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 learn about and choose practices that will help you the most. Because we want you to get better.

Choose Carefully

Ketamine treatment is a powerful, multi-faceted medicine.  And it can save your life. And your marriage. And your job.

It is an exquisite interventional treatment for psychiatric disorders that we are deeply experienced in offering. And we offer it within our scope of practice — not because we’re unhappy with the specialty we trained in, or because we are stepping out and doing a side gig — but because we love what we trained in, we love psychiatry, and we want the best for our patients and for our field.

Ketamine Treatment – IV or IM

There are a variety of approaches that psychiatrists use when they prescribe ketamine for psychiatric symptoms in a controlled office environment, including IV, IM or as an intranasal spray.

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 quickly increased or decreased according to the patient’s needs.

IM injections are more rapid, and slightly less bioavailable, so the dose needs to adjusted for this. The onset is more rapid, the experience of dissociation lasts about the same length of time, and the ending is cleaner.  No beeping of the pump, no waiting for the nurse.

Titrate Dose for Optimal Therapeutic Response

Different people demonstrate different responses at different doses. Some people may need a dose of 0.5 mg/kg  to achieve remission after 6 infusions.  In other cases, that’s not a high enough dose or high enough number of treatments.  Everyone is different, and we work hard to help our patients achieve remission.

For this reason, we provide ketamine treatment using sophisticated pumps that measures precisely the amount of medicine that goes into the brain. And for infusions, we can 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 evaluation 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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