Lori Calabrese, MD

Tag: IV Ketamine Treatment for Postpartum Depression

Dissociation: Is It Key to Ketamine’s Antidepressant Response?

That Floating Sensation May Predict Ketamine’s Healing At Work

Know anyone who’s depressed?

I don’t mean someone feeling blue or disappointed, but really depressed. The hard-to- function type of depression. The hard-to-think-hard-to-get-out-of bed kind of depression. Where everything looks dark and hopeless, and you doubt yourself and your value…and it continues and gets worse for months or years.

Severe depression. The kind that makes you want to die, and you can’t see any value in your life…and those thoughts start coming… that everyone who knows you would be so relieved if you were gone. Lies that kill.

Depression like this messes with your outlook, your decisions, your abilities, your energy, your motivation, your perception of your own value… and it’s almost insurmountable to get out of bed.

We Call Your Disorder “Treated” Only If You Feel Better

In some cases we call this Major Depressive Disorder, or MDD. In others, it may be the depressive part of the cycle in bipolar disorder. Depression of this magnitude can be debilitating. And it needs to be treated effectively. In fact, no matter what treatment is used, if you don’t feel better, then it’s the same as if your depression weren’t treated at all.

No matter how many pills you’ve swallowed or how many therapy sessions you’ve attended —

Treatment must produce results you can feel and confirm. Or else it’s not effective. And if you aren’t feeling better and functioning better … well, what’s the point?

Ketamine is a medicine that was developed in the 1960’s and ’70’s as an anesthesia medicine. It’s been used for 50 years safely with children, adults, and senior citizens. It regulates glutamate in the brain, and blocks the NMDA receptor which prevents it from causing you to feel depressed.

AMPA Gives You Power to Adapt and Develop Flexibility

It also fires up AMPA , which is another glutamate receptor that is responsible for most of the fast excitatory transmission in the brain.

In other words, it’s the AMPA receptors that are behind the synaptic plasticity, which means they empower the connections between brain cells to grow and flourish and move signals around the brain much more rapidly.

Plasticity basically means changeability. Or…changeableness. (Are those even words…?)

So, synaptic plasticity changes the connections in your brain and makes them grow and bud and sprout like crazy…which helps you to develop more and more ability to adapt the way you think, the way you respond, the way you see events and circumstances so you can develop flexibility, healthier thinking habits and more resilience, too.

This is one big part of what makes ketamine work so well.

Ketamine’s Antidepressant Response

Then it tells the cell to make more and more AMPA fast, so you feel better and better rapidly. And this is just one action ketamine performs to fight depression. There are lots of others, but let’s focus on this one for now.

We’ve talked often about ketamine treatment, provided in tiny doses roughly equal to 0.5mg/kg given IV over 40 minutes by a psychiatrist who is adept with psychopharmacological methods that make the most of each infusion.

Ketamine is a molecule that modulates the excitatory neurotransmitter glutamate.

We’ve talked about how important close supervision by a psychiatrist is to determine the rate and dose needed specifically for you, and your brain, so you have the quality of response to the medicine that will provide the best outcome for you.

And…we’ve pointed out that some providers have popped up in the landscape who give the same dose to every patient, or the same protocol, or varying doses to every patient with little attention to precision rate or infusion length. This is super easy for the provider, easy for the clinic. There is no infusion pump, and the only rate control is the rolling wheel on the IV tubing.

You see where I’m going.

Care in Ketamine Administration Yields Better Results for You

We’ve hypothesized that this less precise administration of ketamine may be the reason that non-psychiatrists and psychiatrists alike who use this one-size-fits-all method for treating depressed patients was resulting in a lower percentage of remission from mood disorders across the board.

We know that we’ve seen an 80% response in treatment-resistant patients by using this precise and remission-focused approach.

Well, researchers published a study in February this year in the Journal of Affective Disorders along this line. It demonstrated how the various dissociative effects can predict how much antidepressant effect a person will receive from a ketamine infusion.

Led by Mark J. Niciu, a team of researchers including Carlos Zarate (a leader in ketamine research), conducted a followup study to their previous work to determine whether the quality of dissociation was correlated to a positive antidepressant response.

Dissociation…and Ketamine’s Antidepressant Response

We’ve all been interested in this. Is dissociation “just a side effect,” or does it MATTER? Is it necessary to have dissociation for ketamine to “work?” Or for depression to lift? For anxiety to dissolve? For trauma to heal? And what dissociative features, exactly? How intense are we talking about? And for how long?

The researchers took a group of 126 people from 18 to 65 with mood disorders – 84 with major depression and 42 with bipolar disorder and asked them to complete rating scales just after their treatment about what they experienced during their ketamine infusion.

Dissociation is basically a detachment from reality, but it can include detachment from yourself (depersonalization), detachment from your surroundings (derealization)…and sometimes a sense of amnesia.

The Study:

Now, each patient involved in the study was currently experiencing a full episode of depression that had been going on at least 2 weeks. Prior treatments had failed all of these subjects. In some cases just one, but many had tried multiple treatments.

Researchers selected the subjects very carefully. None of them had psychotic symptoms and none of them had dissociative symptoms at baseline.

Some patients received a ketamine infusion (yep, just one, not a series) at a prescribed dose of 0.5mg/kg over 40 minutes and others received a placebo…

And guess what?

People who experienced dissociation during their ketamine infusions had much more improvement in their depressive symptoms – the more intense the dissociation, the better the improvement.

And the specific dissociative feature (remember there are 3: depersonalization, derealization and amnesia) that was most strongly associated with responding to ketamine? Depersonalization.

The antidepressant effect was strongest at Day 7, not 3-4 hours after or a day later.

You Can’t Know Without Testing – There’s So Much to Learn

Isn’t that interesting? You’d think the response would have been strongest during the first 24 hours, but not so in this study. You know… the miracle WOW that everyone seems to expect. (Boy, do we have to explain and help reset expectations here.) When you think about how ketamine restores signaling structures as well as all the other things it does, it does stand to reason that as the structures in the brain improve, so would the antidepressant effects.

The research team encouraged more studies to pin down and confirm their findings. And we do, too. But it’s exciting to consider that the very dissociative experience you feel during a ketamine infusion is actually connected to the wonderful restoration it does.

Understanding Your Treatment and Your Healing

It’s important to know that the experience itself is important… important for your improvement and healing.

When you understand this, it’ll help you not be afraid.

And it’ll help you understand that the dissociative experience during treatment is not something we see as bad or unwanted or as an adverse event that needs to be avoided or abolished. It’s an integral part of the treatment itself, and something that we have come to understand is critical for transformation.

With proper treatment, and fine control of the dose and rate of your infusion, we work towards just the right place for you … where your treatment, and your dissociative experience during your treatment, fuse together in the best possible way, to give you the best possible outcome.

