Category: Ketamine

Articles About Ketamine from Lori Calabrese, MD | The Ketamine Blog

Breakthrough anesthesia medicine proves life-changing for many who suffer from severe mood disorders.

In the last several years, a medicine began to emerge as a remarkable treatment for mood disorders. It was developed and FDA approved for anesthesia around 1970. Over 25 years later… it began to show its colossal hidden ability. What sort of ability? The power to relieve depression and other psychiatric disorders in a most dynamic way. Disorders like PTSD, bipolar depression, postpartum depression, addiction, social anxiety, and even eating disorders respond to this extraordinary treatment that involves a series of IV infusions. And perhaps the most remarkable of all, ketamine infusions can erase suicidal thinking in a few short hours. These articles about ketamine treatment are presented here to dispel stigma about psychiatric conditions and to give hope about treating them.

Early Testing was Cautious

Researchers tested it with trepidation 10-20 years ago. Then each study built upon the last. Their work revealed more insights about what actually causes depression, and how to treat it effectively. Never before has a medicine helped relieve symptoms in such a wide variety of people and their symptoms.

Researchers Still Learning All Ketamine Can Do

Ketamine works in multiple areas and systems of the brain. It improves the function of mechanisms that have been impaired by the stress of depression and anxiety. It helps the G proteins that pile up on lipid rafts in the cell membrane slide to off. This equips them so they can do their job enhancing signal transmission.

It also turns on the mRNA switch which in turn flips on DNA to build up brain-derived-neurotrophic-factor (BDNF). BDNF then causes synapse connections between neurons to proliferate in turbo mode, transforming and replenishing the connections between brain cells all around the brain, lighting it up with information, cognition, creativity, and insight.

There’s more that it accomplishes, like tamping down the cell bursting in the lateral habenula so you can experience the reward of pleasant moments. We don’t know what researchers haven’t discovered yet, but we look forward to hearing what’s next.

Ketamine Does More Than Bring Relief, It’s Transforming

The results of IV ketamine treatment are transformative. Those who have been weighted under a blanket of lethargic apathy and despair typically find they feel better and better after treatment. They often find they have the energy and motivation to dive into tasks they couldn’t face in recent memory.

More patients with treatment resistant conditions respond to ketamine than any other medicine available. It may sound odd, but the patients it helps the most are those who suffer the most from severe disorders. With continued research, neuroscience researchers and psychiatrists are learning methods of administration that help more and more patients enjoy a rapid and robust response,.

As a result, these individuals enjoy renewed hope. They express amazement at their energy for life and work, and an overall transformation in what they enjoy and are able to accomplish. They report a more balanced and joyful outlook, and the desire to rebuild and strengthen their relationships.

Ketamine is NOT for Everyone

With all the good IV ketamine treatment accomplishes, some people still don’t respond to it at all. The percentage of people who don’t respond is comparatively small, and we need to see more studies that can help explain why.

Why Ketamine Sometimes Doesn’t Work

There are others who have a significant response initially, then the response fades. One reason for that may be they have a deficiency of certain components in their blood. They may have a low folate level, or low testosterone, and some other deficiencies. In cases like this, sometimes replacing those nutrients helps that patient respond to ketamine treatment and experience resilience again. There are even cases where a patient’s blood levels are normal but the levels of certain components in their cerebral spinal fluid is low. By replacing that deficiency, the patient is able to enjoy a very positive and robust response to ketamine treatment.

Neuroscience is gaining knowledge by leaps and bounds in the 21st century. We hope to see more and more medicines that work as well as ketamine for those who have not yet been helped.

These articles about ketamine expand on those things we learn from neuroscience research in the labs, as well as those things we learn from research in our practice.

Want to Help Ketamine Remission Last? First Strengthen Your Personal Infrastructure

In past posts, we’ve talked about remission by ketamine, the 50-year-old anesthesia medicine that stepped up to the plate in the last ten years or so… to bridge the gap in the treatment of an array of psychiatric disorders.

And once you’ve achieved remission, you want to help ketamine remission last. You don’t want to return to your same old ways of reacting. Or to the same old stress and risk losing the ground you’ve gained.

So let’s continue. We’ve talked about the growing body of evidence that demonstrates the extraordinary antidepressant effects of this medicine in numerous psychiatric disorders. Illnesses like severe treatment-resistant depression and bipolar depression. as well as its unparalleled impact on PTSD to arrest symptoms and restore peace to the traumatized individual.

In our own practice, Innovative Psychiatry, we’ve seen ketamine treatment make a dramatic difference with social anxiety, that cruel disorder that creates obstacles between you and financial success, self respect, meaningful relationships, and general fulfillment in life.

So that after ketamine treatment, you can effectively interview for the job you want. You can initiate and develop loving relationships. In fact, you can basically BE who you are and at your best. While you contribute to your team at work and your family and community, as well. So you want to help ketamine remission last.

But it doesn’t stop there. We’ve also seen ketamine treatment relieve OCD symptoms, providing the neuroplasticity for needed changes through therapy.

And then there’s alcohol use disorder as well as crack and other addictions, which ketamine (as demonstrated through the work of Dakwar and others) helps you conquer by weakening or erasing cravings.

We’ve seen similar positive results in our own practice, though there have not yet been enough studies to validate this benefit across the board… yet.

Then, possibly the most amazing of all is suicidal thinking…no matter what the cause that led to it… can be eradicated, often within an hour, and usually in less than four. We’ve seen extensive positive outcomes of this life-saving benefit in our office.

Your Personal Infrastructure Seems to Play Some Role in Making or Breaking Your Remission

Sometimes people achieve remission with ketamine treatment only to lose it after a few months as the stressors of life wear away at the repair work the treatment accomplished, and the remission is lost… or seems to be.

Interestingly, because stress is such an important cause of the pruning of brain cell connections (synapses) it appears that sometimes when patients receive ketamine treatment while under severe stress, it seems to not work for them.

Then, sometimes it happens that the patient finally begins to enjoy ketamine’s benefits after the stress is significantly reduced. This is something we’ve observed multiple times but lack the extensive research to back up… yet.

So it’s important that we distinguish those benefits we see every week at Innovative Psychiatry from those that have already been validated by peer-reviewed research.

It takes time for research to catch up with the widespread use of ketamine treatment. And it requires multiplied studies upon more studies to establish the reliability of any benefit.

So let’s be clear that the benefits of ketamine treatment we’ve seen at Innovative Psychiatry have already been reported in research studies. But, not with the overwhelming stacked-up body of evidence that stands behind ketamine for depression. Not enough to proclaim them from the housetops without an explanation.

Even so, it’s important that you know these things are happening, and we’re playing a waiting game for the research to catch up and explain what we’re seeing in practice.

Meanwhile, while we wait, we want to let you know that we’re discussing what we’ve found works for our patients. And although we make the disclaimer that this is not individualized medical advice for you personally, we want to share the best of what we’re reading and actually doing. In the name of transparency. And in the name of hope.

Now to recap…we were talking about how stress seems to undermine the benefits of ketamine…or at least it appears to. And there’s more to stress than meets the eye. Right?

Sometimes the stress is inside our heads…like things aren’t going the way we wish they would, or something we hoped would last doesn’t, or maybe people aren’t doing what we think they should.

Or we like the job but hate the commute and arrive at work ready to rip someone’s head off…or we hate the job and every day is miserable.

…or we have friends who drive us crazy, use and abuse us, but we keep spending time with them.

And that’s where “infrastructure’ comes in. You want to help ketamine remission last. And the rebuilding of your environment, your decision-making, your thinking patterns, and your responses to the challenging moments in life, is part of your personal infrastructure. All of that tries to return you to your former state before treatment…or can establish you in your new peaceful life of joy and productivity.

It’s impossible to cover all those elements in one post, but we’ll attempt to show ways you can tackle certain elements that make up your inner and outer environment over time… here and in some posts to come.

A Full Overhaul Of Your Life, Step by Step, Can Be the BEST Medicine

And a good place to start is by taking a look at learning to let go. It’s completely normal and natural to assume that any depression or anxiety you have is the result of the behavior of others. That you just got worn down from it all.

And there may be some truth in that.

But in exploring the causes, it may surprise you to learn that their behavior may not actually be the cause, as much as your reaction to their behavior that is.

Now understand this. We’re not implying here in any sense that your lack of response to ketamine, or the loss of remission, is in any way your fault, or even within your control.

But it’s important to understand that the best prescription for maintaining stability with remission includes maintaining health in those things in your life and environment that you can control.

Things like your respect for yourself and for other people. Your persistence in pursuing peace in your life and relationships. The development of a kindness-centered approach to yourself and those in the world around you.

…And the evaluation of your life and simplification of the burdens and demands it presents. Ensuring you have the power to enjoy life’s simplest pleasures…which may include letting go of things that pull you down or hold you back.

These are things that can help ketamine remission last.

So let’s talk about a fundamental skill that can change your life…for the better.

Letting Go

When we talk about letting go, it’s not reserved to only one thing…such as letting go of a relationship. Since relationships can be so important in our lives, and the ending of them can be so painful, letting go of relationships that have died is high on the list.

But there are other issues in our lives that may present themselves as we consider letting go to reduce stress.

Such as letting go of being right in our discussions at work with our boss or co-workers, and in our discussions at home with those we love most, such as our spouse and kids.

And what about letting go of fighting to get our way, when obstacles are thrown in our path? This may be akin to letting go of being right, but it has a personality all its own.

Possessions Can Shift from Useful Tools to… Jailer

How about letting go of your pride in your possessions…? For instance, let’s imagine a teenager sets his icy soft drink can on your dining room table…allowing condensation to mar its flawless finish?

What goes through your mind when you see it? Rage that a kid with no manners has caused your beloved heirloom table some damage…? Fear that your spouse will hit the ceiling? Compassion for a young man who didn’t know better… so you pick up the can and set it on a coaster for him?

It’s ok to enjoy having nice things, but when the “thing” is higher on your priority list than the development and well-being of a person…well that “thing” is controlling you.

Which do you value more: A 19th century mahogany table with a flawless finish that was handed down through your family over a hundred years….? Or a tall and lanky boy who needs a haircut and a clean t-shirt ?

If you’re honest with yourself, it really might be the table. But if that’s the case, maybe it will help you see the kinds of things you can work on, possibly with a therapist, to improve the infrastructure in your head.

Because anger causes stress. And anger toward that kid is stress you don’t need. Compassion on the other hand doesn’t, and actually supports your remission frame of mind.

Remember…you’re learning to nurture peace… in your head. And to do it means developing a response of gratitude, humility, and kindness.

What If You Lost It All?

On the other hand, picture your belongings lost in a fire. No one’s fault, really. But it cost you every material thing you own. How do you feel about that? Sad? Sure… all those memories and photos…but the house and belongings?

This is a loss you’ll never fully recover from materially, but does it reach the core of who you are?

Now. Picture the phone call that makes the world STOP. Your spouse, your three children, and your only grandchild have been in a terrible car accident. No one survived.

What do you feel? What does the furniture or sports car mean to you now?

My point here is that we have a way of putting people and things on a priority list… and that list can get all mixed up. But this scenario helps to show how those things we think are important lose their glow instantly when those at the core of our hearts are lost.

And that being the case, putting ourselves through unnecessary stress to preserve things that pale in comparison to those we love… well, it’s a waste of valuable moments and energy when we think about what really matters to us.

And therein lies the secret. Rather than wasting our lives by hurting people to preserve things, we find our life is best spent preserving the moments with those we love the most.

And the things…the houses, cars, antiques, reputation, recognition…none of these things can compete with the people we love the most.

The Greedy Monkey

You’ve heard the story of the monkey who is shown a jar of cookies. A jar that has a small mouth. He sticks his hand in and grabs a cookie…but can’t pull his hand out unless he lets go of the cookie. The opening just won’t accommodate anything larger than his open hand.

Because he won’t let the cookie go, he panics. Swinging the jar around in the air in a temper because it won’t give him the cookie, he finally smacks himself on the head with the jar and it hurts so much, he immediately lets go of the cookie to hold his head.

Sound familiar… at all? Is there anything in your life that’s pleasurable to you that you don’t want to let go? And if circumstances prevent you from having it or keeping it…does it make you mad?

If you have any marred tables or unyielding jars in your life, take a moment and breathe… Think about what trying to protect and preserve that “thing” costs you. Are your feelings on your cuff? Do do you snap at people when its security is threatened? Do you feel panic at the idea of it being removed from your life…?

The Surprise Benefits of Letting Go

The unexpected surprise you can discover by disengaging from “it” is that the angst of control that you’re powerless to perfect is replaced by a growing peace and relief. And when you have succeeded in reaching that point, that same peace and relief is a signal that you’ve now added a brick to the foundation in your personal infrastructure.

