What is all this stuff, right?) We jump right in to understand the controversies, to wade through the weeds — with new treatments like ketamine and with new world-wide health threats like COVID-19 — and we’ve been looking the safest technology to create a safe space. Staying safe, and staying healthy, is really the biggest game in town.

So we stay up late, reading. And sometimes, like you, we’re up early, worrying. About how to stay safe. How to make it. How to make sure that you make it.

And we’re doing that with VB Enviro Care.

If you’re thinking about ketamine treatment, you should see a psychiatrist who is on the forefront of innovation — in every aspect of their work, including the space they’ve created to offer you treatment. We believe that, and we live and breathe it. So today we’re going to talk about that space — our incredibly lovely space — and the air you breathe when you’re with us.

VB Enviro Care provides us with the best technology that destroys viruses like coronavirus in our offices.

So we can all breathe easier. So we can be less fearful.

It’s tough enough to come up for a breath of air when you’re depressed, or anxious or dealing with trauma.

You shouldn’t have to worry about that breath of air when you’re in your doctor’s office.

We have plasma cell technology that was developed at MIT and NASA, prepared for a time when we might be faced with biological warfare. (OK… so I would say we’re facing the fight of our lives with this pandemic… it sure feels like that.)

It’s a plasma cell technology that not only removes but destroys viruses, bacteria, and mold from the air and the environment in a closed space. So it’s perfect for a doctor’s office. A ketamine clinic. An infusion center. Hospitals, ERs, walk-in clinics… you name it. In fact, it’s been rigorously tested in hospitals and ICUs around the world specifically against stubborn, highly-resistant infectious viruses and bacteria.

And we’ve got it here for you.

A symphony of technology, products, and procedures to clean, disinfect, sanitize and protect our air and every hard and soft surface in our office. (Yep, even the gorgeous ones.)

Lori Calabrese, MD

So let’s talk about surfaces first. The ones you touch and see. As you know, there is a difference between surface cleaning and sanitizing (removing pathogens). For instance, some surface cleaners remove 97% of all viruses and bacteria from a surface. Others remove 99%. 

But in a pandemic, and in a doctor’s office, you deserve not just thorough but the most thorough sanitizing available. Technology that targets and removes pathogens like viruses, bacteria and mold not JUST from the air, but from all of the hard surfaces you see and touch. The Novaerus units and Steramist service we use through VB Enviro Care obliterates and erases those microorganisms from the air — and even lifts them from those surfaces — continually and regularly.

They do MISTING regularly to sanitize our surfaces and further sanitize our air.

(Sometimes it’s called fogging or electrostatic spraying. We like “misting.”)

MISTING DISINFECTS AND SANITIZES ALL HARD AND SOFT SURFACES AND LEAVES A PROTECTIVE COATING BEHIND TO REPEL VIRUSES AND BACTERIA FROM LANDING ON THOSE SURFACES. THIS TECHNOLOGY DESTROYS VIRUSES IN THE AIR AND ON EVERY SURFACE.

Our system–our symphony–destroys 99.99% viruses, bacteria, and mold from surfaces…like cabinets, counters, tables, chairs, equipment, handles, and knobs. Including coronavirus… and flu.

So we clean regularly, disinfect continuously (all day and all night) with Novaerus, and then have VB Enviro Care come in to mist with confidence and on schedule… which destroys virtually all of the organisms that can make you sick. Obliterates them. And leaves a protective barrier behind on every surface (even the soft ones).

Why Is This a Big Deal?

Because we live and work and see our doctors in enclosed spaces. We’re not talking about your back yard or the city park. 

In the open, air can circulate constantly and replace the air that surrounds you. That constant circulation and diffusion thins out the concentration of any micro droplets of SARS-CoV-2 (the virus that causes COVID-19) — as long as people are distanced in open air areas. So coronavirus particles that waft your way are less concentrated.

Oh wait. Microdroplets. What are those? When we talk about micro droplets, we aren’t referring to big juicy drops or even little juicy drops. These are so tiny they’re suspended in the air. (That’s why they’re called aerosols.) In fact, they can remain suspended for up to 16 hours. So the more an infected person talks and exhales in the same closed space, the more concentrated those aerosolized droplets become. And the more likely to spread the virus.

Little side note here: This is also why we’ve been concerned that social distancing of 6 feet is not enough…because these particles can float 10 ft, 20 ft, even dozens of feet.

And you know those sneezes and coughs we’re all so worried about? Those emit big drops…that are heavy and fall to land. But, the tiny aerosolized ones that are simply breathed out? They’re floating all over… ready to be inhaled.

So what to do about them?