Now that’s a sweet spot!

When you’ve felt trapped by a disorder, you’ll do just about anything to live a fulfilling life and wake up every morning with hope.

Every single step of research that shines another light on ketamine’s extraordinary impact on depression and other mood disorders brightens the path for all of us who treat patients with ketamine, and for those who suffer from all these mood disorders and haven’t been helped by anything else before.

There really is hope!

We Want You to Enjoy a Rewarding Life

Here at Innovative Psychiatry we continue to see people like you who suffer and have given up. Then, after a ketamine treatment series, we often see them achieve remission and enjoying their restored ability to create, to invest themselves, to build relationships, and to savor life’s moments. We see this everyday.

If you’re struggling with a psychiatric mood disorder that has not improved with other treatments, call us. We’re here to help you find the relief thousands of others have found.

This is a new era, and you really can feel better…you can even feel well. Kick that disorder to the curb… let’s work together to help you live again.

To the reinvigoration of your best self,

Lori Calabrese, MD

September 24, 2018
Marti’s Story: How Ketamine Smashes Treatment-Resistant Depression

Ketamine Can Eradicate Severe Depression

Do you know anyone who’s severely depressed?

I want you to meet Marti. If you’ve never experienced severe depression yourself, learning about Marti’s journey may give you a glimpse into what it’s like. And if you have…well…I hope Marti’s story helps you feel less alone…and helps you find hope for your future, too.

Marti was a sparkling preschooler, obviously intelligent, and full of charm and spunk. But the spark disappeared when she was about six years old. She was also diagnosed with Type 1 diabetes that same year…which only increased the stress in her young life.

In spite of the depression, she pushed through the best she could and performed well in school…receiving all sorts of academic awards. School was her refuge and solace. Even so, her immunity to infection was reduced by the diabetes and she seemed to get sick with every bug that floated through. That made things worse…and pushed her stress higher.

Family Crises Can Trigger Greater Severity in Symptoms

Then, when she was in 8th grade, her dad collapsed and had to go to the hospital by ambulance. Long QT syndrome they called it… basically a heart attack but he survived. However, he was in the hospital for 2 weeks…and because she was sick she couldn’t visit him. The helplessness of the diabetes, the constant double workload at school, her brothers’ illnesses, and her dad’s near death event, became the final straw.

A darkness began to build inside her beyond anything she’d known before. Her mind seemed to become numb…vacant… she seemed unable to think. Things like motivation, initiative…or even the energy to do anything… had disappeared. She felt lost, but that wasn’t all.

There were new fears. Fears of people, places, leaving the house, answering the telephone. School became an insurmountable mountain to climb. She began to hide under her bed for the school day so no one would know she didn’t go. She couldn’t go.

That was on the worst days. On the days she could muster the courage to get on the bus, she sat silently in class…looking at her desk. Holding onto her chair with all her might to keep herself from running out.

Classmates would watch her behavior and assume she was using drugs. They’d ask her…and she’d tell them no, horrified that she gave that impression.

Academics Suffer When Medications Fail

Her parents took her to regular visits with an acclaimed psychiatrist. After 18 months he was amazed she wasn’t doing any better. Concerned their intelligent and awarded student would not graduate from high school without close support, her parents took her out of school and homeschooled her during her senior year. She was able to make up the credits she’d lost and graduate, mostly due to the decreased stress of the public school atmosphere.

But…her condition worsened. She registered in a university hoping the new routine would help her improve. But it wasn’t that simple.

She had intermittent periods of working at school and making top grades, then falling back into the abyss of darkness that had become her constant prison. A good semester then a terrible semester. Finally, she was placed on academic suspension for a semester… and eventually dropped out.

Her doctor continued to increase her dosage, and change her medicines. But nothing really worked. She slogged along in the proverbial mud, losing her hope, her self respect, and adopting a new outlook that was angry, bitter, and critical… an outlook she called “realistic.”

These changes in her view of herself and others resulted in friendships with others who were also angry and despondent. The motivated and emotionally-healthy friends she’d had during her childhood and early teens all but disappeared.

Treatment-Resistant Depression Spreads DOOM

Marti wore “toughness” like an overcoat, and functioned well enough to be sullen and angry with her friends. Her social circle was a tough lot, but she tried her best to fit in with them.

Then she met “him.” He was handsome, weathered, and wore chains and black leather. Her epic bad boy.

Within 2 weeks, they’d had their first big fight.

Shattered by his dirty and cruel tactics, Marti realized she was in over her head. But she was determined to live up to the challenge. The verbal abuse and horrific scenes deteriorated to physical abuse, but just reminded her that she knew what it was to suffer. And he’d been alone without support, so she was determined to be that support and “help him heal.”

This pattern continued, with periodic breakups, apologies, and a patched-up relationship for two or three years. Marti’s depressed condition deprived her of the energy, the judgment, or the initiative to improve her situation. And she told herself magical stories about how her love and loyalty – no matter what he did – could heal his wounds…and they’d enjoy a happy life together forever.

So she trudged.

A Disordered Brain Obsesses on Death

And there were suicidal attempts. And interventions that saved her life. But if you know anything about depression, you know that suicidal thinking or attempting doesn’t stop because you want it to. Your disordered brain creates images of death and darkness…and compulsions… It’s the very opposite of a healthy, imaginative brain that creates beauty and joy.

Marti’s nightmares became a constant torment. Waking up in a cold sweat over and over in the same night, with visions of cruel and terrifying demons destroying her… and as soon as she fell asleep again they were back.

Insomnia kept her awake for 5 or 6 days at a time…she’d feel brittle, reactive, hysterical at the smallest provocation. Screaming and cursing when the dog barked or the doorbell rang. Her coordination was also brittle, so she’d accidentally break a glass or stub her toe and fly into a screaming, cursing rage.

The phobias increased. Marti loved photography and was given an all expense-paid trip to Thailand with a professional photography group who would help her learn more artistic techniques for her craft.

An Opportunity Becomes a Crisis

She’d acquired outstanding equipment for her photography business, but the depression made it nearly impossible for her to follow through on opportunities.

Meeting with clients, doing a shoot or a sitting, became too difficult to manage, as social anxiety, fear of failure, and agoraphobia stripped her of the confidence to follow through.

She boarded the plane to Thailand with her gear, and on a layover in Bangkok she suffered a gargantuan panic attack. She couldn’t think to find her luggage, her gear, or her phone. Finally, she called her family collect and asked them to help her get home. Knowing her fragile state, they readily complied.

Once home she slept for days as she recovered.

Her Own Worst Critic

Then the shame set in. How could she squander such a life-changing opportunity? How irresponsible could she be? She’d always hated herself, but now she LOATHED herself. How could she bear the disgust she felt for her inept failure?