That thing, whether it’s your marriage, your shiny sports car, your child who’s supposed to fulfill your dreams….your house, the money you make in your job that prevents you from spending time with those who yearn for your attention…no matter what it is, has been holding you back and isn’t deserving of what it takes from you.

Picture serenity in your life. Peace. What has been removed from the picture when you think of it?

An alcoholic wife, an abusive screaming boyfriend, a job that you bring home and work on till you go to bed…? Maybe it’s more house than you can afford, so you’re driven to work three jobs to pay the bills. If it is, that house controls you.

Life is short. We get the most out of it when we can cherish every moment. In your daydreams, when you wish for reprieve…what do you erase from your life in your mind’s eye to make room for hope? Peace? Love? Enjoyment?

Commit to Finding Ways to Let It Go

First of all, in your mind and heart.

This is one facet of the infrastructure in your life that you may need to confront and adjust to make room for remission.

It will be easier to explore these things after you’ve had ketamine treatments because of the neuroplasticity that results. The ability to think in new ways. To change, and make productive decisions for your life.

So…to get there… you may want to consider ketamine treatment for severe and suffocating depression, your wracking and immobilizing bipolar depression, PTSD that injects traumatic reactions into your days…and your nights.

OCD that stands in the way of your achievements, and that social anxiety that has plagued and isolated you since you were a child. And for suicidal thinking that threatens to snuff your life before you even have a chance to recover.

Wanna Help Ketamine Remission Last? You Can If You Strengthen Your Infrastructure

Strengthening your infrastructure involves ferreting out burdens you can lift off yourself, like excess belongings, excess weight, whatever it is that requires your service and obligation…and prevents you from freely enjoying opportunities with those relationships that matter.

Let it go. Help Ketamine Remission Last

By giving your brain…your inner self…the most optimal environment for healing and growing possible.

It means simplifying the grandness of your life… For you, it might mean living beneath your means so you can travel, write, or volunteer. Or shedding those friendships that demand your time but don’t contribute. It’s shedding the less meaningful to free up time and space for what’s ultimately important.

For this person it may mean letting go of the bitterness he carries toward his ex-spouse for leaving him. For another, it may mean selling the house to travel the country in an RV and stop and paint when the view is spectacular.

And for someone else, it can mean retiring from the corporate job to teach underprivileged children, or to cook meals in a soup kitchen for the homeless.

For you? Maybe it’s saying no to all those obligations that crowd your life so you have time to spend with those who adore you.

Basically, it’s about pulling weeds in your life to help ketamine remission last, and to preserve your joy. To put the life ketamine helps you find to the very best use.

You know what your strengths are…if you take time to think about it. Those special gifts you have ached to get out.

No one can tell you what it is for you. But that’s the fun of exploring your own infrastructure to find your path for cherishing the moments of life, and enjoying your new found joy. It’s a painful process that gives birth to fulfillment. And along that path, you’ll find joy.

Even though we don’t see everyone achieve remission with ketamine treatment, we do get to see that most do. And more and more physicians are learning better and better methods for administering ketamine for the best possible outcomes.

The result is that more physicians are reporting higher numbers and better outcomes. The field of ketamine for psychiatric disorders is growing as physicians and researchers collaborate and learn from each other.

Meanwhile, researchers and physicians alike continue to discover more with hopes of bringing relief and remission to those who aren’t experiencing it now.

If you suffer from symptoms that no medicine has helped, call us.

We’re here to help you experience life the way you’ve longed to live it.

To the liberating of your best self,

Lori Calabrese, M.D.

January 21, 2019
Treatment of Psychiatric Disorders: 2019 Year of Promise

Compounds and methods for treating severe psychiatric disorders are getting better and better…

Charlie sank into a chair in utter discouragement, as she realized she had awakened again, after hoping as she went to sleep that this would be her last night. Her last time to breathe. Night after night she prayed to die in her sleep. Morning after morning she woke up again. Ugh.

She felt betrayed by whatever cruel powers that be…that there seemed to be no compassion for her misery…and no escape.

She dragged herself to the bathroom and turned on the shower. Instantly, she saw an image of herself hanging by a rope from the shower head.

And she screamed.

Then climbed into the bathtub and stood sobbing under the shower.

Finally, she shampooed her hair, soaped up her body, rinsed, and turned off the water.

There was nothing to do but go to work…AGAIN…and try to function…AGAIN… and hopefully not get fired, because of her poor performance. Tears filled her eyes…

Suicidal Thoughts Can Be Deadly

Charlie is one of millions in the US who want to die as a result of depression. Approximately a million people commit suicide each year, and many times that amount try but survive. And many times more than those get struggle with suicidal thoughts that keep coming back.

Because relatively few tell anyone they’re thinking about or even considering suicide, it’s been impossible thus far to estimate the number.

They don’t want to die, they just don’t want to live with this kind of misery any more. Maybe you know someone like this… or you’ve felt like this yourself.

You are the ones we want to reach, to help, and to treat so you can rebuild fulfilling and rewarding lives again.

Ketamine Treatment Continues to be Misrepresented

With all its talents — with all its extraordinary mechanisms of actions — IV ketamine treatment may need a good PR firm!

When have you seen a safe, rapid, extraordinarily effective, life-saving treatment misrepresented, misunderstood, lambasted, and gossiped about more than ketamine? (Think about that for a minute.)

I saw a comment in STAT magazine the other day that took the cake.

There were lots of great comments, some more informed than others. But you do sort of expect that in a national publication. And… there was a lengthy comment–difficult to decipher–claiming ketamine was inherently dangerous.

It was clear the individual didn’t know about the research and data. All the information that’s poured out around the globe about ketamine and related compounds for psychiatric disorders over the last 10-15 years.

The commenter seemed to only be acquainted with its dangerous and highly abusable street form, Special K. And with the extremely high doses used on the streets… repeatedly over and over and often… he or she had seen the damage that abuse of ketamine can do.

As a psychiatrist, I hate to see it represented that way, but I cherish free speech, and freedom of expression. I also cherish scientific advancement and use it — every day — to relieve suffering.

Ketamine should definitely be administered under a psychiatrist’s close supervision, not self-dosed.

Then … there are the articles by young residents and clinicians, aspiring academics, and others. Those who have little true experience with the medicine or the treatment. But they’ve jumped in to write reviews of the literature or opinion pieces about it.

The best way to learn about ketamine treatment for psychiatric disorders is to hear directly from experts who actually use it — with many, many patients — every day in their offices or research units to treat psychiatric conditions. In this case, from the neuroscience researchers and psychiatrists who have worked with it a long time.

Because the truth is, the majority of physicians have read snippets about it here and there. They’re just now getting up to speed. And some have distorted ideas about it.

An article in VeryWell Mind by Naveed Saleh, M.D., May 2018, made some erroneous statements about ketamine treatment for suicidal thinking.

First, he claimed that ketamine is best absorbed through the intramuscular (IM) route, which is just simply false.

Ketamine is 100% bioavailable only when it’s given by the intravenous (IV) route. In IV form it’s delivered straight to the brain tissues that so desperately need its benefits. IM and IN (nasal spray), lozenges, troches, and oral liquids are all less bioavailable.

In addition, there are other problems with IM injections of ketamine that we’ve discussed and that are described in that Time Magazine article we talked about.

He also made claimed that if ketamine is to be widely-used, it most likely will be as an adjunct to other medications. Another misunderstanding of his research. Because the evidence says…

Ketamine Treatment Acts Independently of Other Medications

While that may or may not be true, my vote is that it won’t need to be. Evidence shows it doesn’t depend on other medicines for its mechanism of action. It’s not dependent on other medications to create a “partial response” that it augments. It acts independently on its own merits.

In fact, the most robust research is in patients where medication has FAILED — patients who have TRD, or treatment-resistant depression.

The left half of the ketamine molecule, known as esketamine, is nearing completion in its FDA trials and IS being tested as an adjunct to other medicines, not as a primary or stand-alone treatment. It’s being packaged as an intranasal spray, and has had some serious setbacks while seeking FDA approval.

It’s exciting to see what new glimpses researchers will find as they continue to study ketamine and other related compounds for treatment of suicidal thoughts, depression, bipolar depression, PTSD, OCD, social anxiety, and addictions. Maybe it will be a new action not yet identified, or maybe additional applications or conditions that could be responsive to this extraordinary treatment.

But the majority of patients who receive IV ketamine treatment report that other antidepressants or anxiolytics have failed, and, even if they walk in on antidepressants and mood stabilizers, they attribute their response and remission to ketamine treatment.

Ketamine Treatment of Psychiatric Disorders…

At Innovative Psychiatry, we see the majority of patients with severe treatment-resistant depression, bipolar depression, and suicidal thoughts. respond and achieve remission. They are real-life, real-world people just like you or people you know. Often, they don’t have just one thing or just one disorder — because psychiatric symptoms and disorders are complex and tend to run hand-in-hand.

We call that complex psychiatric cormorbidity.

Don’t let the term scare you.

It just means that when we see patients with treatment-resistant depression — as in unipolar depression and bipolar depression — they often also have other things, too, like social anxiety, PTSD, OCD, and addictions.

They’re often hopeless. Often suicidal.

It’s one of the reasons we’re so interested in following the research in using ketamine to treat suicidal thoughts and these other psychiatric conditions — and one of the reasons I write about them so often and devote space to them here.

Suicidal thinking can disappear within a few hours with IV ketamine treatment. Think about what that would be like for you … or someone you love.

If you’d like to consider ketamine treatment, give us a call. We can talk it through.

The Microbiome Has Been Underestimated

The microbiome is the collection of genes included in the trillions of bacteria, fungi, and viruses that populate the gut along nerve pathways connecting your brain to the rest of your body. These microorganisms provide our immune system and all work together to help our minds and bodies function properly and in partnership.

Another area psychiatry is advancing quickly forward is in its understanding of the importance of the microbiome and its effect on psychiatric illness.

When the balance between good organisms is outweighed by “bad” organisms, we become sick in some way. This may be an upset stomach, a systemic virus, or a disorder like depression, to name a few. Restoring the balance of these systems in our gut can help restore our health.

In fact, physicians have come to understand that sometimes the extensive use of antibiotics may destroy so much bacteria that the good bacteria that fights disease becomes depleted.

The more we learn, the more we can refine this essential part of our bodies to support our emotional well-being, as well as fight inflammation throughout our bodies.

But, we’re also learning it’s possible to overdo good organisms, too. And other disease symptoms can begin if there are far too many of them. It’s a balanced eco-system we’re looking for… We’ll be talking more about that soon.

Plans Unfolding for the 2019 Year Ahead

And we’re brimming at Innovative Psychiatry. (How’s that for 2019?) With new initiatives, new efforts, and exciting plans.

We’re expanding our hours and our availability, and preparing to publish our outcomes peer-reviewed journals in the hope of adding to the growing body of evidence of ketamine treatment’s remarkable benefits for treating an array of psychiatric disorders. (I’ll keep you posted as that develops.)

We hope to present our outcomes at more national and international conferences this year.

On top of that, we’re adding some opportunities to help us get more help to more of our patients to finance the cost of their treatment, and help fight for insurance companies to reimburse patients for the cost of their treatment.

Ketamine Treatment: Getting Better, Giving Back

Another opportunity in the wings is a program we’re developing — the first in the country– that would allow us to help patients Get Better and Give Back to their communities with special volunteer opportunities.

This program can help patients who would not have access to treatment any other way.

As we get all our irons in the fire scheduled and the details sorted out, we’ll update you so you’ll know what to watch for. G

2019 promises to be a year of hope, and a year of gratitude and goodwill, as we see more people feeling better... and getting well… after years of struggling without solutions.

We want to see progress made toward insurance companies covering ketamine infusions for psychiatric disorders. The medical billing code for ketamine infusions exist but it is usually rejected when it is linked to a psychiatric diagnosis. We continue to fight stigma and stigmatizing terms.

Hope is on the horizon. It’s going to be a good year.

If you battle depressive symptoms, or suicidal thoughts like Charlie, that haven’t gotten better, despite various medicines you’ve tried, please get in touch with us if you’re interested in ketamine treatment.

It consists of several doses of IV ketamine, usually about 6, and sometimes a few more, over 2-3 weeks. Ketamine isn’t appropriate for all patients — and doesn’t work as well for some as it does for most of our patients — so it’s not for everyone.

But we see such high percentages of response, we can say that most likely the chances are it will be a great help to you.

Most of our patients find after a full series of infusions, they can do things they’ve procrastinated about for years, enjoy things they used to enjoy, take advantage of energy to work, create, and socialize they had found impossible, in many cases for years. And build relationships and careers that are rewarding and satisfying.

