The Three Main Routes of Ketamine Administration
Roughly 30% of depression patients do not respond to traditional antidepressants and are considered ‘treatment-resistant’. That’s why ketamine and esketamine (the nasal spray version, branded as Spravato) are two important options that we offer to these patients who have tried four or more antidepressant medications without success. Ketamine affects the brain differently than traditional antidepressants and has a 75% success rate for treatment-resistant patients compared to a 10% success rate if they try yet another antidepressant medication.
Ketamine is fast-acting and may help patients begin feeling better within hours of their first treatment.
When considering whether ketamine is right for you, it’s important to consider the three main routes of ketamine administration, including intranasal, intravenous infusions, or intramuscular injections. At Advanced Brain and Body Clinic in Minneapolis, we offer each of these routes of ketamine administration, allowing you and your provider the flexibility to choose which works best for you.
Ketamine IV Infusion
When ketamine is given intravenously through an IV, patients will absorb much higher levels of the medication (roughly 99%) compared to intranasal infusions. Since the medication is directly inserted into the bloodstream, some patients may experience a sudden lift of their depression after just one dose.
During an IV infusion, ketamine is administered at a steady rate over roughly 40 minutes. IV infusions give the greatest amount of flexibility, allowing your provider to adjust your dosage and rate of administration based on your weight, response, and any side effects you may experience during your treatment session.
While the exact number of ketamine infusions you receive will depend on your unique case, we typically begin with six infusions over 2-3 weeks. After the first two weeks, doses may be spaced out a few weeks apart. Many patients require maintenance treatments at a reduced frequency. Maintenance treatments may be given weekly, monthly, or less. Typically, maintenance treatments are given every 4-6 weeks to start and taper off over time.
Most studies have been done on this infusion route, which is the most commonly chosen route of ketamine administration.
Ketamine may be administered intramuscularly through an injection in the arm. Treatments are quick but may require multiple injections for a single treatment session. Roughly 93% of the medication is absorbed when administered through an injection.
Compared to an IV infusion, there is less control over the dosage. However, the dosage may be adjusted in subsequent treatment sessions based on the patient’s weight, response, and side effects.
Intramuscular injections follow a similar cadence to IV infusions. Patients typically receive six injections over the first 2-3 weeks, followed by one injection every few weeks as needed.
Ketamine Nasal Spray
Both ketamine and esketamine (Spravato) are offered intranasally as a nasal spray that comes in two strengths. When administered intranasally, roughly 20-30% of the medication is absorbed, so more frequent treatments are required to have the same effect as intramuscular or intravenous infusions.
Patients typically receive two treatments per week for the first four weeks, followed by one treatment a week for an additional five weeks.
Work with a Psychiatrist
There are a lot of clinics that specialize in ketamine. Specializing in a particular drug, versus a medical discipline (such as mental health or cardiology) is a relatively new and concerning development. When the focus is on the drug rather than the patient’s symptoms, it can be easy to miss additional conditions that need to be treated or the underlying cause altogether. For example, ketamine alone can worsen bipolar disorder or psychosis, so it is best to be seen by a psychiatrist who can treat all conditions you may be experiencing. At Advanced Brain and Body Clinic, many of our ketamine patients are also being treated for other psychiatric problems at the same time.
Call today to schedule an introductory appointment. Our mental healthcare professionals will be happy to sit down with you to discuss if ketamine is right for you.
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