You know, when you’re struggling, you need a best friend… and if no one else…you need to be your own best friend. But sadly, whenever life got hard, Marti would use that moment to beat herself down into a shriveled nub.

And that’s how it goes, isn’t it? When we feel awful, we tend to make it worse. And we usually need an intervention from outside ourselves to turn the disastrous tide.

A final year with “him” was packed with physical abuse and cruel unspeakable torment that resulted in injury for Marti in her spine, her pelvis, and her neck.

From Abuse of Herself to Assault by Someone Else

The stress of her life led to muscle cramping in her neck and shoulders that left her left shoulder 3 inches shorter than her right one. She was unable to move her upper body without extensive treatment.

But those wounds were just physical. It would be years before physical therapists and chiropractors could help her body recover from the damage.

Still, the worst was the emotional damage. The silent scars that held her in a vice of fear.

Chronic hospitalizations plagued her life as the multitude of terrible stressors triggered vomiting spells that lasted for days at a time. Every 5-10 minutes…around the clock.

And those vomiting spells threw her body’s pH out of whack…and triggered diabetic ketoacidosis…a potentially fatal condition that won’t correct itself without emergency medical intervention in an ICU.

Over. And over. And over.

Then, it got worse. The repeated diabetic ketoacidosis and the high blood sugars that accompanied it, caused damage to the nerves in her stomach.

Gastroparesis… a condition where the stomach’s ability to empty itself is paralyzed… led to deteriorating nutritional absorption. Basically, she was starving because her body couldn’t absorb nutrients.

Depression Can Kill and Must Be Stopped

It all began with depression. But depression is just the beginning… and when it’s severe, it can trigger a cascade of circumstances that can suffocate life.

One day late in the summer, on one of many days when “he” tried to kill her, she grabbed her shoes and keys and fled.

And she never went back.

In the aftermath of that day, she spent more and more time in the hospital intensive care unit. A year and a half later, she was transported to the ICU so often, she was in the hospital more than she was home. A lot more. And she knew she was dying…

She also knew she was losing her ability to see. What began as foggy-out-of-focus moments in the early fall, progressed to full blindness by Christmas.

A retina specialist was called in and she went for surgery the day she got out of the hospital. Within two days she was back in ICU…but the surgery had succeeded in repairing the retina in her right eye. Her left eye was not reparable. But it was a start.

Then, her doctors recommended she undergo surgery for a feeding tube placement in her intestine, and formula was pumped into her body through that tube 24/7. After another week in the hospital, she was beginning to improve. The vomiting stopped. And she began to feel a little stronger.

A Mysterious Joy Begins to Bubble Up

But there was something else. She was feeling better. In barely perceptible ways at first. But little by little, joy was growing. In spite of her intestinal feeding tube. In spite of her blindness. She had hope. And she didn’t know why.

She would wake in the morning, remember she was blind…and cry. She grieved the loss of her eyesight. And facing that each day was so difficult.

But then she would launch into the day with a spring in her step. Initiative to move past this disability and build a new life. She had not had initiative since she was in 8th grade. She’d not felt joy since she was in kindergarten. What was causing this?

Ketamine Smashes Treatment-Resistant Depression

She heard about ketamine treatment… and someone suggested she check her surgery record to see what anesthesia she’d been given in surgery… so she did.

When the surgery record arrived in the mail 10 days later, she was astounded to find out she’d been given ketamine as an anesthesia in surgery. Could that be why she was feeling so much better??

Marti danced across the room just to consider that ketamine might be the reason she was coping so much better, and enjoying so much again. She set out to learn all she could.

That first IV ketamine infusion in surgery restored her wellbeing for 7 months. Then she began to feel the old depression returning, the critical thoughts, the anger, the hopelessness…but for the first time since she was a little girl…she didn’t want to die anymore.

6 IV Ketamine Infusions + A Couple Booster Infusions

So she set out to find a way to pay for a series of 6 infusions, as she’d learned that stacking infusions would produce more lasting results.

Within a couple weeks, her parents were able to help her with the money for a treatment of 6 infusions over 2 weeks. She’d heard that ketamine was available IV, IM, or intranasally...but she’d been convinced that IV was the best route for ketamine’s full benefits.

After the first infusion she felt no better…but that night her mother noticed she was folding clothes…for the first time in four years. Initiative.

Then, after the second infusion she thought she had a glimmer of hope. A lifting of pressure…of the weight that had been crushing her. Decreasing anxiety and diminishing sadness…she could tell she felt a bit lighter.

After the third infusion, she laughed a little, and talked a bit more freely… And from there her outlook grew better and brighter day by day through the last 3 infusions and over the next few weeks.

A few months later she’d been hospitalized more times (and with the intense stress of severe illness) she started “sinking” again…and called her doctor for a booster infusion of ketamine. She’d heard that sometimes that’s necessary. And she was glad she got it… it helped.

But four months later she needed yet another. Even so, that infusion of IV ketamine has held her remission steady for a long time.

She’s learning Braille, training to work, and excited about the life that’s ahead. She’s 32, in love with a wonderful guy who stood by her through the illnesses and surgeries, and life is working for her now on an exciting new level.

Marti believes in herself now and in her potential. And she’s eager to contribute to the lives of others. She’s joined the board of a non-profit blindness advocacy group. She has new friends who also have bright outlooks on life. Who are also productive and contribute to the community and to each other.

By the way, remember those terrifying nightmares that plagued her? They’re gone. Her dreams are bright and beautiful now…or at worst a little frustrating. The terrors that beat her up through all her nights for so many years are gone.

It All Began With Depression

And a co-existing illness. But treating the illness didn’t resolve the depression. Ketamine treatment did.

Marti feels transformed. Her family says she’s finally the person she was when she was 3 years old, before the assault of life hit. Her cleverness, wit, spunk, and joy for life has returned.

Marti is one of those people for whom the 6-infusion ketamine protocol wasn’t enough. She had researched extensively to understand how ketamine treatment ought to work and what to watch for. She also understood that to stay better required building a stronger infrastructure that would support her remission from depression.

And she actively worked to put that in place, through friendships, attitudes, and improved health. Active cooperation with her team of doctors, and doing the work in her outlook about her career and her relationships all helped strengthen that infrastructure.

And today, she’s in full remission. She sings every morning, dances a jig of her own design when she thinks no one is looking. Her life is full of promise.

She’s attracted to upbeat, healthy-minded people, and she loves herself. She enjoys life in a way she’s never been able to, and marvels at the frame of mind that held her captive 25 years.

Severe Depression Affects Every Aspect of Life

For those who have never experienced major depressive disorder in its severity, the fallout in Marti’s life may seem outlandish.

But Marti’s story demonstrates how all-encompassing and dangerous depression can be.