We look forward to talking with you, and helping you find your smile again.

To the best YOU you can be in 2019,

Lori Calabrese, M.D.

January 7, 2019
Advances in Psychiatric Treatment: 2018 in Review
Happy New Year!! The big silver ball falls tonight to celebrate the birth of 2019.

Let’s celebrate the unprecedented, transforming, and ever-accelerating advances in psychiatric treatment this year and the neuroscience that backs it up.

Celebrate is the word. Because we’re so grateful to the courageous researchers around the beginning of the 21st century who dared to test new ideas and compounds to treat psychiatric disorders.

This testing, and subsequent investigation, snowballed into a field of life-changing breakthroughs and developments like ketamine treatment, transcranial magnetic stimulation (TMS), and other “outside the box” novel treatments.

We’ve watched TMS press forward from an almost incredulous idea to its more prestigious position as a very effective non-drug treatment for patients with major depression and OCD who have not responded to traditional treatments.

True advancement risks misunderstanding, distrust, and adjustment before it’s accepted, and the breakthroughs in psychiatry are no different. There have been skeptics and naysayers, and those who prefer to “wait and see.” But tireless researchers press on.

Psychiatric Treatments Are Improving

Ketamine treatment has, in a relatively short time, emerged from being a who? kid on the block to a blockbuster this year. We know it as possibly the most rapid, robust, and effective treatment for patients with treatment-resistant depression and for depressed patients with suicidal thoughts.

The discovery of its hidden talents and the explosion of research publications testing at its effectiveness for PTSD, OCD, addictions, and anorexia (actually one of the first published studies on IV ketamine!) has inspired numerous investigations into other rapid-acting medicines by demonstrating its widespread and neuroplastic actions in the brain.

Across the fields of psychiatry and neuroscience, 2018 has been a very good year, with breakthrough research published all year long.

Let’s look at some of the 21st century discoveries that have been rising to new heights in 2018.

Outside The Box

Schizophrenia and Autism Spectrum Disorder
In 2018, the ballooning mental health crisis drove researchers to find more biological causes for these illnesses, and more ways to treat them effectively.

For instance, researchers identified master keys (neat name!) in terms of genetic markers that identify complex disorders like schizophrenia and autism spectrum disorder (ASD).

And after studying the genetic connections, they found that too much of a specific master key: MIR-137, can result in symptoms of schizophrenia … and too little of it can result in symptoms of ASD.

How’s that for a startling connection?

Just knowing this can potentially pave the way for development of treatments for these disorders — using MIR-137, for example.

Better Therapy for PTSD

Since treatment for PTSD has traditionally been burdensome for both therapist and patient, treatments are being sought that are effective but more practical. Research supported by NIMH produced a new psychotherapy approach, called written exposure therapy, or WET.

By writing about the specific traumatic event, patients were found to improve as much in only 5 sessions as they improved in 12 sessions with cognitive processing therapy, or CPT.

5 sessions are better than 12, wouldn’t you say? For patients tormented by severe PTSD symptoms, 5 sessions are far better than 12. Just ask them.

Better Suicide Prevention..?

Since there are 45,000 suicides in the U.S. every year, it’s essential to develop ways to predict and prevent suicide in individuals that don’t rely on that individual telling someone. Because, many of those who succeed in ending their lives never tell anyone, so it behooves us to find more effective ways of predicting … and preventing.

Researchers tackled electronic medical records and found that half of those who commit suicide and 2/3 of those who try but fail, have had a mental health evaluation in the last year.

Using these records, they leverage things like diagnosis, substance abuse, use of mental health emergency treatment and in-patient hospitalizations, self harm, and scores on Patient Health Evaluations, to predict those patients at risk for suicidal intent and death.

By better predicting those most likely to attempt suicide, we hope to provide adequate treatment in time… and help restore the lives of those who have lost hope.

It’s not enough … but it’s just one more way to try to reach and help some people before it’s too late.

Social Media Surprise

We think of social media in the “fun” category, don’t we? Or do we? If you’re like me, you know more people than you want to admit who have sworn off social media. But why? Isn’t it all about the fun? …or is it?

The first study ever to examine the link between social media usage and mental health issues found that there’s an undeniable link between the amount of time you use social media and the intensity of the loneliness you feel.

Or, put another way, if you’re depressed to start with, the less time you spend on social media the less depressed and lonely you’ll feel.

These researchers only included Facebook, Instagram, and Snapchat in the study.

Now… finally…

Ketamine Treatment Continues to Demonstrate Its Prowess

There are so many more breakthroughs and advancements we could talk about that they would fill a book…and it’s just too much for one blog.

But it’s an exciting time in the world of mental health disorders as neuroscience researchers continue to delve into and investigate the causes, mechanisms, treatments, and prevention of these disorders.

Your hope for recovery… and remission… is more warranted than it’s ever been. You really can get better…even well.

During 2018, physicians and researchers have collaborated, exchanged, and built upon the information that’s accumulating to support the rapid and robust antidepressant treatment of more and more disorders.

We’re Learning about Doses

A study published in October 2018, led by Massachusetts General Hospital researchers, tested four ketamine infusion doses against each other to determine the more effective dose.

Their trial tested 0.1mg/kg, 0.2mg/kg, 0.5mg/kg, and 1.0mg/kg of ketamine in a single 40 minute infusion. The results showed that the two smallest doses weren’t very effective at all for depression, but the two largest were.

And that’s the range that we usually use at Innovative Psychiatry. It’s a very small dose…smaller than the dose typically used for anesthesia.

More study is needed, testing these two against some slightly higher doses. And also more testing with these two doses measuring the most effective dose against bipolar disorder, social anxiety, PTSD, OCD, general anxiety, panic attacks, addictions, and eating disorders.

The more we learn, the more we need to know!

And We’re Learning What Doses Halt Suicidal Thinking in Outpatients

I presented my work using ketamine infusions on an outpatient basis with suicidal patients, and reported how quickly it works to halt suicidal thinking, and the doses required in Oxford, England at the First International Conference on Ketamine and Related Compounds and again at KRIYA Conference 2018 in San Francisco.

Ketamine’s Impact on G Proteins Transforms Depression Treatment

Extensive work on ketamine’s antidepressant actions with G proteins shows these actions are independent of the NMDA receptors… and that it relieves depression faster than SSRIs can by quickly sliding the G proteins off the lipid rafts. Plus…and this is a big plus…it also lasts longer than the half life of ketamine itself because the Gs are much slower to return to the rafts.

A November 2018 study demonstrated that removal of G proteins from the lipid rafts was not only rapid…beginning within 15 minutes…but that returning to the lipid rafts was much slower after ketamine treatment than after SSRI’s.

All of this knowledge lights the path to more research as well as customizing personalized treatment for major depression … and soon, for other psychiatric disorders.

Advances in Psychiatry Treatment

Ketamine treatment is quickly becoming more sophisticated. The more we learn, the more effective your treatments will become.

Those naysayers who scoffed in the early years of ketamine development, who said ketamine will never see the light of day, have reason to rethink their stance now about this tide-turning treatment for those afflicted with disorders like major depression or anxiety.

The snowball is rolling down the hill and is quickly becoming gargantuan. It’s exciting to consider…at this rate… the wonders we’ll learn about ketamine and all the other new insights into psychiatric treatment this coming year in 2019.

It just keeps getting better. And more hopeful.

Restoration is Available for You

So before you look forward, take a quick look back. If you face your own daily battle with symptoms of mood disorders. If you have sought treatment for severe depression, bipolar depression, social anxiety, PTSD, OCD, substance use disorder, and even suicidal thinking… and if that treatment hasn’t relieved your symptoms, perhaps you should consider ketamine treatment.

We encourage you or your doctor to contact us and discuss this extraordinary treatment that’s taking psychiatry by storm.

Not for any other reason than the hope of getting you better and getting your life back. Reclaiming your joy, your relationships, your work satisfaction, and overall fulfillment in life.

We love collaborating with your healthcare team to help you reach the best health and wellbeing you possibly can.

Ketamine treatment won’t make you someone you’re not. But it can restore you to the very best version of yourself. A version you may not remember right now, but the one who’s buried inside you underneath the difficult symptoms that can seem to dominate everything.

Ketamine, like any other medicine, isn’t for everyone…but if you’ve suffered without relief from numerous other medicines, it may be just right for you. Ketamine struts its best stuff in those who are the most severely ill.

This treatment has nothing to do with the world of “getting high…” It just works in your brain in interesting ways to get a lot done fast. It works on your mRNA, your BDNF, your lateral habenula, in your synapses and signaling systems, and in your cell walls with the G proteins and lipid rafts. So much happens so fast. And day by day, the symptoms of disorders fade away.

You can be vibrant, creative, motivated, patient, and engaged. You can enjoy the little things again, build your relationships again…put thoughts together and excel again.

Start your New Year 2019 on the path to wellbeing and feeling whole. Call us.

We’re eager to help you find the life you were meant to live without symptoms blocking the way.

To the restoration of your best self in 2019,

Lori Calabrese, M.D.
December 31, 2018
2018 Innovative Psychiatry: Ketamine Developments

What a year it’s been!!

As this busy year creeps toward its end, it’s fun to look back on all we’ve accomplished in our hard work to help find more effective treatment for those who suffer with symptoms that don’t respond to traditional treatment.

Since the early beginnings in my work as a psychiatrist, I’ve been devoted to staying on the leading edge, and to finding solutions for those whose symptoms persist despite their best efforts.

As I’ve added innovative and advanced treatments to my practice to extend our effectiveness. And I’ve discovered that IV ketamine treatment in a series of infusions given closely together, is the most exciting, effective treatment for depression that just won’t lift.

So, we’ve invested time, money, and staff to help us learn more about this treatment for those who need it, and about what it can do.

Interventions and Adjustments

At the beginning of the year, we explored a variety of schedules and extended hours. We’ve continued to adjust them all year. It’s always a moving target as we try to offer an opportunity for everyone to be seen and treated.

Since I began providing ketamine treatment 3 years ago, we’ve been compiling data to learn more about the outcomes with our own patients here, as well as with those who come to us from outside Innovative Psychiatry.

And we’ve consistently been amazed at what we see. But more about that in a bit.

Then, in March, I had the opportunity to attend the International Conference on Ketamine and Related Compounds for Psychiatric Disorders 2018, in Oxford, England.

This conference was the first gathering globally of neuroscience researchers, psychiatrists, and psychopharmacologists specializing in ketamine research for psychiatric use.

This momentous academic gathering explored the rapidly emerging data on the history, development, and use of ketamine, and related compounds in psychiatric treatment — in basic neuroscience, neuroimaging, and clinical studies. How does it work? Why does it work? How can we know? What does neuroimaging tell us about ketamine and the default mode network (DMN)? What’s in the pipeline with esketamine and related compounds? These are some of the questions research has been answering about ketamine. We’re gaining confidence in it as a viable and extremely useful treatment, as opposed to just an experimental treatment that would soon dissipate (as naysayers claimed).

I presented some of my data on treatment of suicidal thinking, and what ketamine can do to erase it in a poster session.

Next, came the first annual American Society of Ketamine Physicians (ASKP) Conference in September, where I saw a number of the same professionals I’d seen in Oxford…again meeting to share insights and experiences with the use of ketamine treatment in psychiatry and in pain management.

Again, we talked about the broad applications of ketamine.  And the openness among us sharing information and insights helped to broaden the horizon for all present regarding what ketamine can do to relieve suffering in our patients.

Suffering that, for far too many, had remained unrelieved before ketamine.

Friendships were building at both of these conferences as we learned from each other, asked questions, and exchanged information. I took notes as fast as I could type. The information was compelling, exciting, and clinically useful.

Then, in November, along came KRIYA Conference 2018. Many of the same medical professionals gathered along with a host of others, and something magical happened.

These celebrated and deeply experienced experts in the field of ketamine treatment for psychiatric disorders left any pretense (they might have justifiably possessed) at the door.

Deep connection happened. And a light bulb turned on.

We took notes voraciously, exchanged ideas generously, talked intensively, asked questions of each other, and utilized every second we were together.

We gathered for coffee before the speakers began. Chatted on the steps. Talked on the way in and out, and everywhere in between. And lingered even after we were ushered from the building at the end of the day … then met at restaurants and continued far into the night.

I presented from the podium this time, and appreciated the enthusiastic response my data received. But I have to say, when it comes to the feats of ketamine, it’s hard to not be excited.

In fact, Raquel Bennett Ph.D., the founder of KRIYA, declared in her opening remarks that we’re witnessing, and are also players in, the birth of a new field: ketamine for psychiatric disorders. And that this time will go down in history as a renaissance of psychiatric treatment.

