Best Practices

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

Lori Calabrese, MD, provides these articles about best practices in psychiatric treatments to help you choose interventions best suited for you. We intend for these articles to help you choose practices that will help you the most. Because we want you to get better.

Ketamine Treatment – IV or IM

In administration of ketamine treatment, for example, there is a variety of approaches providers use. Some doctors provide ketamine as an IM injection. This calls into question the amount of medicine that’s actually reaching the delicate systems in the brain where it’s needed.

Another big problem with intramuscular injections is that the physician can’t manage the medicine once it’s injected. Once the medicine is injected into a muscle, the patient must endure whatever dissociative side effects take place, and the doctor is unable to stop the infusion if needed, or reduce the rate. Plus, she can’t personalize the dose for that patient or titrate it according to the patient’s response.

On the other hand, IV administration puts the medicine straight into the blood stream. It travels straight to the brain systems and structures where it’s needed. The dose and rate can be increased or decreased according to the patient’s experience.

Titrate Dose for Optimal Therapeutic Response

Different people demonstrate different responses at different doses. Some people may need a dose of 0.5mg/kg  to achieve remission after 6 infusions, in other cases, that’s not enough. Other patients need a higher dose of 0.6 or 0.9mg/kg to achieve the appropriate response. Also, expect to give them 8 or 10 infusions, because 6 were not enough.

For this reason, we provide only IV ketamine infusions using a sophisticated infusion pump that measures precisely the amount of medicine that goes into the brain. And we adjust the dose and rate during each infusion. We want to get the best possible response and outcome for you. Because we’re striving for remission.

We also complete a thorough history of each patient before the first infusion. This helps us better determine whether this patient is a good candidate for ketamine. During this session we also prepare him or her for the experience.

Additional infusions or “Boost Infusions”

In some cases, the benefits of ketamine treatment may decrease after weeks or months, especially in cases of extreme stress. In such instances, it can be helpful to receive another infusion to refresh the work the ketamine treatment had begun. Many times this additional infusion can revive the remission and restore the joy, hope, motivation, and energy that was lost.

These articles about best practices are provided to help you choose a practice and a method that will give you the best outcome for your treatment.

Enjoy…and we hope this is educational and shows you options for a symptom free life.

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