And why ketamine treatment is the golden child in psychiatric treatment these days. There’s no other treatment available that is as effective, potent, and all-encompassing for restoring life, hope, motivation, initiative, and a bright outlook to this degree.

At Innovative Psychiatry we’ve watched thousands of patients with treatment-resistant disorders follow the path Marti has in full remission.

Relief from social anxiety, depression, panic disorder, PTSD, OCD, bipolar disorder, addiction, substance use disorder, and suicidal thinking.

(Did I mention ketamine can stop suicidal thinking in 4 hours or less?)

If you suffer from severe depression that other treatments haven’t helped, call us. We can help you rediscover the life you’ve lost, just like Marti did. You, too, can enjoy remission from the crippling throes of mood disorders.

Give yourself the opportunity to live again, or even for the first time, and develop a fulfilling and productive life. Because you can.

To the restoration of your best self,

Lori Calabrese, MD

August 27, 2018
Rapid-Acting Antidepressants Help You Get Better FAST
Smash Treatment-Resistant Mood Disorders with Rapid-Acting Antidepressants: Like Ketamine Treatment

We’ve talked before about the line to the throne where ketamine treatment now reigns. Formulators in a lab were seeking to create a new anesthesia, and they thought they’d found one. They called it Sernyl—but the unpredictable side effects, hallucinations, and sometimes violent behavior, drove the pharmaceutical company to take it off the shelves.

It was not the kind of medicine doctors wanted to give their patients. Through a series of leaks and improprieties however, it began to drift onto the streets as an illegal substance. The drug was phencyclidine, or PCP. Remember during the ’70’s and ’80’s? If so, you know the havoc that PCP – or angel dust – wreaked on the street crowd.

Rapid-acting Antidepressants

But those researchers weren’t willing to give up. They kept working and developed another safer anesthesia that had some of the dissociative properties Sernyl had, but less in side effects when used at therapeutic doses.

They coined it a “dissociative anesthesia” and it became internationally popular in the surgical suite, in the emergency department, and in war zones around the world.

That medicine was ketamine hydrochloride. And testing for treating depression began forty years after ketamine was developed and widely used as an anesthetic.

And we’re now seeing outstanding results, as in remission of depression and other mood disorders, in both research studies and the clinical setting.

So it’s not surprising, is it? That ketamine treatment has become the role model for emerging new medicines that treat mood disorders.

Still, knowing what ketamine treatment can do for major depression, postpartum depression, social anxiety, bipolar disorder, PTSD, OCD, and suicidal thinking isn’t enough for neuroscience researchers.

They want more.

If ketamine does great work treating patients with treatment-resistant mood disorders, there must be more medicines that will also work as well.

Or so they hope..?

Antidepressants that Work as Well as Ketamine Treatment

So the search is on to find other rapid-acting antidepressants that eradicate major depression, PTSD, bipolar disorder, OCD, social anxiety… and stop suicidal thinking in four hours…or less, like ketamine treatment does.

It’s a tall order, but it’s the quest of the hour.

Conventional antidepressants improve symptoms by increasing levels of neurotransmitters like serotonin and norepinephrine.

But it takes 9-12 weeks or more for someone to experience that improvement. So the loud and strong need for rapid-acting antidepressants shouts its demand for these solutions.

Why? Because when patients with severe disorders are inundated with thoughts of suicide, if those thoughts can’t be eradicated quickly, the risk of death is high.

In addition, lost work time as well as abandonment of the medication regimen, is more likely to happen. In short? Patient safety is compromised.

Seeking Ketamine Wannabes

So, there’s a strong focus on compounds that CAN bring fast relief. They include ketamine, scopolamine, and “mechanistically-related” compounds. We’ll get to those in another blog post.

But researchers added some newer ones to this list in the surge to find more rapid-acting medicines.

Compounds like:
- Antagonists of metabotropic (mGlu) 2/3 receptors
- Negative allosteric modulators of α5-containing GABA A receptors
- Psychedelic compounds like psilocybin
I know…I know… sounds like Greek.

How about this?

These compounds need to demonstrate their effectiveness in large groups of people. Most importantly, when medications fail to help people get better, these compounds need prove they can be effective.

And…as always…the biggest challenge is finding ways to make the positive effects last.

Rapid-Acting Antidepressants Help You Get Better Fast

Since the use of ketamine for depression began, the path of discovery started when ketamine first caused remarkable relief for depressed patients, but that relief didn’t last more than a few days or a week.

Researchers tested a variety of methods, and discovered an effective regimen was 6 ketamine infusions given every few days over 2 weeks.

By doing this, it seemed to bypass the short term beneficial effects and instead prolong them. As we’ve moved forward in clinical practice, we’ve found that increasing the number of infusions in some cases can ensure remission. That is, if the initial six fell short of that goal. And we’ve worked with different infusion protocols over 2-3 weeks.

Like all aspects of psychiatry, personalizing the treatment to fit the patient’s needs yields the most effective outcomes.

Review of Literature Clarifies the Search

A brand new review was published in Current Pharmaceutical Design July 29 focused on these specific compounds and their potential. The team, led by Jeffrey M. Witkin, reviewed the current literature on compounds that produce immediate symptom relief.

They determined that a foremost system for producing rapid effects is by amplifying excitatory neurotransmission (by glutamate) while activating AMPA receptors.

These drugs cause glutamate to flow out of the cells which provide what researchers hypothesize is a triggering mechanism to increase the amplitude of AMPA receptors.

They concluded that the focus in pharmaceuticals these days is rapid-acting antidepressant compounds like ketamine, scopolamine, and psilocybin. All of these need extensive study. And they pointed out that two medicines, rapastinel and esketamine are in the last stages of FDA trials.

So let’s look again at the up and coming compounds and medicines in the running to potentially supply the benefits that ketamine is now providing:
- Ketamine — still at the top
- Esketamine (developed by Jansen, a division of Johnson & Johnson)
- Rapastinel (developed by Allergan)
It’s probably fair to say that in the next few years we’ll be bombarded with many new medicines that operate quickly to treat mood disorders. But that’s the way of progress.

Even though esketamine is only half the ketamine molecule — with its own challenges and problems — it’s generating anticipation despite the problems that can come with an intranasal medication.

Keep in mind that FDA approval doesn’t guarantee a medicine is superior to others. But it’s a sign we’re in a new era of better, faster, and more effective medicines for psychiatric disorders.

Ketamine still reigns supreme. And physicians will likely need to combine esketamine with traditional antidepressants and mood stabilizers. Even so, mood disorder treatment is better than it used to be. Remember before ketamine treatment?

Back then, it was necessary to wait for weeks or months to enjoy the benefit of a medicine.

Times are changing and suffering is declining.