As the year has progressed, those of us in this new field are collaborating and continually refining and improving our methods of treatment as we probe more deeply into the potential of this extraordinary treatment.

The Birth of a New Field

If you or someone you love suffers from depression that has not responded to treatment, this collection of researchers and doctors understands, and we’re all working tirelessly to find answers for you.

You really aren’t alone.

We’re also watching research for more evidence about new areas of ketamine research to show us more ways to apply it.

At the same time, ketamine’s actions inspire more research into why it’s so effective, and pharmaceutical companies are developing new and related medications with the advances in this frontier.

Ketamine treatment consistently shows a strong response rate for treatment-resistant depression and bipolar depression; plus there is exciting emerging data for those with disorders like OCD, social anxiety, and substance use disorders that haven’t responded to other medications.

2018 Innovative Psychiatry ketamine developments include research opportunities.

We continue to collaborate and follow research to find ways to increase those numbers. To make a rewarding life available to more people.

I’ve been busy behind the scenes reviewing new research for upcoming new treatments– like esketamine, rapastinel infusions, and brexanolone infusions for post-partum depression and the exciting work done by the scientists at Neuro-Rx.

Our Experiences at Innovative Psychiatry with You Provides Useful Aid to Other Patients in Other Practices

My experiences with my patients in the last few years inspired me to respond to a Request of Information from the NIH/NIMH on the use of ketamine for suicidal patients — hopefully to help shape future research directions. And … to write an article that we plan to publish in a scientific journal. More information about this should be coming in the weeks ahead.

As a result of all these new connections, I’ve had the opportunity to collaborate on an international level.

Over the summer, we began exploring how to serve as a potential study site so we could offer patients the opportunity to participate in clinical research trials with new medications — more on that to come.

This would give people an opportunity to get treatment with a new agent long before it’s available to the general public.

Exciting, isn’t it?

As you know, we’re all about educating our patients.

In addition to our Ketamine Blog, we offer The Ketamine Library for our patients. (Who does that? I can tell you, from my trips around the country and into Europe … no one we know.)

Extraordinary efforts at education. It’s one of the things we’re known for.

2018 Innovative Psychiatry

And we’ve also added Instagram to reach more of our readers. We’re getting the word out about new breakthroughs in treatment.

And have you noticed the facelift to our website menu bar?

You’ll notice a new menu along the top emphasizing our Ketamine Blog. (It should really be called the Ketamine and So Many Other New Things Blog –but that didn’t fit very well!) Seriously, we’ve been busy writing all year.

If you haven’t explored the blog much, jump in — we write about everything from science to heartache, from fear to gratitude, from children to aging gracefully, from friendships to loneliness, from narcissism (STILL such a hot topic!) to ketamine wannabees.

And… we also offer advice, recommendations, and insights on the topics that are hard to find anywhere else — from how to screen a ketamine clinic to why your doctor might not yet be offering ketamine treatment. Check it out!

We write about stories, successes and failures.

I look forward to telling you more about all that and about other new initiatives we have planned, coming up in the new year ahead.

This has been such an exciting year in the advancement of better and more effective treatment for our patients. The ground is rumbling with new breakthroughs for 2019.

Enjoy your holiday season as it unfolds, and remember to take a moment to show kindness to those around you. It’s one of the most important things we can do for each another.

Ketamine Inspires Hope

Lots of inspiring news here. The purpose in all we do is to help you get better. And with the hundreds of medicines at our disposal, only about 2/3 of people psychiatrists treat with all those medicines actually improve.

Ask your psychiatrist to help you get better. But if you’ve tried a couple of medications…or even if you’ve tried 30!…and you don’t feel better, ketamine may really help you.

Ketamine treatment is amazing. It can smash depression, relieve social anxiety, dismantle PTSD, break addiction, and erase suicidal thinking within a couple hours. That’s why we’re celebrating the 2018 Innovative Psychiatry ketamine developments that are saving and restoring lives.

Ketamine treatment seems to demonstrate its greatest power with those who are the most ill, who’ve had the least amount of hope.

If this sounds like you, or someone you love, call us.

We are most thrilled by the opportunity to help you get better, really truly better, and to feel well and able to build the life of meaning you’ve always wished for.

To find the motivation and initiative to pursue, and invest in, those things that are important to you. To build relationships that have the depth and longevity to add strength to your life. Basically, to have the energy to live well, rather than endure.

Give yourself your best hope. Call for an appointment to see if ketamine treatment is right for you.

To the release and restoration of your best self,

Lori Calabrese, M.D.

December 18, 2018
BDNF and Microbiome: Your Paved Path to a Fulfilling Life

Strengthen your microbiome, build up your BDNF: Live Better and Enrich Your Relationships

Feel sluggish…like your brain is falling down on the job? “Why did I come into the kitchen?” “Where are my keys?” “I’m so overwhelmed…!” Wishing you had more physical and mental energy… and feel kind of foggy..?

It’s not surprising if you do. It can happen to anyone, but there are things you can do about it.

BDNF Grows Brain Cell Connections

We’ve talked before about BDNF (brain-derived-neurotrophic-factor) and how it works like a rich compost causing brain cells to branch prolifically creating a dense network of connections to move signals around and through the brain.

We talked about how the abundance of signals help you think more clearly and understand with more depth. In turn, you have more neuroplasticity to change your perspective and your outlook to improve your enjoyment of life and the meaning you draw from it.

Did you know there are things you can actually do to increase your BDNF, and in so doing, improve your sleep, your memory, cognition, and outlook?

We’ve talked about the impact stress can have. How it prunes away signaling structures in the brain, wearing down and destroying synapses, and leaves you with a sparse number of connections between brain cells that slows down thinking, creativity, problem-solving, and hope.

Brain Cell Connections Empower Life Connections

Dr. Hannah Critchlow is a Cambridge neuroscientist whose work shows us how we form our own subjective views of the world. She weighed in on the effect of stress on your function as a leader in the workplace which also applies to your role in important relationships in your life, and basically your own well-being, as well.

In a NYT article by David Donaldson April 4, 2018, she made the point that stress “seeps into the brain, and basically starts to damage the dendritic spines — the connections in the brain — so you get a much less connected brain and it becomes much more difficult to think flexibly and creatively.”

She points out that research has shown that working out at the gym or going for a jog can help reduce the effects of stress on the body, and mental and physical activity can reduce the effects of stress on the brain’s functioning.

And…since BDNF is such a huge boost for building synapses — those connections between brain cells — and improves resistance against stress – doing things that increase BDNF is the ticket.

Dr Critchlow says that some people have high levels of BDNF naturally. This certainly helps them with productivity when they’re under stress. But for those who don’t, regular exercise can actually boost their own BDNF levels.

But there’s more.

BDNF and Microbiome: There’s More To It than Exercise

She emphasizes that beyond exercise, engaging in meaningful socialization and getting a full night’s sleep also boost BDNF. Things like going to new places, exploring new environments, exchanging new ideas — both listening and expressing — also give more synapses a jump start.

But here’s the rub. It’s tough to discipline yourself to regular exercise, go to new places, stretch your boundaries, and have stimulating conversations when you’re depressed and lack the energy to do anything. Even if you’re just feeling a bit blue.

So Dr. Critchlow recommends developing an attitude of positivity, to keep those synapses growing.

Her own hack is to maintain a gratitude journal…and she writes down 3 things at the end of every day she’s grateful for. Doing that helps her keep her mind focused to help herself think with more positivity as well as think about how she might pay it forward and help others have more positive days ahead.

It’s also helpful to listen to your own emotions, and use them to try to pick up on key alerts within you… and try to make sense of them. It’s not always easy, but it helps to learn to let them inform our decisions, rather than pulling us down into a dark pit.

Sometimes the alert is about something or someone in our environment, and other times it’s about our own “slightly flawed view of reality.” Either way, it gives us something to work on or make new decisions about how to live better and help others, too.

What Makes BDNF Increase?

So…since you and I want to live better lives, and enjoy richer relationships by deeply engaging in stimulating conversations… and reaching out to show interest in others, how can we increase our BDNF to help us have the energy to want to?

Harvard neuropsychiatrist John Ratey is the author of, Spark, The Revolutionary New Science of Exercise and the Brain. He stresses the importance of exercise for release of BDNF. From his point of view, exercise is more for the brain than the body. (Think about this and how important this might to you!) He says that it turns the power switch in the brain to ON.

But, if exercise isn’t the only way to cultivate the release of BDNF, what else can you do?

Well, one suggestion is to reduce your intake of sugar. Because it so happens that high glucose decreases BDNF release, the neuroplasticity fuel in your brain that helps you learn and change, and stimulates the very ability to learn itself.

Most of us are either trying to lose weight or avoid gaining it. (So we already have a guilt trip in place about our waist size.)

Try this instead of self-reproach:

Reach for a clearer mind, success in your work, and fulfillment in your relationships…. Make your diet decisions in light of your desire to enjoy your friends, your spouse, and your children. And to find work meaningful, to work more effectively with your coworkers, and to enjoy the success that goes with better team building.

No guilt here. Just rewards.

Give Your Pancreas a Break!

Another method is to use short periods of fasting now and again. You can work it into your schedule daily like some do, or just plan it for once a week. For example, if you stop eating at 8pm, then go to bed and sleep from 10pm-6am and put off breakfast til 8am, you’ve given yourself a 12-hour fast and hardly notice it.

A 12-16 hour reprieve like this gives your pancreas some off-duty time and boosts BDNF.

This can increase the resistance to dysfunction and degeneration of those brain cells we talk about so often. The healthier and more resilient your brain cells are, the more resilient you are.

There have been a number of studies focused on what happens to BDNF following intense exercise. One example involved a 3 minute sprint, followed by 2 minutes of rest, then another 3 minute sprint.

Participants enjoyed a 20% increase in their learning ability immediately afterwards.

You can, too.

Rich Socialization = Higher BDNF

Did you know that children who grow up in a highly stimulating and engaging social environment display less anxiety and higher levels of BDNF? In addition, they develop better social behavior in adulthood as a result.

You can probably think of someone this describes.

Children involved in team sports with social activities that occur around their team are an example that comes to mind. The exercise, the sense of accomplishment, and the great times with their friends increases their BDNF — and their synapses — and their sense of well-being.

But, this need for rich social interactions — and their benefits! — applies to all of us, even the introverts. Rich socialization is about the quality, more than the quantity, of your relationships. And as long as there is quality engagement with people you enjoy stimulating your emotions and your mental performance, BDNF increases.

The Benefit of Supplements

Supplements can boost BDNF, too, and including them in your diet or supplement regimen can play an important role in your sense of well-being, emotional balance, and bright outlook.

Krill oil, for instance, increases the omega-3 levels in your body, and one of the omega-3 fatty acids can help increase BDNF.

Resveratrol is found in dark grapes and red wine. It can also help increase BDNF, as can components found in green tea.

And, curcumin can increase BDNF, so it’s not surprising that it’s being studied for its antidepressant as well as anti-inflammatory benefits. We’re learning that it may help prevent cognitive decline as you age.

BDNF and the Microbiome

Add to those nutrients a regular dose of broad-spectrum multi-strain probiotics to strengthen your microbiome and your gut-brain axis, and you have the set-up to greatly improve your brain’s ability to produce and release BDNF, your sense of wellbeing, and your fulfillment in important relationships.

When diet is not enough…

But what if you do all these things — really do them –and still don’t feel well? In that case, you may need treatment to gain enough function so you can improve your outlook.

And if you’ve suffered with depressive symptoms for months or years and no doctor has been able to help you feel better, you may need a different type of treatment than pills.

Some people need something novel…more advanced than pills.

Consider ketamine.

Ketamine treatment is a series of IV infusions that can turbo boost your BDNF to stimulate dense branching and new connections between the neurons in your brain. Its actions are so rapid, so robust, that you can begin to feel improvement within a couple of hours.

At Innovative Psychiatry, we’re witness to the transformation people experience with this extraordinary and effective medicine. Daily.

If you suffer with little to no improvement and need a real solution that can help you enjoy a rewarding life and fulfilling relationships, call us.

We can help you find the you that seems lost and forgotten. The you that has ached for a chance to live … and love.

Reach out and give yourself the chance to enjoy. To love. And to be productive.

We’re in your corner. And we want to help you live the life you long for.

To the igniting of your very best self,

Lori Calabrese, M.D.

December 11, 2018
NYT asks: Can We Stop Suicides? Here’s Our Response

An article published this past Friday, Nov. 30, 2018, in the New York Times Opinion section, asks about a possible remedy for suicidal thinking. Well researched, but not quite well enough. Keep reading…

Author Moises Velasquez-Manoff explored the notion that maybe…just maybe…we can quell the epidemic rate of suicide. He points out that the suicide rate keeps rising, and according to the Centers for Disease Control and Prevention, suicide is now the 10th leading cause of death. After nearly two decades of growing statistics, suicide seems to be higher than it’s ever been.