While it’s important to keep washing your hands, to clean them of big droplets and keep them away from your face, it’s just not enough. Even wearing a mask isn’t enough. All those floating contaminants hang suspended indoors, slowly diffusing. Every time someone enters or leaves a building, more of those particles enter.

Ok, so why not just boot up your laptop and order an air purifier?

Because those have filters, and even some highly sophisticated systems that use UV, ozone, or chemicals…can block and hold the pathogens that are killing us. And there they can colonize, multiply, and escape back into the atmosphere.

So think Plasma: It Destroys Infectious Organisms at the Molecular Level.

VB Enviro Care and Novaerus use plasma technology. It kills airborne pathogens at the molecular level. Plasma, known as the fourth state of matter, can create an ultra low-energy “force field.” When bacteria, fungi, or virus particles—no matter how microscopic—move across this field, they are instantaneously destroyed at the level of their DNA. Every single one. Obliterated. 

Novaerus is used in hospitals worldwide to safely kill airborne superbugs like MRSA, C. diff, and Tuberculosis, and has been proven to even be able lift and destroy them from hard surfaces. It has been tested and proven by more than 50 laboratories and clinical research sites, including the NASA Ames Research Centre in California. 

So, this system is designed both for rapid remediation and continuous treatment of a given space.

Our Novaerus units from VB Enviro Care perform with flying colors. They have been independently tested against MS2 Bacteriophage, a commonly used surrogate for SARS-CoV-2, and shown to reduce the virus by 99.99% in just 15 minutes.

Plus they’re gorgeous. (Always a good thing.)

A study published in June 2020, edited at Stanford University, highlighting the fact that COVID-19 is spread by sneezing or coughing has been corrected.

Listen up because this is really important.  

The truth is that just exhaling and talking release micro droplets containing the virus. So someone who has no symptoms can release infected micro droplets.

The use of masks helps to manage these micro droplets. But only partially. 

For this reason, it’s important to have the technology to destroy viruses in these infected micro droplets from the air you breathe.

We have that technology. (I’m so excited that I’m saying it again, just in case you missed it!) Novaerus units through VB Enviro Care use patented filter-free ultra-low energy plasma technology with a single speed fan. And we’ve installed one of these units in every room in our offices.

The result is that when you come in for ketamine infusions, the air you breathe is 99.99% free of coronavirus, influenza virus — and even the viruses that cause mild illnesses. It’s also free of bacteria and molds.

What else are we doing?

Locking our doors, keeping delivery folks outside, sanitizing what we bring in with ultraviolet lights. Washing our hands. Wearing masks, face shields, gloves. Cleaning with 70% alcohol throughout the day. Sanitizing each infusion room with with ultraviolet light after each infusion. Abiding by the rules, following quarantine guidelines, meticulously screening our patients and ourselves. We’re doing it all.

We have protocols for you to follow to keep yourself safe, and for the safety all of our ketamine patients (and ourselves). We’ll send these to you before you come in for the first time and go over them again on the phone. Ask us about them before you come in for a follow-up infusion or maintenance infusion.

These steps — combined with the best plasma cell technology and environmental care available that destroys viruses in our rooms — help you relax…and know you’re in safe hands. And in a safe place.

So you can breathe easy.

A symphony of care. Multiple layers of attention, time, and protection. You can have confidence when you’re with us.

It’s enough that you are dealing with everything else this pandemic has caused while suffering from symptoms of treatment-resistant depression, anxiety, trauma, or suicidal thoughts.

It’s ENOUGH.

When there is so much to deal with, so much to overcome, to hold together, at least you can come in for your appointment and relax during treatment, knowing we’ve got your back. And the air that you breathe. Covered.

We’ve talked often about how to screen a ketamine clinic. The 21st century technology that protects you when you are in that clinic is an important item to add to your list of requirements. For you, your family, and everyone you meet.

At Innovative Psychiatry, we want to help you get better. And we’re relieved to be able to offer these advances in our office environment, so you can focus on your treatment and recovery.

The medical journals these days talk about the increases in those who need psychiatric care during this pandemic — many who’ve never needed it before. Now, especially, you need to be not afraid to seek treatment for your symptoms.

You need to feel better to cope. And you need to feel safe while you receive that treatment to feel better.

So if you suffer from severe depression, bipolar depression, or PTSD that has not responded to treatment, call us. If you struggle with alcohol or other substances, call us.

IV ketamine treatment may be the treatment that will make the difference for you. Although it doesn’t work for everyone (because nothing works for everyone), it does work for most. It can deliver hope, joy, and the capacity to build a rewarding life.

Reach out and give yourself that opportunity safely.