At Innovative Psychiatry, we’re celebrating the onward development of pharmaceutical progress, while also providing the outstanding benefits that ketamine can offer to our patients with treatment-resistant illnesses.

Our specialty is treating disorders that haven’t gotten better with other treatments. We’re here because we want to help you experience life like you were meant to live it.

To the restoration of your best self,

Lori Calabrese, MD
August 13, 2018
Ketamine Boost Infusions: When You Feel Better-ish, But Not Better Enough

Ketamine Boost Infusions Combined with Infrastructure Changes May Help You Sustain Remission

What do you do when the symptoms return?

You spent years in that condition. The sadness, the hopelessness…the numbness. That terrible shame. Unable to participate. Shut down. Withdrawn.

Or, maybe the symptoms were reactions to sudden noises…smells…darkness… or touch.

They may even have been obsessive thoughts…and compulsive actions that follow.

Or the old dreaded cravings…and relapse close behind.

You even wondered if you could go on much longer.

Then, you heard about ketamine treatment, and you found a way to pay for the treatment series of 6+ infusions. Afterwards, you came alive and felt so much better.

For once, you had hope, motivation, initiative. There was energy to live, invest your effort, build healthy relationships. You enjoyed your job and began to really excel. You actually felt happy. It was exhilarating to not just barely hang on.

Then it happened. …out of nowhere…those old symptoms began to return.

Maybe your job performance led to more responsibility. And the higher level of stress began wearing down your synapses…those connections between the cells in your brain. It’s possible that after awhile those cells in your lateral habenula began bursting too much and too often.

Plus all those G proteins that had slid off the lipid rafts in your cell membranes may have started piling back up on those rafts. The numbness that had gone away, came back.

Why?

Could it be because your wife’s cousin is living with you, taking advantage of your hospitality, rather than trying to find a job or her own place. And you keep stuffing your feelings…you don’t want to upset your wife.

Or maybe your boss takes credit for every innovation your create. But you? You keep working long hours and your husband is fed up that you’re never home.

Stress.

You’re so mad at yourself for not accomplishing more, so you carry your feelings on your sleeve, and jump down the throat of anyone who crosses you. You KNOW they don’t deserve this treatment…but you’re too ashamed to apologize.

Or, perhaps you got a little cocky with your sobriety, and began hanging out with friends who still use the substances you’ve broken away from… ? Any type of hard and stressful situation can make you think back to the old days…

It also might even be that this disorder is in your genes…that your whole family fights depression and it’s like a heavy gray blanket covering everyone around you. It could be to get better you might have to purposefully surround yourself with more positive, uplifting people …?

Or separate yourself from obligatory situations…

Sometimes we can’t see the nose on our proverbial face. We need someone to point it out and help us see specifics like these in our own complicated lives.

And we need to take action.

Tell your spouse what you really feel. Stand up to your boss even at the risk of getting fired. Because your self respect is too important to just silently bow to his abuse and dismissal of your value. That might reduce your stress.

Sometimes it doesn’t take much…just a step… to stand for what’s right. But when you do, the chains fall off.

And your own personal infrastructure – the things that make your life yours – is freed up to support your well-being.

So back to the causes. All of the mechanisms associated with stress can go into play, and undo some of the work the ketamine treatment had accomplished.

This is why it’s important to find ways to improve the “infrastructure” in your life, to reduce stressors that wear down your resilience.

Without making healthy changes in the areas most critical to your wellbeing, the same stressors that caused you to need ketamine treatment in the first place may cause you to need it again.

But…let’s be clear: there are no published studies about “booster” infusions

Can you believe that?

None.

But in all fairness, it can take years to gather data on recurrence of symptoms and how to best treat them.

Still. We need research!

Meanwhile, what do we do? The best we know to do is to use our clinical judgment if symptoms try to creep back in. We collaborate with you, and your treatment team, about the best way to proceed.

Lifestyle changes? Any improvement in the stressors in your life that you can make…well, that can be a big help.

A medication change perhaps? Some people continue their medications while receiving ketamine infusions. A change in medication might help…

Or is an additional ketamine boost infusion what’s called for? Perhaps so. If nothing has ever worked for you before to control your symptoms, you may know that ketamine infusions are your “go-to” solution.

Those of us in clinical practice have learned that additional infusions down the road can help refresh the work ketamine began.

Many patients…and their doctors…take a shortcut straight to ketamine because of their experience that it worked so beautifully after all those failed rounds of antidepressants and other treatments.

But we still don’t have research to show us in those cases how often we should prescribe a booster infusion or whether maintenance is inevitable for the foreseeable future.

My experience says that ongoing maintenance doses really aren’t required in many, if not most, cases. There is no research to guide us at this point. I do wonder why? …and hope that changes soon.

For now, I think it’s premature to make a blanket recommendation for ongoing maintenance “booster” infusions every few months indefinitely.

There are too many cases of patients who only need one or two or three after the initial series… then no more for a year or more. Psychiatrists need to work with their patients and the health care team to guide the best recourse for each individual patient.

But remission is the goal. Helping you feel truly good and able to live productively.

One or two ketamine boost infusions at a time can support and sustain remission. Especially if the patient’s infrastructure is in place and strong.

So…maybe you still feel better than you did before you knew about ketamine…but you don’t feel as good as you did a few weeks ago.

What do you do?

When you feel better, but not better enough, you may need a ketamine boost infusion to get your brain working well again and get you back on track.

Kick It Up a Notch!

Every brain is different, just as every person is different. Dosage and frequency can vary.

Another point… for the purpose of rebuilding and strengthening your personal “infrastructure,” you might benefit from therapy with a skilled therapist after each of your ketamine infusions.

This is when the neuroplasticity in your brain is very high, and it’s easiest to consider new ways of thinking, of reacting, of decisions…that make your life more functional, less stressful, and more rewarding.

Some people don’t need additional infusions at all. When you feel better, really so much better you’re empowered to build the life you want, there’s no need for boosters. And there’s no need to schedule them in advance.

But when you feel better but not better enough, you need to take action and find ways to get completely better. Start with another ketamine infusion. And take an inventory of your daily life. What do you need to change to make it better?

It might be taking action to change something. Or it might be taking action to change your attitude about something. But use those extra ketamine infusions to explore your life, your heart, your attitudes. And with the help of your therapist, make some solid decisions that renew hope in your life.

Renew your wellbeing.

Slash that powerless feeling and remove it…put yourself back in control.

It may require additional infusions every few months for awhile to get your life on track, your infrastructure in line with your purpose, and to create a life you enjoy. But it’s worth the effort.

And by the way, there’s no shame in additional ketamine boost infusions. No one but you knows what’s working for you. This is not a competition.

The goal is for you to live life as your best self, rather than a shadow of that. That you can enjoy your work, your hobbies, your relationships, and your purpose.