Tragically, medicines to quell that tide have not kept up with the death statistics and doctors have been increasingly helpless to save a life in time.

Until now. As research and clinical use of ketamine has increased, thousands of suicidal patients have been saved, giving them time to participate in therapy and other treatments so they can heal and rebuild fulfilling lives.

Best Mainstream Article on Ketamine to Date

Kudos to Mr. Velasquez-Manoff for his thorough research about ketamine and its effectiveness in treating suicide. All too often, articles in national publications provide a narrow, myopic view of ketamine and what it can do.

These articles have sometimes misrepresented the potential of this medicine because of a lack of thorough research. While there’s more to the story, which we’ll talk about, there’s lots of good information here for you to read and pass on to your friends and family.

So…Can We Stop Suicide?

Let’s take a stroll through this NYT article, and talk about the truths and the half truths in the quest for what matters.

NYT: Using ketamine to treat depression and suicidality is somewhat controversial. Numerous small studies suggest that it holds great promise, but it’s only now being tested in placebo-controlled trials with hundreds of patients.

Dr. Calabrese: It’s true that it’s been controversial. Like with many controversies, those who make the effort to find and read the research results for themselves quickly understand the value and significance of this drug. Too many listen to hearsay and scuttlebutt and form erroneous opinions…

“Ketamine will never get approved for this,” or “There are too many dangers with ketamine,” they say …. cautious? skeptical? negative Nellies?

We hear their voices loud and long. But clearly, in real-world psychiatry, this is a medication that is revolutionizing outpatient practice.

In all fairness, there is plenty we don’t — and can’t — know. Not yet. IV ketamine treating for treatment-resistant depression (TRD) — and other psychiatric disorders — has only been in moderately wide use for a few years. And it will be years before we really know the long-term consequences of single and repeat infusions, even with these tiny doses. Of course. That’s what long-term means.

And we want to know long-term physiologic effects from low-dose repeated ketamine infusions or maintenance treatment — on the bladder, particularly.

What about long-term impact on quality of life? Let’s talk about that. Since ketamine infusions for TRD use a much, much smaller dose than is ever used in anesthesia, and since we have 50 years of surgeries to go on, it seems pretty unlikely that a short sequence of a few tiny doses of ketamine will have any more negative impact on an individual’s quality of life than their severe treatment-resistant depression did.

What we hear — and what my colleagues around the country hear –is that ketamine treatment can be transformative.

At the same time, the idea that it’s only now being tested in placebo-controlled trials is only true if the author is referring to this decade. Early trials at the beginning of this century were purely investigative to see what ketamine could do.

We’ve said all along, ketamine isn’t for everyone.

Still, its effectiveness is extraordinary especially for those who are most severely ill, and at highest risk for suicide.

In the last few years, trials that were launched even earlier have finally gotten published. It takes time to conceptualize a study, and get it approved by the ethics committees and reviews boards that do these things. Then to recruit exactly the right patients if you’re a major academic center, collect, and analyze the data… we’re talking about a lot of time.

But even with that said, placebo-controlled trials have flourished in the last few years, as witnessed at the International Conference on Ketamine and Other Compounds for Psychiatric Disorders 2018, where researchers came from across the globe to present their findings. And more roll off the presses each month.

NYT: Now, scientists think that they may have found one — an old anesthetic called ketamine that, at low doses, can halt suicidal thoughts almost immediately.

Dr. Calabrese: Yes! Isn’t that great news? In the last 50 years, there has been nothing that could stop suicidal thinking in 4 hours or less — sometimes within the first hour.

And the beauty is that IV ketamine treatment doesn’t just make the suicidal thoughts easier to bear, it erases them.

I wish it happened this way with every patient, but we still haven’t found a medicine that works the same way on everyone. Even so, psychiatry has never seen a medicine do this so quickly, so clearly, and so effectively in so many patients.

NYT: After her suicide attempt, Louise’s psychiatrist suggested she try ketamine. She agreed, and received an infusion intravenously. Within hours, her sense of well-being improved. The hospital discharged her. Back home, she discovered that going to the market was no longer a “herculean task.” Getting her car washed wasn’t an insurmountable chore. “Life was better,” she said. “Life was doable.”

Dr. Calabrese: I love that the author included Louise’s story. Her description is characteristic of the descriptions I hear from my patients after ketamine treatment begins to take hold. And note that her response was hours after one infusion, not a series. Then the hospital discharged her.

A single ketamine infusion can provide a wonderful respite from the heavy lead blanket that is depression, the emptiness and vacancy of feeling, the darkness and despondency…for a few days, or a week, or maybe even 2 weeks.

But we know that one infusion fades. Pretty much everybody knows that.

If your doctor provides you with only one ketamine infusion, it’s almost cruel…it whets your appetite for how life could be…only for it to be snatched away again in a week or two.

This is the reason “ketamine treatment” has come to mean a series of IV infusions at tiny doses over 2-3 weeks. It’s the repetition of infusions close together that seems to stack the benefits and overcome the temporary nature of a single infusion.

What we’re feverishly all working to find out is: exactly how many infusions? 6? 8? Should the dose be based on real body weight or ideal body weight? Some ask if it should be based on body weight at all or just fixed like they’re doing with esketamine. Should the series be all one dose? or should the dose increase? how fast and how high? is there a best dose?

Research has not answered these questions yet.

In our practice, we are sticklers for data, and we collect (and are about to publish) our outcomes. We’ve already presented them at conferences in Europe and in the U.S.

Here’s a clinical pearl: dose titration is important, and many physicians and nurses don’t titrate the dose to achieve the best response.

This practice is often the cause for patients to believe ketamine doesn’t work for them. Not in every case, but far too often.

Seek out a psychiatrist who is up-to-date.

There seems to be so much misinformation circulating, and disappointed patients could possibly avoid disappointment if they — and their doctors — had access to more up-to-date information. Doctors only know the up-to-date information if they take the time to search it out.

NYT: The drug seems to address a longstanding problem in emergency psychiatry. Sedation and physical restraint aside, doctors have few ways to quickly stop suicidal ideation, or thoughts of killing oneself. The current crop of anti-depressants can take weeks and sometimes months to work, if they work at all. They may also, paradoxically, increase suicidality in some patients. Talk therapy takes time to help as well (assuming it does).

Dr. Calabrese: This is a paradox to be sure. The antidepressants prescribed to treat depression can sometimes actually increase suicidal thoughts and actions as a side effect in some people. Confusing and discouraging if you’re suffering without solutions. And they’re slow to work. Even lithium and clozapine — clear anti-suicide champions — are slow to work.

Imagine what rapid relief would feel like. Quick relief from suicidal thoughts — whether you’re an adult or an adolescent or even a child — can give you time to do the work to scaffold things into your everyday life that can keep you well.

One infusion can give you relief. Several can cement remission. Not for just hours or a day or a few weeks or a month. For many patients, remission gives them the time and space to make changes that keep their symptoms at bay.

Imagine that instead of sitting in an ER or on an inpatient unit somewhere.

NYT: Dr. Michael Grunebaum, a Columbia psychiatrist who studies ketamine, thinks the drug should no longer be relegated to a last-line treatment. “It makes sense that it move up in the treatment algorithm in E.R.s and inpatient units,” he told me. (Although if emergency rooms everywhere began offering ketamine, it could create new problems, he adds. As has occurred with opioids, people might claim to be suicidal when, in reality, they’re trying to get high.)

Dr. Calabrese: There’s an important point we need to make here. When a psychiatrist provides ketamine in the safest, most therapeutic way, the psychiatrist manages the dose and rate and the therapeutic experience so that the biological changes that ketamine induces — dendritic branching and synaptic proliferation — can be optimized. One of the indicators of this during the infusion is the degree of dissociation. With an infusion (as opposed to IM or intranasal or oral use), this can be very carefully controlled. And the responsibility for controlling the access, and the infusion experience lies with the doctor. This is not about getting high.

Because people have used ketamine abusively in clubs and on the street, the massive doses they use in those settings — and repeat far too often — can provoke frightening hallucinations. Some people crave that, and use more and more.

If you use ketamine on the street you may think you “get” ketamine treatment…what it’s like… and that it’s likely all about the “trip.” But, that’s a street culture thing. That’s not the science of medicine that heals depression and anxiety and erases suicidal thoughts.

But when psychiatrists provide this medicine with skill and deep expertise, titrating the dose and the number of infusions, working synergistically with the rest of the patient’s medications and clinicians, it’s neither dangerous nor addictive.

The goal is remission, not ketamine ad infinitum.

When a patient needs a new dose every month, ad infinitum, that patient likely didn’t achieve remission in the first place.

We want remission for you. We want you to get better, get going, and give back.

All in all, we loved Moises Velasquez-Manoff’s article. And glad we’ve had this opportunity to set the record straight.

It’s refreshing to read a journalistic article about ketamine treatment for mood disorders that’s as close to accurate as this one.

The question was, “Can we stop suicide?” And the answer is a resounding YES, most of the time, if you let us know you need the help.

It’s wonderful when journalists help spread the word about novel and advanced treatments that relieve severe symptoms like suicidal thinking. The goal is to find relief and remission from the suffering. And new hope that you take with you into your future.

At Innovative Psychiatry we see patients every week who experience renewed joy, purpose in life, creativity, motivation, and initiative after a full course of ketamine treatment. And those who have the best results are often the ones who had the most severe symptoms.

Even if no other medicine or treatment has helped you before, even if your doctor told you there was nothing more they could do to help you, even if you’ve been sick for decades, you are not hopeless.

So take hope.

So many people with a story like yours have gotten better with ketamine treatment.

If you have lost hope, call us.

Find out what it’s like to feel alive, hopeful, and able to to build a new life. Chances are we can help you live again… and enjoy the little things in life like you haven’t in what may seem like a lifetime.

We want to help you get well.

December 3, 2018
Fuel Hope With Gratefulness All Year Round

Surprising Results Can Follow Counterintuitive Choices

Thank you.

Such sweet words.

Here in the US, we’re just ending a four-day celebration we call Thanksgiving weekend. True, the official day for Thanksgiving is the fourth Thursday of November each year — but it’s also true that most families spend the entire four day weekend continuing to celebrate, spend time together, and enjoy this holiday set aside for gratefulness.

Plus, you probably know that “the holidays,” starting with Thanksgiving and lasting through New Year’s Day, is a difficult time for some people. Yet many others actually enjoy all the festivities, sharing, eating, and laughing that goes with good times together.

Whether you’re a celebrator or an abstainer from these gatherings, there are some things we can talk about to improve these days for the grievers, and improve sensitivity for the revelers.

Thanksgiving was first conceived by the Pilgrims after their original successful harvest in the New World.

That doesn’t mean it was their first harvest, but rather the first time it was successful and there was food to eat. There’s nothing like starvation to inspire gratitude for food.

They called it their harvest festival.

George Washington made a proclamation that Thanksgiving should be celebrated in 1789, and it was sporadically celebrated. However, Thomas Jefferson chose not to celebrate the observance, so the day of gratefulness tended to be hit and miss until 1863.

In the midst of the Civil war, Abraham Lincoln declared Thanksgiving be observed as a federal holiday on the fourth Thursday of November … and that has continued to this day.

It might strike you as odd that President Lincoln started a federal holiday observation when the country was at war with itself, when families were torn apart by sons, fathers, and grandfathers marching off to to battle…

Homes and farms were burned. Families were seeing more funerals than birthdays.

Does that sound like a time to be thankful…?

Can you imagine the uproar?

“Have you heard what he’s done now??? He’s declared thankfulness as a national holiday, of all things!!”

“I’m not surprised…after all, seeing as how we do have SO MUCH to be thankful for right now… I’m so sick of this war and this administration! I’ve lost my farm! How will I feed my family?!!

…and on and on it might have gone.

Doesn’t sound all that different from what we hear today, does it?

Counterintuitive Declaration in the Middle of the Chaos

Is it possible he had a higher purpose than just creating confusion in the midst of the terrible war?

We do know that he had an abiding faith. He seemed to understand that choosing thankfulness can inspire better decisions and better outcomes. Thinking of others inspires generosity…and his nation needed generous hearts from top to bottom if it were to heal.

Some of the most liberating principles of life have been around for hundreds of years and dozens of generations. And sometimes they’re hard to grasp because they’re locked in counterintuitive thinking.

Oprah Winfrey put it this way:

“Be thankful for what you have; you’ll end up having more. If you concentrate on what you don’t have, you will never, ever have enough.” — Oprah Winfrey

And therein lies the secret. The secret of justice and unity that President Lincoln reached for, the secret of poverty vs. abundance that Oprah warned about, the benefit that we all receive when we take the time to focus on everything and everyone in our life that’s good.

