Do I Qualify for At-Home Ketamine Therapy?

Ketamine, a dissociative anesthetic that was originally used in veterinary medicine and then in operating rooms, is gaining traction in treating several different conditions, from depression to migraine.

Though IV infusions are always administered under a doctor’s supervision in the office or a hospital setting, there are some instances where you may be able to use the medication in any of its different forms right from the comfort of your own home.

At the office of Dr. Michael Kullman, we offer both ketamine infusion therapy and at-home ketamine treatment to our patients in White Plains and Pleasant Valley, New York. Not every person qualifies for at-home therapy, though, so it’s important to know what’s involved before you get started.

More about ketamine

Researchers aren’t exactly sure of ketamine’s mechanism of action, but they do know it works on the glutamate system, which is different from most antidepressants, which target the serotonin system. As a result, it may address treatment-resistant depression (TRD), where patients don’t see positive effects from two or more different medications.

In one study, 70% of patients with TRD who were given the nasal spray form of ketamine (Spravato®) improved, compared to just over half in the control group. Ketamine also works much faster than traditional antidepressants, sometimes showing effects within 24 hours, compared with four to six weeks.

Ketamine targets the NMDA receptors in the brain, and by binding to them, it increases the amount of glutamate in the areas between neurons. Next, glutamate activates connections in the AMPA receptor, which leads to the release of other molecules that help neurons communicate with each other by forming new neural pathways.

This process is called synaptogenesis, and it affects mood, thought patterns, and cognition. It also provides the ability for patients to develop more positive thoughts and behaviors.

Ketamine may also reduce signals involved in inflammation, which has been linked to mood disorders, or may help with communication within specific brain areas. Most likely, it operates by using multiple pathways.

What conditions can ketamine help?

Ketamine helps with a variety of problems, both in the mental health area and with various types of pain.

Mental health conditions include anxiety disorders, major depressive disorder and postpartum depression, TRD, bipolar disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD).

Pain-related conditions include complex regional pain syndrome (CRPS), nerve and neuropathic pain, and migraine disease.

Do I qualify for at-home ketamine therapy?

Not everyone is a good fit for at-home ketamine therapy. To determine if you’re a good candidate, Dr. Kullman meets with you during a virtual evaluation, in which he discusses your overall health and medical history, current medications, lifestyle choices, and the symptoms you’re experiencing.

If he determines that you’re safe and prepared for at-home treatment, he prescribes the drug in the form of pills, dissolvable tablets, or the nasal spray and lets you know how often you need to take it. He follows up with you either virtually or in person to evaluate your experience and measure your progress.

At-home ketamine therapy requires that you be in a comfortable, calm, and relaxed environment. You’ll also need to have a friend or family member with you during the treatment, both for support and safety. Make sure you don’t have any alcohol or take any non-prescription medications beforehand, since they can interfere with ketamine’s effectiveness.

Take the medication exactly as directed, and don’t schedule anything after the treatment. That means not driving and not going to work. If you’re comfortable with this arrangement, you can continue at-home therapy. If you aren’t, you have the option of coming into the office for treatment.

Learn more about ketamine therapy or schedule an evaluation by calling our office at 914-465-2882 or visiting our website for more options.