At Innovative Psychiatry we work closely with you and your health care team to help you find the most productive and fulfilled you. Call us.

To the emerging of your very best self,

Lori Calabrese, M.D.

June 25, 2018
Remission by Ketamine Treatment: How You Can Hold On to the Benefits

IV Ketamine is a Most Extraordinary Medicine

Here Are Some Ways to Hold On to Its Benefits

This ONE medicine can relieve a wide array of psychiatric disorders. Remission by ketamine treatment is at center stage of the mental health world.

The same medicine that lifts depression and restores creativity, initiative, and hope, also stops suicidal thinking in 4 hours or less and relieves social anxiety.. and, oh yes, OCD. It restores balance in bipolar disorder, and dramatically reduces cravings in substance use disorders…it helps PTSD heal and may also prevent PTSD in first responders.

Ketamine isn’t just an anesthesia medicine any more.

It’s changing lives and taking the world by storm.

It can restore your power to enjoy the beauty of a yellow warbler as it sings among the cherry blossoms. Remember when you felt nothing…? A void. Empty. Isolated. But remission with ketamine treatment changes everything.

You’ve never seen a medicine like this. While pharmaceutical companies are testing other forms of the ketamine molecule, or other molecules similar to ketamine, there is so much more to be learned about ketamine itself!

These other molecules don’t rival ketamine in effectiveness — well, actually, nobody’s doing head to head comparisons.

Because ketamine itself has become the gold standard. Its broad reach and widespread actions relieve suffering in so many different disorders that for so many it has become hope in a jar.

Who could have ever dreamed the day would come when a few infusions could lift a new mother right out of postpartum depression and empower her to bond and enjoy her newborn…? Those heartbreaking stories you hear in the news … can be averted.

Think what ketamine could have done for Vincent Van Gogh if ketamine treatment had been available in his world. Of course, it was unheard of, but it could have saved not only his ear…but his life.

Because it’s saving lives.

Remission by Ketamine Treatment: Antidote for Psychiatric Misery

The terrible anguish that depressed persons suffer has an antidote now. Six treatments (or a couple more) and you can live again, create again, enjoy people again, come out of the terror of darkness again.

You can feel love, hope, initiative, motivation, and creativity. In the morning, you can spring out of bed, and sustain energy and productivity all through the day. Enjoy the taste of a flavorful tomato right off the vine. Tackle long forgotten projects again, complete them, and look at your work with deep satisfaction.

You no longer have to be trapped in a vacuum, unable to connect, lost in the shadows of your mind. You don’t have to fear your own reactions to unexpected noises, or insensitive comments someone drops in your presence.

Feel whole again, find out you can have self-control, and build a life you’re proud of. For many who suffer with depression anxiety that just won’t cut them a break, such a concept is an elusive dream.

But it’s time for us to take a step further, and learn more.

For instance, what factors influence how effective ketamine treatment is for you?

Infrastructure for Optimal Wellbeing

Without question, one factor is simply all those unknowns. Because we’re learning daily about what ketamine can do, as well as the unique genetic, environmental, and other factors that may prevent one brain from responding to ketamine when the next one responds so dramatically. There are factors we just don’t know or understand yet.

We have so much to investigate and learn.

But there are some factors we do recognize.

For instance, it appears that there are environmental factors and personal ones, too, that may determine how long a series of ketamine infusions will benefit you.

Remission is Most Enduring when Your Personal Infrastructure Is in Place

When we speak of infrastructure, we’re referring to all the things in your life that play a part in your outlook and productivity. Things like your attitude, your response to stress or conflict, your nutrition.

To get the most out of ketamine treatment, it helps to do the work to learn and practice healthier reactions and responses, so you don’t pull the same old problems in after you.

It helps if you’ve learned to practice self-love along with respect for others. To manage your anger, and avoid the pitfalls of co-dependency. It helps to feed your microbiome to help maintain your emotional balance.

Because even if ketamine’s wonderful repair work brings you to peace, if you haven’t done repair work in your thinking, your attitude, your outlook, your view of yourself…as well as your view of others… the destructive habits that may have crept in with the misery of your disorder in the first place will slowly tear down the work your ketamine treatment accomplished in your brain.

Not what you want.

You could, then, get a booster infusion to refresh the good repair.

On the other hand, if you’re actively participating in therapy to help you change your attitude and outlook, as well as your responses to the things that happen in your life, you may find your outlook stabilizes after you reach remission… and lasts.

This, of course, is not to say that if remission doesn’t last, it’s your fault. It’s not. There are far too many factors involved in what you’ve experienced to blame your symptoms on any one thing, especially something within your control.

But consider this.

Choices You Make Can Strengthen Remission

If a stressful life has found you reacting and angry in response to small frustrations, or if you’ve been in a toxic relationship where you know you’re being abused and exploited, and stressors like these aren’t changed, you can see why you’d become more and more worn down and stressed…even despondent…all over again.

But let’s say you found the courage to leave that destructive relationship…or you figured out how to change the way you perceive small frustrations so you’re able to be unruffled by them (and ketamine can help you accomplish these things)…you can see how the peace and emotional health in your life would benefit. Don’t you think..?

That’s the thing about ketamine. It can do its part to restore those brain structures that have been worn down and broken by stress, but it can’t force you to get some distance from those factors.

That’s a step you must take … and ketamine treatment can help you get there.

Hard Decisions Lead to Better Living

Here at Innovative Psychiatry we’ve seen this happen in our patients time and again. Sometimes, a patient reaches remission and has a new lease on life. But in a month or two she’s so disappointed because she thinks the ketamine treatment has “worn off.”

However, rather than the treatment wearing off, it’s far more likely that new damage is happening because of her unchanged thinking or environment. When our patient understood the impact of those things, and she entered counseling, her need for booster or refresher infusions seemed to disappear. We have seen this process in many patients.

Many patients have been able to enjoy remission for over 2 years once they learned to make healthy changes in their lives.

There really are things you can do – with ketamine’s help – to maintain the joy of remission by ketamine treatment.

Medical Skill with Ketamine Treatment Can Turn B- Results to A+ Results

Another important factor in achieving and maintaining remission seems to unmistakably be tied to the methods used in administering this medicine. The outstanding and life-saving benefits of ketamine treatment have changed the way the world views depression, social anxiety, bipolar disorder, PTSD, OCD, substance abuse disorders, eating disorders…and suicidal thinking.

But, to get the most out of your ketamine infusion, in addition to building your infrastructure, you need to choose a psychiatrist who is most skilled in administering ketamine to your best advantage.

We use precision infusion pumps, state-of-the-art monitoring equipment, and we’re adept at titrating dose, rate, and frequency to achieve optimal outcomes.

Our goal for you is remission of your symptoms with ketamine treatment.