The Secret of Gratefulness.

“At times our own light goes out and is rekindled by a spark from another person. Each of us has cause to think with deep gratitude of those who have lighted the flame within us.” –Albert Schweitzer

Albert Schweitzer may not be a familiar name to anyone under the age of 50. But, he won a Nobel Peace Prize in 1952 for his extensive work in Africa in an area now known as Gabon, near the Republic of the Congo.

He had studied extensively in theology and medicine, and as a newlywed set out with his bride to live in this place where sickness and suffering were crushing the people. Over the course of his life he built an enormous hospital complex to treat the thousands who came to him for help.

He wasn’t perfect — and even embraced perspectives that would offend us now in our modern culture — but he gave what he had from who he was and helped make life better for thousands.

It’s no mystery why he might have felt his “light go out” from time to time. His work was demanding and unrelenting in a place where hardships abounded.

But he understood gratitude.

Do you ever feel as though your light is going out…and you need it rekindled? Me, too. In fact, most of us can say that words of encouragement spoken at the right time can help to turn us around.

Beloved 20th Century Actress Doris Day has seen it all. She knows the value in that counterintuitive assertion of gratefulness. In her own words:

“Gratitude is riches. Complaint is poverty.”

On her way to becoming a dance star, her car collided with a train. Her injuries took a serious toll that permanently ended her dancing career. But, rather than give up, she turned to singing under the training of a voice coach. She soon made movies that were wildly popular in the mid 1900’s … and her fans assumed her life was perfect.

But behind the sweetheart-girl-next-door image she presented to the public… was a victim of domestic abuse, a history of 4 marriages, the widow of the only man she loved, loss of her fortune, and complete exhaustion.

But she, too, understands gratitude in the face of adversity.

As humans we may envy what another has that we don’t. Wealth, charm, health, fame…but focusing on what we don’t have does nothing to improve our situation.

Turning a laser beam of attention on our envy of another person only fuels a raging fire of jealousy inside us. And we grow more bitter and focused inward. It isolates us and doesn’t improve anything.

On the other hand, being grateful for the gifts, the benefits, the talents we do have, empowers us to make those gift, talents, and benefits bigger, brighter, and more abundant.

Helen Keller said that she cried that she had no shoes, until she met a man who had no feet.

Helen Keller, if you’re not familiar with her, was blind, deaf, and mute… so you can see her metaphor about the lack of shoes…

“Necessity is the mother of invention,” they say. So her gratitude for having feet led her to find ways to serve mankind, and especially others who were blind, deaf, or mute… or all three.

Miss Keller knew there was no place in her life for self pity.

She came to understand gratitude at a young age.

During World War II, as able-bodied men went to war, and women and children were left behind, women who’d never considered such a thing went to work for wages. It was a time of hardship. But, rather than complain, these women put on their work shoes and headed for the factories.

Many of us had grandmothers and great grandmothers who worked in the factories to make bombs, aircraft, trucks, and other tools needed to fight the war.

Is it any wonder that gratefulness and the can-do attitude that was required to rise above those difficulties led to a song in the last year of the war that strengthened that frame of mind? :

You have to accentuate the positive,

Eliminate the negative,

And latch on to the affirmative,

But don’t mess with Mr. In-Between.

Comical? Maybe so…but you get the message.

Like we saw with the man with no shoes, there is always something to be grateful for. And gratitude has a way of propelling you above the circumstances you wish would change, so you can see the bigger picture.

Gratefulness transforms your perspective.

And when that happens, you’re no longer a victim, but rather on top of your circumstances. The circumstance may not change the way you want it to, but your improved outlook can give you power over it.

No one is without flaws, and no one’s life is perfect. But each of us can contribute to the lives of others in some way, and in the process gain the freedom to overcome our own struggles on some level.

Psychiatric disorders can render you emotionally paralyzed… trapped inside inertia, fatigue, and despair. And as you know, there are other types of paralysis. If you’ve experienced this, you may be able to relate to Jon Morrow.

Jon Morrow is a wildly successful blogger whose body is paralyzed by Spinal Muscular Dystrophy. He can move nothing except his eyes and lips. Helpless? Well, he was for awhile. But he has pushed through from a point of inertia and despair to doing what he could do…until he learned to drive traffic to his blogs and has achieved the status of the most widely read blogger in the world.

He has generated more than 200 million views of his blogs and earned $50 million as a result.

A spoiled rich kid? Not in the least. This guy was facing the end of his life because of his need for healthcare, and no money to pay for it. His story is hugely inspiring. If he can accomplish his dreams…anyone can.

And Jon understands gratefulness.

Look for his blog Unstoppable.me. It will give you a shot in the arm to choose and express gratefulness and overcome adversity.

Gratefulness is liberating, empowering, and humbling… all at the same time.

So now that the Thanksgiving 2018 holiday weekend is behind us…let’s not lose sight of the lessons we’ve learned together as we venture through the rest of the winter holiday season and into the new fledgling year 2019.

With gratefulness you can turn on the light in someone in your world, and illuminate your own heart at the same time.

Still, if you’re suffering under the weight of a psychiatric disorder that hasn’t yielded to any medicine you and your doctor have tried, there is something more you can do as you focus on gratitude in your life.

Ketamine treatment is a series of IV infusions that have demonstrated in thousands of cases an extraordinary capacity for relieving depression and anxiety in the vast majority of those who have not been helped by anything else.

From severe treatment-resistant depression, bipolar depression, and suicidal thinking, to social anxiety, PTSD, OCD, and addictions, ketamine has the remarkable ability to rebuild signaling structures and systems along with regulating a wide variety of puzzle pieces in the brain that make up the sense of wellbeing, joy, motivation, and initiative you long for.

At Innovative Psychiatry, we’re big believers in joy. Happiness. And gratitude. We offer help and we offer hope — with new treatments that can turn things around for you.

Call us. We want you to experience relief and the ability to build a rewarding life you enjoy… and to revive and renew the relationships in your life that are important to you.

With gratitude for the opportunity to share my thoughts with you this year, I want to wish you a warm and heartfelt joyous season of holidays.

To the renewal of your best self,

Lori Calabrese, M.D.

November 26, 2018
Ketamine KRIYA Conference 2018

KRIYA!!

The most phenomenal ketamine conference to date!

Last weekend I attended and presented at the ketamine KRIYA Conference 2018 in San Francisco. This conference emerged as the most dynamic gathering of front-line ketamine practitioners I’ve ever experienced.

And what an event!

The ketamine KRIYA Conference 2018 was extraordinarily different than any other research or clinical conference I’ve attended. It’s clear that the realm of ketamine treatment for psychiatric disorders is growing wider and deeper.

There was a true spirit of inquiry, extraordinarily open collaboration, and presentations of risks, failures, and triumphs. Sheer transparency. Openly exposed vulnerabilities. A clear admission of the limitations of what we know. The latest information about clinical uses of ketamine in psychiatry.

The insider news.

What happened when Raquel put all of it — and all of us — together?

Palpable energy instantly exploded!

During the presentations — which were riveting. As we met for coffee. Chatted on the beautiful conference grounds, sprawled out over the steps, snugged down into comfy couches, talked over creative and inventive lunches, inhaled coffee (for some of us, all throughout the day!) — there was the sense that we needed to learn from each other as fast as we could. So … we shared Ubers and Lyfts and dinner tabs.

We came from all over the country … and from as far away as Russia.

We’re serious about this.

And what a weekend! We learned so much from each speaker and each other. We talked about our data, our practices, our experiences, what we’ve learned. What we still don’t know.

Soooo many different backgrounds, so many different approaches providing patient care, so much desire to reduce suffering in our patients.

Founded by Raquel Bennett, Ph.D., KRIYA is the Ketamine Research Institute and it is devoted to understanding the use of therapeutic ketamine in psychiatry and psychotherapy.

I must give a shout out to Raquel Bennett.

In such a few short years, she single-handedly founded, organized and grew KRIYA, an organization devoted to helping people heal and live fuller lives through safe, legal, and effective ketamine treatment. She is originator of the first international ketamine conference — KRIYA’s first conference, in 2015 — on the therapeutic use of ketamine.

Raquel has earned our respect, appreciation, and applause for the enormously hard work of bringing together experts who work with therapeutic ketamine in very different ways, using different routes, for different therapeutic purposes, in all aspects of psychiatry and psychotherapy, as well as in chronic pain and hospice.

Ketamine is a visionary medicine.

But Raquel Bennett, Ph.D, is a visionary.

Fantastic speakers, wonderful food, and gorgeous (read: non-hotel) settings gave all of us opportunities to pick the brain of someone nearby. We shared, we ate, we discussed, we listened. And at the end, we kept talking until they put away the chairs, and turned out the lights … until we each left for the airport. And then checked in and kept going.

Meet me in Terminal 2. I’m at Starbucks. Find us in the International Terminal. We’re sitting in the food court.

Until one by one, each had to break away to catch a plane.

… You haven’t seen anything til you’ve seen the excitement that comes from connection.

Many thanks to Raquel and her incredibly talented, organized and generous team for making this all possible.

Raquel Bennet, Psy.D.

Though our backgrounds are different, and our methods varied, it was clear that we share the same passion: to help reduce suffering from psychiatric symptoms and physical pain.

Next, let me say, I can’t possibly share it all with you here — there were 30 different speakers over 2 days, fascinating and varied discussion panels, and a lively sharing of experiences and ideas that kept us on our toes till the wee hours.

This conference was thrilling.

Thrilling.

I attended KRIYA last year. But there has been so much growth, so much more research, so many new frontiers since then … that this gathering really can’t compare.

These 30 speakers ran the full gamut of experience with using therapeutic ketamine in psychiatry — different practice settings, different studies, varied doses, varied routes of administration, varied preparation. Varied goals.

This was no room for small or closed minds.

We ALL learned and grew during those two days.

Raquel Bennett opened to set the stage for this smorgasbord of ideas.

She said, “We are witnessing the birth of a new field.” She spoke about how ketamine was developed for anesthesiology and has served that field well. But the therapeutic use of ketamine has birthed a new field of ketamine in psychiatry.

And she emphasized that the two are as different as apples and toast.

One way they’re different is in the goals of treatment. For anesthesiologists, ketamine has been used for managing consciousness or sedation and addressing physical pain. In psychiatry, the goal of treatment is all about treating psychiatric symptoms and managing psychiatric distress.

The second difference is in training and areas of expertise, diagnostic skills, and managing emergencies, and she described the differences between anesthesiologists and psychiatrists. Anesthesiologists are best at managing surgical emergencies, interventional pain procedures and life support. But psychiatrists are experts in diagnosing psychiatric conditions and managing psychiatrist emergencies.

The third difference is in the type of patient who presents for treatment. In psychiatry, our patients need a lot of contact, a high degree of emotional safety, and a great deal of emotional support and reassurance. Things we’re deeply attuned to by our psychiatric training.

She also talked about the differences in routes of administration as well as the dose used for each type of patient to reach the individual goals of sedation vs. relief of psychiatric symptoms.

Add to that the amount of preparation required in each field. An anesthesiologist can walk into the surgical area, say hello to his patient, and tell him to count backwards from 12.

However, psychiatrists and psychologists offering ketamine treatment invest in substantial and detailed preparation of the patient before beginning ketamine treatment — to prepare for the treatment itself, the treatment experience, and how to metabolize or make sense of the treatment experience.

And the preparation involves not only a thorough history of symptoms, treatment course, previous medication and treatment failures, but also a thorough developmental and social history.

Our education and training centers on entering into an ongoing therapeutic relationship with our patients and the critical understanding and provision of a safe, therapeutic frame to do the deep work we do.

These two fields are two different animals.

Dr. Bennet encouraged everyone to learn from everyone else, in effect, to “cross pollinate” these fields and help each other to improve in clinical practice.

Then she described the use of ketamine in psychotherapy as a “lubricant” for psychotherapeutic work.

Several of the speakers described this method in their practices. This is called ketamine-assisted psychotherapy, or ketamine-facilitated psychotherapy.

And she went a step further, to describe the use of therapeutic ketamine in psychotherapy as a tool for deep spiritual exploration. This is where the goal of treatment is not symptom relief per se, but personal growth, self-knowledge, or transcendent exploration.

All in all, she encouraged matching the treatment to the individual patient, recognizing our responsibility to learn more about varied strategies and to share our findings within our field.

