Frequently Asked Questions
What is ketamine?
Ketamine is a dissociative anesthetic, originally developed in 1962 for use as a sedative in the operating room. Since then, it has been used widely in emergency medicine, veterinary medicine, and wound care around the world. Ketamine is often used for the most vulnerable patients, including children and the elderly, due to its safe profile and minimal side effects. The World Health Organization has designated ketamine as one of the 100 most essential drugs in the world WHO.
Research since 2000 has found that when administered in low doses, Ketamine addresses symptoms of mood spectrum disorders, including depression, anxiety, PTSD, and bi-polar disorder. It is also used to address symptoms of severe pain.
Is ketamine right for me?
For appropriate patients, ketamine can be an exceptionally effective option to relieve symptoms of depression. It can help people even when other treatments have not worked.
Studies have shown that ketamine relieves depressive symptoms for 75% of patients with depression, including Major Depressive Disorder and Treatment-Resistant Major Depressive Disorder. This is compared to antidepressant prescription medications, which have shown to be effective for only 30% of people with depression, and often include extensive side effects JAMA STARD*D .
Some patients experience relief after one infusion, some experience relief after multiple infusions, and some patients receive infusions without obtaining any relief. Each individual is unique, and the outcome of their infusion treatment plan may not match the results found in studies or experienced by other patients Nature.
Is ketamine safe?
Yes. Ketamine is used extensively in hospitals and clinics every day, and has been administered safely to millions of patients for decades.
To ensure safety, ketamine infusions should be administered by medical professionals trained in anesthesia or emergency medicine.
Does ketamine have side effects?
During infusion, the most common side effect of ketamine is mild nausea. In rare cases, patients may experience allergic reactions, elevated blood pressures, elevated heart rate, or cardiac arrhythmia. A monitoring physician will intervene in the case of any of these effects FDA .
There are no known negative long-term effects of ketamine when used at the appropriate doses for depression and anesthesia. Select cases of long-term, daily use of ketamine by those who abuse the drug have shown some negative effects on the bladder and on cognition Yale .
Is ketamine addictive?
No. Ketamine is well documented to be a non-addictive medication. There is no physical dependency established with the use of ketamine, and patients who stop using the drug do not experience symptoms of withdrawal WHO .
That said, there are cases of abuse of ketamine among some people seeking an altered mental state who have access to the drug in a non-medical environment, without supervision of trained medical professionals.
Is ketamine an opioid?
No. An opioid is a compound that binds exclusively with opioid receptors in the brain. While ketamine has been found to interact with the Mu Receptor (an opioid receptor in the brain), it also interacts with 15 other receptors in the human brain Wiki .
Unlike opioids, ketamine does not cause euphoria, it does not slow down or stop breathing, and it is not addicting.
How much do infusions cost?
At Ember, we charge $500 per infusion. This includes the cost of the medication as well as its administration and monitoring. We do not charge for initial screenings or interviews prior to infusions.
Will insurance pay for infusions?
We are an out-of-network provider to all insurance plans.
Depending on your insurance plan, you may be reimbursed for a significant portion of the fee. 50% of our clients with out-of-network benefits have had their treatments paid for by their insurance plan.
After treatments, we will provide you with a statement called a "superbill" reflecting services rendered out-of-network to expedite the reimbursement process. If you are unsure about how the out-of-network process works, please do not hesitate to contact us.
Payment is due at the time that services are rendered, unless we agree to an alternative arrangement.
How long do infusions take?
Each infusion includes 40 minutes of medication administration, with an additional 20 minutes of resting time before discharge.
How many infusions will I need?
The American Psychiatry Association suggests a total of four infusions within a two-week period as a foundational course of treatment JAMA.
For how long will I feel better?
For most patients, ketamine relieves depressive symptoms for between two and six weeks after each infusion. Patients may receive booster infusions as depressive symptoms recur JAMA.
We work with each patient to identify a suitable maintenance program. Sometimes, this consists of a regular cadence of infusions according to a patient’s needs and schedule. Some patients find that their need for boosters becomes less frequent over time, prompting them to come in every 2 - 3 months. In some cases, patients experience full remission of their depressive symptoms and do not feel the need to seek continued treatment Yale.
Ketamine boosters may be given for as long as needed with no known long-term side effects.
What if I don’t have a referral?
At Ember Health, we only provide ketamine treatment to people who have been referred by an accredited and trusted healthcare provider, including psychiatrists, psychologists, therapists, or primary care providers.
This is important to us for several reasons: For one, we never want to be the ones to diagnose people directly with depression or encourage our therapy if there are other options that might be of greater help. Second, data shows that ketamine treatment is most effective when accompanied by continuous therapy.
For those not yet connected to a provider, we’re happy to help. We’ve built a strong and trusted network of mental health professionals who can assess symptoms of depression and discuss whether ketamine is an appropriate option.
Will any medications interfere with this treatment?
Yes. Ketamine will not be effective in addressing depressive symptoms for patients actively taking Benzodiazepines (trade names: Valium, Klonopin, Xanax, or Ativan). A handful of other medications may also decrease the effectiveness of ketamine.
We discuss medication history with each patient before treatment, and work with healthcare partners to suggest modifications of existing medication as appropriate.
What if I'm on other antidepressant medication?
While starting ketamine infusion therapy, the concurrent use of other antidepressant medications will not interfere with ketamine's effectiveness of addressing depressive symptoms, nor will it present negative medication interactions.
Many patients who experience relief from ketamine have found that over time, they can reduce or eliminate other antidepressent medications. We advise each patient to tailor their unique medical treatment plan in partnership with their mental healthcare provider.
Will other medical conditions exclude me from treatment?
There are no medical conditions that preclude the use of ketamine treatment. That said, ketamine is not advised for patients with schizophrenia or uncontrolled heart or blood pressure issues.
Our physicians review the medical history of each patient prior to treatment. All patients are closely monitored during treatments by a physician trained in emergency medicine to ensure the safety of the treatment (see above).
What if I don't live in New York?
While the majority of people we treat live in or around New York City, we make every effort to accommodate the needs of those who come to us from farther away.
Consistent with the American Psychological Association’s guidelines, we administer four foundational ketamine treatments to all new patients over a 7 - 14 day period. For those coming in from out of town, this often entails a week-long stay in New York or two, three-day visits over the course of two weeks. That said, we tailor treatment plans based on individual medical needs and travel restrictions.
After the foundational treatment, we provide infusions as depressive symptoms may recur, and will continue to work with individual calendars and travel plans as needed. For those new to the area, we’re happy to recommend nearby accommodations and services.