There’s no question that ketamine treatment can renew your hope if you or your loved one suffers with stubborn symptoms.

Know that you can feel better, live better, and restore what your symptoms have taken from you. You can find your real and best self, and enjoy the world you’re in.

If you suffer from symptoms that medicines and treatments haven’t helped, call us. We can help you turn your emotional and mental chaos into order through ketamine treatment. You can enjoy new hope and purpose for your life.

To the realization of your best self,

Lori Calabrese, MD

June 18, 2018
2018: Neuroscience Breakthroughs like IV Ketamine Treatment Mean Breakthroughs for YOU

Neuroscience breakthroughs like…IV ketamine treatment..?

Exactly.

2018 lies before us, like a valley that spreads to the horizon. And while it’s impossible to access the future, you can move forward knowing that each “today” you live has promise that was unheard of until recently.

Especially if you suffer from untreated or treatment-resistant depression, anxiety, bipolar disorder, PTSD, or anxiety — social anxiety, OCD or phobias.

Neuroscience researchers have been discovering more and more about treating psychiatric mood disorders that has transformed our approach to treatment — and the outcomes, as well.

The 21st century breakthrough of IV ketamine treatment for depression is transforming psychiatric medicine. Studying the effects of this treatment has revealed that depression and other mood disorders wear away at the signaling structures in the brain, leaving synapses, dendrites and dendritic spines broken, weakened, and sparse.

Neuroscience breakthroughs like IV ketamine treatment can bring breakthroughs to you … to your life.

The clearing away of those broken down structures, and the rebuilding of new ones in a denser, more prolific, forestation turns out to be key to treating depression. The old theory that depression was caused by levels of serotonin or dopamine that were too low … well they’re ancient history now.

Neuroscience Breakthroughs like IV Ketamine Treatment means Breakthroughs for You

Actually, so far we know of four ways ketamine clears away depression and erases suicidal thinking so quickly. And we’re watching with anticipation to see if research this year will reveal even more.

So another intervention ketamine performs is related to the G proteins that are piled on lipid rafts in the cell membranes of the neuron cells in the brain. Depressed people have these G proteins piled up on lipid rafts, where they can’t do their job to enhance signaling from synapse to synapse.

For those who are helped by traditional antidepressants, it takes several hours for those G proteins to slide off the rafts and become productive.

This is one reason it takes so long for traditional antidepressants to work for those they help. But when ketamine is given, they slide off the rafts within minutes. Remarkable.

Yet another healing action of ketamine is its effect on DNA. Turns out it also switches on mRNA which in turn flips the DNA switch to “ON” and that fire hoses BDNF across the synapse network.

BDNF is a growth factor like the richest of composts, and it empowers the dendrites and dendritic spines to burst into blooming branches like a giant oak tree. When the BDNF is fueled by ketamine, it turbo boosts that prolific branching of synapse structures, and your brain lights up like New York City. Unprecedented.

A well-lit brain is a happy brain.

Quoting from our earlier post entitled, “Breaking News: Another Way IV Ketamine Smashes Depression,”

As new synaptic connections are built, and greater communication between brain cells develops, the brain gains the ability to see things in a different perspective, and your outlook becomes brighter and healthier.

IV ketamine can jump start that process. Wait. No. It can turbo-charge it.

Extraordinary.

And the fourth action IV ketamine treatment performs is increasing glutamate levels to equip synapses to send more and faster signals across the brain, which traditional antidepressants don’t touch. Brilliant.

APA Task Force Issued a Consensus Statement in May 2017

What a year it’s been!

Four actions of ketamine we know about so far. The outcome is so extraordinary, so successful in such a large number of treatment-resistant cases, the American Psychiatry Association assigned a task force to issue a statement about the use of ketamine, this anesthesia medicine, off-label for treating depression.

Their statement was one of the most momentous and widely read articles of the year. In fact, it’s listed as #3 on JAMA Psychiatry’s “Most Talked About Articles of 2017.” Suffice it to say that those who were on the task force are true experts in our field. They’d seen ketamine’s power to lift depression right out of the water.

So they offered guidelines and cautions, and expressed their elation when interviewed that such a thing has happened in their lifetime.

They also specify that ketamine should be administered under a psychiatrist’s supervision.

TheHealthSite.com featured a list of the 6 best medical achievements of 2017 that everyone should know about…. Ketamine for depression stood strong on that list.

Of course, we know ketamine’s discovery didn’t happen this year. Many years of studies and clinical trials laid the groundwork for ketamine’s popularity now.

Thousands of patients have experienced the relief, the return of joy, initiative, creativity, and energy without side effects that ketamine provides.

Never before has there been such a medicine that treats so many disorders in such a huge percentage of the population as ketamine.

Ketamine has delivered HOPE.

At Innovative Psychiatry, we see 80% of patients who’ve suffered for years with treatment-resistant depression, crippling panic attacks, suicidal thoughts that won’t stop, severe bipolar disorder, PTSD, social anxiety, and OCD experience relief, restoration, and relaxation after treatment.

Another neuroscience breakthrough that means breakthroughs for you is Transcranial Magnetic Stimulation or TMS. It uses a coil to create a focused magnetic field over the front left side of your head. Specifically the left dorsolateral prefrontal cortex region.

Then it sends tiny repetitive pulses deep into the brain to the emotion-regulation region. This stimulates the nerve cells and wakes them up. When they wake up, they begin to function again and give you better emotional regulation and function.

With TMS treatment, you sit quietly for anywhere from 16 to 37 minutes, five days a week for 6-8 weeks. About halfway through the series of treatments, depression begins to lift, and you begin to feel better and better. Again, faster than traditional antidepressants, and without any of the weight gain, sexual dysfunction, fatigue, or GI side effects they can cause.

The sophisticated technology of TMS continues to develop. Even 5 years ago TMS seemed experimental and wasn’t widely available. But, like ketamine,TMS built a strong reputation for effectiveness.

In general terms, clinicians and hospitals report 60-75% success with TMS around the US. We see 75% of our patients consistently respond — and often remit — at Innovative Psychiatry.

Again, HOPE.

Curcumin has gained an ever stronger reputation for its use as an adjunct in treating depression. Plus the connection between the brain, mood, and the strengthening of the microbiome is growing and gives us more and more opportunities to work with your diet and lifestyle to improve your mood.

No known treatment lifts depression, anxiety, bipolar disorder, PTSD, or OCD in 100% of cases at this point. But these innovative treatment options prove successful for 75 – 80% of people who suffer in spite of traditional treatments. Obviously, hope soars for you if suffer with depression.

If you suffer from suicidal thoughts, depression, bipolar disorder, PTSD, social anxiety, OCD, you can feel better. The age of despair for sufferers is quickly dissipating. This has never been the case before. You really can feel better….lots better….as in really good.