Speakers were diverse and fascinating. If you’ve been keeping up with progress in the field of psychiatric ketamine treatment, some of these names are sure to jump out at you:

Will Van Derveer, M.D., Wesley Rylan, M.D., Scott Shannon, M.D., Michael Stanger, M.D., Jeffrey Becker, M.D., Jason Wallach, Ph.D., Dan Engle, M.D., Lori Calabrese, M.D., John Krystal, M.D., Phil Wolfson, M.D., Jeff Guss, M.D., Elias Dakwar, M.D., George Greer, M.D., Evgeny Krupitsky, M.D., Patrick Sullivan, D.O., and Jennifer Winegarden, D.O.

And we had some lively and fascinating panelists, including Gary Bravo, M.D., Alison McInnes, M.D., Steven Levine, M.D., Steve Best, M.D., Veronica Gold, M.F.T., Greg Wells, Ph.D., Bob Grant, M.D., Genesee Herzberg, Psy.D., Jessica Katzman, Psy.D., Jennifer Dore, M.D., Julie Megler, P.N.P., Steven Levine, M.D., Steve Best, M.D., Sandhya Prashad, M.D., Steve Mandel, M.D., and me.

Oh yes, I mentioned I also presented my own data, and am excited to tell you more about that…

But… that will have to wait for another day … Without question, our fledgling new psychiatric field has turned a corner.

Ketamine KRIYA Conference 2018.

We’ll never forget this one. We can only hope they keep getting better…if that’s possible.

As exciting as this wealth of information may be, if you’re suffering from depression, bipolar depression, PTSD, OCD, social anxiety, substance use disorders…and even suicidal thinking, don’t wait. Call us.

Thankfully, if your symptoms are mild, there are a host of antidepressants and other medicines and treatments that can hopefully help you.

Ketamine is at its best for those who are severely suffering.

If you’re deeply affected by severe symptoms of depression and anxiety, we can help. Call and arrange an appointment.

Ketamine isn’t for everyone. Of course not. It doesn’t help everyone. But even among those who aren’t helped initially… sometimes there are those who get a delayed response and in a few months reach remission quite by surprise.

And even though we can’t promise everyone they’ll reach remission, the truth is that a very large percentage do.

As we’ve said before, ketamine is the most rapid and effective treatment for depression that we’ve seen in our lifetime … and really … ever.

We’re constantly learning ways to help more people benefit and get better. And chances are…you’ll experience the most remarkable transformation you could have imagined.

Our Results

At Innovative Psychiatry, we see people with these symptoms and disorders get better every week with ketamine treatment. Our results are extraordinary, and our remission rate is very high. Call for an appointment and let’s talk.

Ketamine works in some different areas of the brain in different ways than traditional medicines you might have tried that didn’t work for you. Your life really can improve dramatically.

Find out what this remarkable treatment can do for you.

November 12, 2018
Bipolar Disorder and Hypersexuality: Symptom or Excuse?

Most misunderstood symptom of bipolar disorder that divides families, shames sufferers, and hurts those who love them… BEGS to be treated before damage is done.

It was 1am. Deftly, he slid the window open and quietly climbed into the room. In a moment his clothes were off and he was under the covers. 14-year-old Jillian whispered, “What took you so long?”

Bernie, who was 15, whispered, “My parents took forever to go to bed. I’m so glad you’re still awake, and so glad you didn’t scream when I opened the window!”

“Bernie, you should go home. What if my parents check on me..?”

“Don’t worry, Jillz. They’ll never know I’m here. Everything’s ok.”

Then, he moved above her in the dark, and began to kiss her…

Shocking, even horrifying for parents. But when a teenager has bipolar disorder, parental structure and rules aren’t enough to dampen overwhelming urges.

And sadly, the teenager begins to develop a reputation for making trouble before he even knows who he is.

Emotionally charged…? You bet.

Damaging labels? Oh yes.

Challenging for parents to respond productively? More than words can say…

But an early teenager usually doesn’t have the mental/emotional equipment, no matter how balanced he may be, to manage such compelling, overwhelming impulses and urges.

You try it with the same circumstances.

Add to that a disordered early teenager smack in the middle of puberty who also is suffering from bipolar disorder where the upswings presents with hypersexuality…?

And sadly, sometimes these kids who don’t know how to handle the urges can’t imagine having the forethought of contraception… and somebody is likely to get pregnant. Disaster compounds upon crisis, critical illness, and parents are hit with it all at once.

Then, think about this scenario…

Is It Betrayal…? Or a Symptom??

Dahlia was diagnosed with bipolar disorder when she was 12… and she’d had quite a few episodes of mania over the years. Now she was nearly 30, and had been married for years.

As the pits and darkness…the isolation and emptiness…of depression began to dissipate, and she was beginning to see the light of day again…she noticed something new rising up. At first she thought it was just the relief of feeling better…but as it slowly grew in intensity she couldn’t ignore it anymore.

Arousal.

For awhile, she and her husband were having delightful “private times” together. It was the best bedroom fun they’d ever had. She felt on top of the world. And she felt more and more charming, more clever. She laughed easily, chattered with sparkle…and she began to think she must be the most entertaining person in the world.

But as her twinkle and charm ballooned, so did her capacity for arousal. And her efforts to satiate her desire just weren’t enough. Not in the bedroom, not with her husband…whom she loved with all her heart…not as the “belle of the ball” when entertaining at home or at the holiday cocktail party at her work.

It wasn’t long before she was aroused at work, during lunch, in meetings with co-workers… Not knowing what to do about it, she’d excuse herself and go to the restroom.

Finally late one night while her husband was asleep…she found one of those “hookup” websites she’d heard about and signed up. Wild, right? Within minutes…someone contacted her.

She never intended to act on it. And never intended to be unfaithful to her sweet and supportive husband. She had reached the point that her ears were ringing from the constant arousal…and she reached out to find release…relief.

And hated herself immediately.

Her husband was devastated. So were her friends. So she called her psychiatrist who adjusted her medications to help bring her back into balance. Then professional counseling, with her heartbroken husband, to help them heal and put boundaries and safe guards in place to ward off the triggers.

Think This Sounds Like an Excuse for Bad Behavior?

So many behaviors of people with bipolar disorder seem like poor self-control. Which it is…and that’s the point.

We don’t judge a person who has no legs for not walking. A person with severe bipolar disorder is missing his self-control, his judgment, and his ability to weigh consequences as if he was missing his “legs.”

So, let’s start by acknowledging yes, this condition can be emotionally-charged for loved ones.

Hypersexuality…sounds rather scientific…doesn’t it..? If you didn’t know better, you might think it was caused by a virus…like diarrhea or rhinitis might be… But if you heard this condition was afflicting your spouse or child, the SEX part of it would probably catch your attention pretty quick!

And yes…symptoms can also result in betrayal.

But there’s a difference between virus symptoms and bipolar disorder symptoms… when someone with bipolar disorder acts on hypersexuality, people can get hurt, disasters can happen, friendships can be broken, and marriages betrayed.

How can a symptom hurt anyone besides the person who’s ill?

Because hypersexuality usually involves someone else…or multiple “someone elses.”

Hypersexuality is when someone has an intensely increased, overwhelmingly strong, desire for sex.

And in bipolar disorder, it can accompany mania. It’s not a part of that person’s character. It’s caused by the disorder in their brain.

Here’s another definition: Any compulsive sexual behavior that interferes with normal living and causes severe stress on the family, friends, loved ones, and one’s work environment.

You might say, well why didn’t he/she resist the urges?

Try this: Picture yourself inhaling a bowl of black pepper through your nose.. Now…don’t sneeze.

Like with a sneeze, it’s difficult to resist an overwhelming urge.

What causes hypersexuality in people who suffer from bipolar disorder?

In a review of the literature published in Cureus in Oct 2015, Kenneth Blum and his team wrote that the nucleus accumbens (located within the ventral striatum, not far from the amygdala) controls behaviors evoked by incentive stimuli.

More simply, when you do something knowing there’ll be a reward for it, this structure mandates your behavior. So think of things like eating, drinking, and sex.

They make the point that an imperative rule of positive reinforcement is that the response increases in magnitude and strength if it’s followed by reward.

So whatever you do that gives you a sexual reward, you’re likely to do more often and with more intensity to get more reward.

For someone who suffers from severe bipolar disorder with hypersexuality, the sexual reward is worth seeking with massive passion. And when you take into account the impulsivity that goes with bipolar disorder, considering consequences in advance of action is just too big an order.

In her article in EverydayHealth on hypersexuality and bipolar disorder, Diana Rodriguez points out that an increased interest in sex isn’t of itself a problem. But, when the “heightened sense of sexuality” is paired with bipolar manic symptoms like impulsivity, risk-taking, and poor judgment, the resulting behavior can be damaging to far too many aspects of your life.

So what can you do?

First, call your psychiatrist. She can help bring your symptoms under control with medication. When your symptoms are controlled, the urges will most likely dissipate.

Second, therapy and counseling for you and your loved ones. Information is power. Communicate with your loved ones about this symptom, and build a plan with your therapist for treating the sexual arousal when it shows up again.

You need to break the mania, and hope you come in for a smooth landing. Without falling through the floor and into another depressive episode

But What If You Fall Through the Floor?

Sometimes what happens when mania breaks is a depression so deep and unrelenting that nothing can lift it. If that’s where you are, you may want to consider a novel advanced treatment that’s demonstrated it can help in the majority of cases that weren’t relieved by other medicines. IV ketamine treatment.

Since bipolar depression can include agitation and a sense of worthlessness, it’s important to effectively treat it before you have suicidal thoughts or immediately after they start. Those who suffer with untreated bipolar disorder have a high risk for suicidal thoughts.

Thankfully, ketamine for suicidal thoughts is one of the best and most rapid treatments we have for suicidal thinking. It can stop suicidal thoughts in 4 hours … and usually far less.

Ketamine treatment shows extraordinary effectiveness in relieving bipolar disorder symptoms.

So…maybe you’re asking yourself, How do I find the most skilled treatment with ketamine from a psychiatrist near me?

At Innovative Psychiatry in South Windsor, CT ketamine for depression, bipolar depression, and other mood disorders can help patients with terrible depressive symptoms who haven’t been helped by any other medicines or treatments.

Ketamine is so effective with depression. Although it doesn’t work for everyone, in most cases it does, like gangbusters.

If you suffer from severe bipolar disorder, and have been failed by other medicines and treatments offered you, it doesn’t help to think that you’re “treatment-resistant.” You just need something that works in a better way.

Think about ketamine treatment — administered with skill, insight, and psychiatric expertise to ensure the best possible outcome for you.

Bipolar disorder can be one of the most devastating psychiatric disorders, and can cause extensive damage in your life, until it’s treated. But you can get your life back and enjoy it again. You don’t have to be driven by the symptoms you experience or suffer with shame from the damage they’ve caused.

Call us, and let us help you find the life you long to live.

To the reinvigoration of your best self,

Lori Calabrese, M.D.

November 5, 2018
PTSD Can Make You Sick. Can Ketamine Stop That Before It Does?

Studies Imply PTSD is a Gateway Condition That Can Lead to Other Critical Illnesses.

Ketamine treatment can bring PTSD to remission, and hopefully prevent these other illnesses.

Bang! A sudden loud noise breaks the stillness.

“What tha…??!! Your companion jumps with a startled exclamation, missing that you’re standing there frozen, pale, and in-one-motion spun around with fists raised and ready for a right hook.

In a flash, you’ve advanced from calm, to terrified, to ready-to-fight-for- your-life.

Your friend laughs at his own jumpiness. But you’re not amused. With adrenalin coursing through your body, you’re angry.

It’s awful to be so angry, when “nothing” has happened.

It’s just not that easy to calm yourself when the deafening sound turns out to be a slammed door, rather than a life-threatening attack.

Your hands are shaking, it’s hard to speak … you clench your jaws, trying to hold onto the thread of self-control that’s keeping you from doing serious damage. A thread that grows thinner by the second.

Your friend slaps you on the back in a good-natured gesture, to snap you out of it. That was the worse thing he could have done. In a fraction of a second, you’ve swung around and your powerful fist connects with his not-so-solid jaw.

He groans and hits the floor.

And suddenly you realize you may just have lost the best friend you’ve had all year.

You never told him about your PTSD. You didn’t want to start the friendship out with shame. You wanted to be on even ground. Now this.

PTSD Can Make You Sick

PTSD has been called “a life sentence” according to a review of large cohort studies by a team led by KC Koenen in the Journal of Psychological Medicine in January, 2017. This “sentence” is derived from the multitude of health conditions that accompany PTSD symptoms.

Several large studies have shown a link between PTSD and metabolic as well as cardiac diseases, such as myocardial infarction (commonly called “heart attack”), stroke, Type 2 diabetes, and coronary heart disease. Of these conditions, it seems that those hit hardest are African Americans and Hispanics.

Having PTSD increased their risk over other combat veterans from the same war zones…veterans who even had other psychiatric disorders. Over 660,000 veterans were studied. Compelling, isn’t it?

Another study led by A. O’Donovan and published in the Journal of Biological Psychiatry in February of 2015, showed that combat veterans from Afghanistan and Iraq diagnosed with PTSD were more likely to develop autoimmune and endocrine disorders.

They had a greater risk for IBS, thyroiditis, rheumatoid arthritis, multiple sclerosis, and lupus erythematosus.

Terrible diseases.

See the diseases and conditions piling up?

But there’s still more.

Genome studies of trauma and PTSD have identified specific genes that are linked to dysregulation of the immune system. Michael Breen led a team to write a mega-analysis published in Psychopharmacology of five studies that focused on genome effects from types of trauma and PTSD.

They found that there was lower expression of cytokine-related genes in men who’d been exposed to interpersonal trauma or combat… than was found in women.

With the collection of all the data, they identified the common pathways of inflammation in PTSD, and painted a picture of extensive dysregulation in the immune system in people with PTSD.

More Studies, Please, about PTSD and It’s Relationship to Illnesses

Researchers recognize that more study is needed to understand whether activation of these inflammatory pathways are caused by PTSD, or whether they’re a natural consequence of the behaviors and lifestyles of people with PTSD, or something else.

For example, people with PTSD reportedly often smoke tobacco, have erratic sleep patterns, lack of physical activity, poor diet choices, etc.

But if the associated illnesses are actually a result of the trauma itself and the conditions it triggers, it implies that PTSD is part of a broader systemic illness triggered by psychological trauma.

I’ve pointed out for a very many years that I’m not a fan of the term “mental illness” — as though psychiatric disorders are not part of the body, not physical, not legitimate. Something woo woo… Kind of unbelievable given that there are so many complex brain structures, processes, and functions involved.

Your brain is physical. Your heart is physical. Your kidneys are physical. We refer to illnesses of the heart, of the lungs, of the kidneys, as physical illnesses. Well disorders of the brain are physical, too.

So in this research that suggests that these psychiatric disorders are actually larger systemic illnesses, I’m surprised that’s not obvious but glad we’re talking about it.

How the Brain and The Body Interact

Let’s look at some simple examples, just to illustrate.

If you have anxiety, you probably have some sort of physical symptoms that express it. For some people, it may be that they break out in hives. In others, it may be a sick pit in your stomach, or intestinal cramps and watery stool. In someone else, it may be shaking.

When you’re in love… remember those butterflies? That’s a physical sensation that accompanies an emotional experience.

If your heart is broken, it can feel like your chest is ripping apart.

Rene Decartes was a French-born philosopher in Sweden who purported the theory of dualism. The idea that the mind and the body are utterly separate. But the simple act of shedding tears shows that the two are quite influential on each other.

This is another important step in vanquishing stigma, and getting help for those who suffer.

With that said, it’s vital we understand more about PTSD and what it triggers in someone who has it. In fact, perhaps with deeper study, we could see insurance companies beginning to pay for all aspects of the disorder… autoimmune, cardiac, lung, kidney, Type 2 diabetes…and psychological terror and pain.

PTSD Can Make You Sick. Can Ketamine Stop That Before It Does?

Multiple trials with ketamine treatment for PTSD have demonstrated its rapid and robust effectiveness in treating symptoms.

One of the ways it works is by influencing cytokine production. And since cytokine-related genes seem to be expressed less in certain men with PTSD, improving the expression of cytokine may be one of the reasons for ketamine’s effectiveness in PTSD.

There is so much to learn and understand about ketamine and how it works as well as it does. It doesn’t work with everyone…of course not. No medicine works for everyone. But, it works better and in a higher percentage of people than any medicine that’s ever been available for treatment-resistant mood disorders.

Ketamine for severe depression.

Ketamine for PTSD.

And ketamine for bipolar disorder, ketamine for social anxiety… plus ketamine for OCD, and ketamine for addiction… and yes, ketamine for suicidal thoughts.

At Innovative Psychiatry, we treat people every week with ketamine treatment for all of these psychiatric disorders.

We’ll take an in-depth history of your symptoms, treatment course, health and family history, and evaluate whether you’re a candidate for ketamine treatment.

We use only the best and most thorough practices when we provide your ketamine infusions. With a cozy and appealing environment, a comfy recliner or soft leather sofa, and warm blankets, the lights will be low and many people bring their own soft music to listen to.

You’ll be monitored continuously during the infusion, and treated for any uncomfortable side effects. Most patients tell us they have never felt so relaxed.

But what they really love is how they feel … better and better as the series of infusions advances.

Most leave our office with a new lease on life, and report later they can enjoy hobbies, work, friends, again, and that they have initiative and motivation to tackle projects they’d put off for years. They enjoy their family and their friends — and have the energy to build relationships and make them strong again.

Put simply, they have the power to build a rewarding and fulfilling life.

PTSD is a serious disorder that can lead to serious, even critical, additional illnesses. Can ketamine stop that before it happens?

If you wonder, how do I find a psychiatrist near me who can give me a good chance at getting better..??

We sure understand.

And if you suffer from PTSD, and no other treatment has helped you to function, call us. Call us now.

Let us help you get your brain working again as it should, so the nightmares fade, the flashbacks melt away… and you can enjoy loving your family and your life. You can even have fun again.

If you suffer from any of these conditions and haven’t improved with at least two other medicines or treatments, call us. We want you to live the life you wish for, the best life you can live.

To the restoration of your best self,

Lori Calabrese, MD

October 29, 2018

Category: Ketamine

Articles About Ketamine from Lori Calabrese, MD | The Ketamine Blog

Breakthrough anesthesia medicine proves life-changing for many who suffer from severe mood disorders.

Early Testing was Cautious

Researchers Still Learning All Ketamine Can Do

Ketamine Does More Than Bring Relief, It’s Transforming

Ketamine is NOT for Everyone

Why Ketamine Sometimes Doesn’t Work

Want to Help Ketamine Remission Last? First Strengthen Your Personal Infrastructure

Your Personal Infrastructure Seems to Play Some Role in Making or Breaking Your Remission

It takes time for research to catch up with the widespread use of ketamine treatment. And it requires multiplied studies upon more studies to establish the reliability of any benefit.

Sometimes the stress is inside our heads…like things aren’t going the way we wish they would, or something we hoped would last doesn’t, or maybe people aren’t doing what we think they should.

A Full Overhaul Of Your Life, Step by Step, Can Be the BEST Medicine

But in exploring the causes, it may surprise you to learn that their behavior may not actually be the cause, as much as your reaction to their behavior that is.

But it’s important to understand that the best prescription for maintaining stability with remission includes maintaining health in those things in your life and environment that you can control.

Letting Go

Possessions Can Shift from Useful Tools to… Jailer

What If You Lost It All?

My point here is that we have a way of putting people and things on a priority list… and that list can get all mixed up. But this scenario helps to show how those things we think are important lose their glow instantly when those at the core of our hearts are lost.

And therein lies the secret. Rather than wasting our lives by hurting people to preserve things, we find our life is best spent preserving the moments with those we love the most.

The Greedy Monkey

The Surprise Benefits of Letting Go

Picture serenity in your life. Peace. What has been removed from the picture when you think of it?

Life is short. We get the most out of it when we can cherish every moment. In your daydreams, when you wish for reprieve…what do you erase from your life in your mind’s eye to make room for hope? Peace? Love? Enjoyment?

Commit to Finding Ways to Let It Go

This is one facet of the infrastructure in your life that you may need to confront and adjust to make room for remission.

Let it go. Help Ketamine Remission Last

Treatment of Psychiatric Disorders: 2019 Year of Promise

Compounds and methods for treating severe psychiatric disorders are getting better and better…

Suicidal Thoughts Can Be Deadly

Because relatively few tell anyone they’re thinking about or even considering suicide, it’s been impossible thus far to estimate the number.

Ketamine Treatment Continues to be Misrepresented

When have you seen a safe, rapid, extraordinarily effective, life-saving treatment misrepresented, misunderstood, lambasted, and gossiped about more than ketamine? (Think about that for a minute.)

I saw a comment in STAT magazine the other day that took the cake.

It was clear the individual didn’t know about the research and data. All the information that’s poured out around the globe about ketamine and related compounds for psychiatric disorders over the last 10-15 years.

Ketamine should definitely be administered under a psychiatrist’s close supervision, not self-dosed.

Because the truth is, the majority of physicians have read snippets about it here and there. They’re just now getting up to speed. And some have distorted ideas about it.

Ketamine is 100% bioavailable only when it’s given by the intravenous (IV) route. In IV form it’s delivered straight to the brain tissues that so desperately need its benefits. IM and IN (nasal spray), lozenges, troches, and oral liquids are all less bioavailable.

Ketamine Treatment Acts Independently of Other Medications

Ketamine Treatment of Psychiatric Disorders…

It’s one of the reasons we’re so interested in following the research in using ketamine to treat suicidal thoughts and these other psychiatric conditions — and one of the reasons I write about them so often and devote space to them here.

The Microbiome Has Been Underestimated

Plans Unfolding for the 2019 Year Ahead

Ketamine Treatment: Getting Better, Giving Back

2019 promises to be a year of hope, and a year of gratitude and goodwill, as we see more people feeling better... and getting well… after years of struggling without solutions.

Hope is on the horizon. It’s going to be a good year.

It consists of several doses of IV ketamine, usually about 6, and sometimes a few more, over 2-3 weeks. Ketamine isn’t appropriate for all patients — and doesn’t work as well for some as it does for most of our patients — so it’s not for everyone.

Advances in Psychiatric Treatment: 2018 in Review

Happy New Year!! The big silver ball falls tonight to celebrate the birth of 2019.

Let’s celebrate the unprecedented, transforming, and ever-accelerating advances in psychiatric treatment this year and the neuroscience that backs it up.

This testing, and subsequent investigation, snowballed into a field of life-changing breakthroughs and developments like ketamine treatment, transcranial magnetic stimulation (TMS), and other “outside the box” novel treatments.

Psychiatric Treatments Are Improving

Outside The Box

Schizophrenia and Autism Spectrum Disorder

And after studying the genetic connections, they found that too much of a specific master key: MIR-137, can result in symptoms of schizophrenia … and too little of it can result in symptoms of ASD.

Better Therapy for PTSD

By writing about the specific traumatic event, patients were found to improve as much in only 5 sessions as they improved in 12 sessions with cognitive processing therapy, or CPT.

Better Suicide Prevention..?

Researchers tackled electronic medical records and found that half of those who commit suicide and 2/3 of those who try but fail, have had a mental health evaluation in the last year.

Social Media Surprise

Or, put another way, if you’re depressed to start with, the less time you spend on social media the less depressed and lonely you’ll feel.

Ketamine Treatment Continues to Demonstrate Its Prowess

Your hope for recovery… and remission… is more warranted than it’s ever been. You really can get better…even well.

We’re Learning about Doses

And We’re Learning What Doses Halt Suicidal Thinking in Outpatients

Ketamine’s Impact on G Proteins Transforms Depression Treatment

A November 2018 study demonstrated that removal of G proteins from the lipid rafts was not only rapid…beginning within 15 minutes…but that returning to the lipid rafts was much slower after ketamine treatment than after SSRI’s.

Advances in Psychiatry Treatment

Restoration is Available for You

Not for any other reason than the hope of getting you better and getting your life back. Reclaiming your joy, your relationships, your work satisfaction, and overall fulfillment in life.

Ketamine treatment won’t make you someone you’re not. But it can restore you to the very best version of yourself. A version you may not remember right now, but the one who’s buried inside you underneath the difficult symptoms that can seem to dominate everything.

2018 Innovative Psychiatry: Ketamine Developments

What a year it’s been!!

As this busy year creeps toward its end, it’s fun to look back on all we’ve accomplished in our hard work to help find more effective treatment for those who suffer with symptoms that don’t respond to traditional treatment.

As I’ve added innovative and advanced treatments to my practice to extend our effectiveness. And I’ve discovered that IV ketamine treatment in a series of infusions given closely together, is the most exciting, effective treatment for depression that just won’t lift.

Interventions and Adjustments

And we’ve consistently been amazed at what we see. But more about that in a bit.

Then, in March, I had the opportunity to attend the International Conference on Ketamine and Related Compounds for Psychiatric Disorders 2018, in Oxford, England.

I presented some of my data on treatment of suicidal thinking, and what ketamine can do to erase it in a poster session.

Next, came the first annual American Society of Ketamine Physicians (ASKP) Conference in September, where I saw a number of the same professionals I’d seen in Oxford…again meeting to share insights and experiences with the use of ketamine treatment in psychiatry and in pain management.