If you’d like to start 2018 on a brighter, fuller, more functional, and happy path, call us. We live one day at a time, because “now” is all we really have. But live well. Live as the best you you can be.

To your very best self in 2018,

Lori Calabrese, MD

January 1, 2018
Will My Doctor Give Me an IV Ketamine Treatment Referral?

Hoping for an IV Ketamine Treatment Referral?

Recently, we talked about reasons some doctors may be reluctant to provide IV ketamine treatment for psychiatric mood disorders. We talked about how difficult it is to harvest all the information about ketamine for depression on the internet and become informed. No drug company spends millions of dollars in marketing a drug they won’t profit from. So there aren’t the usual easy-to-digest brochures and videos that help a doctor assimilate the information quickly. And there’s so much out there!

Over 1200 papers, thousands of pages, that require trainloads of nights and weekends to study. When does a busy physician ingest all that?

Skepticism about Prescribing Off-Label

We also talked about the skepticism of doctors who want to see more solid long term studies. Studies with large numbers of subjects followed for years to see what long-term side effects might arise.

In addition, we talked about what an enormous undertaking it is to set up a practice or clinic for IV ketamine infusions. The protocols, the staff, the expensive equipment for monitoring and delivering the infusion. Plus the extra office space, the federal and state regulations that have to be followed regarding storage of a controlled substance, biohazardous waste, etc.

It can be overwhelming for a psychiatrist who is accustomed to a practice of verbal evaluations and 15 minute med checks.

To make a long story short, some psychiatrists aren’t that eager to prescribe a drug off-label. They want to see more studies, and they want to be sure it’s safe. Not to mention the fact that there’s fear of abuse.

Ketamine for Depression is Spreading by Word of Mouth

And this is the reason doctors who are currently treating their patients with ketamine for psychiatric mood disorders are publishing their results.

We want you and your doctor to have the benefit of our experiences with our patients, the methods we’ve found to be the most effective and safe, and the reports of our patients after treatment.

Because as we mentioned in the prior article, since pharmaceutical companies can’t make a huge profit with a drug that’s off patent, doctors everywhere just aren’t receiving all the usual aids offered to familiarize us with all the data about ketamine.

Without Pharmaceutical Billions, Ketamine Resorts to Grass Roots

So it’s become more of a grass roots movement, if you will, to share information with each other, with neuroscientists, and with the public, and raise awareness of the effectiveness of treatment with ketamine for psychiatric mood disorders, like depression and anxiety.

Using the best practices encouraged by the Consensus Statement of the American Psychiatric Association Council of Research Task Force on Novel Biomarkers and Treatments, psychiatrists across the US and around the world, are finding ketamine treatment to have rapid and robust antidepressant results. And their patients are enjoying restored lives, restored enjoyment, and restored hope.

Ketamine’s Short Duration: A Solution that Restores Joy in Life

Some professionals caution that ketamine treatment has a short duration. But, psychiatrists and the anesthesiologists who’ve been using ketamine for decades, have made a discovery. And that is that approximately 6 infusions over a 2-week period seems to “stack up” enough of ketamine’s benefits that they last far more than just six times longer than one infusion. Like a synergistic treatment cluster.

For many patients, this regimen brings more than improvement… it brings remission. For others, as long as there are maintenance doses to keep ketamine’s actions working, their lives are lived as if they’re well. Really well.

So with so many doctors treating hundreds and thousands of patients with extraordinary results, why isn’t word spreading faster?

Frustrating, isn’t it?

“Will my doctor give me an IV ketamine treatment referral?”

Sorting Through the Literature

You hope so. But understand that your doctor may need more time to come to an informed and confident opinion about ketamine treatment. It may have a lot to do with the information he or she has found on the subject. She may be reading peer-reviewed studies as she gets time. Or he may have run into some articles that present vague results. But encourage them to keep researching. Because there are plenty of professional journals publishing exciting findings, even though there are some articles that are less optimistic.

In fact, there are dozens of articles across the internet, written about ketamine treatment by biased individuals. Those who either aren’t medical professionals, or are biased without experience with ketamine. And these articles influence those seeking information, and sour them against recognizing the facts when they see them.

When people form opinions without building them upon a foundation of neuroscience, but rather on the comments of others, prejudices form. Biases form based on impressions, opinions, hearsay… you can read examples in all sorts of forums on the web. Opinions tossed out with “impact,” but with little or no fact.

Second Opinions May be Helpful

And truth be told, while your doctor’s learning for himself what he believes about ketamine, you can learn about ketamine treatment and discuss seeking ketamine treatment. And then share your results with your doctor and with your family.

In fact, your family may suggest you let “a second set of eyes” look at you and your illness. Especially if they can see you haven’t been improving. Most doctors respect that, and it’s an ideal time to check with a doctor who offers innovative treatments like IV ketamine treatment.

Still, understand that your doctor may not feel comfortable referring you for a treatment he’s not yet confident about. But you’re responsible for your own well-being and health. In the 21st century healthcare environment, individuals have become informed about their health and wellbeing and are far more engaged in looking for solutions than ever before. And you can choose to seek out physicians who do offer ketamine treatment, then report your results back to your doctor. By doing that, you’ll give him a data point to build his own research around.

It’s true that some doctors have been known to react to a patient’s stepping away from their recommendations. And that’s a shame, if their advice has not helped you recover. It’s also true that you as the patient are the person actually living with your symptoms. And enduring them. I daresay, you should not be punished for actively seeking a better quality of life.

The same is true if you’re a parent of a teen who struggles with a mood disorder. An example is with treatment-resistant bipolar depression. Since research shows that early treatment gives your child the best hope of getting better, as a parent you probably feel compelled to find the solution that really works.

IV Ketamine Treatment for Depression – Experimental?

Ketamine treatment is still considered “experimental” by some psychiatrists, but for those of us who have seen extraordinary success in the lives of so many patients, it’s become a relied upon and almost miraculous solution.

The consensus statement by the task force mentioned above points out that more studies are needed with large populations. True. Of course that’s true. But, the task force members also laud the results of IV ketamine treatment with their own patients. The guidelines they suggest for providing ketamine were not to discourage doctors from using it, but rather to encourage doctors who offer it to offer it within safe parameters.

At Innovative Psychiatry, we use the same careful monitoring and other safeguards recommended by the APA task force, as well as others, and have for years. We’ve seen very positive responses in 80% of our patients who have been failed by traditional antidepressants over the long term.

They’re amazed at the continuous improvement in their lives, their relationships, and their enjoyment of life.

If traditional antidepressant treatment has failed you, call us. We’ll schedule an appointment to determine whether IV ketamine treatment is right for you.

We’re here to help you find joy in life again.

To the emerging of your best self,

Lori Calabrese, M.D.

September 5, 2017

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