NOVA Health Recovery LLC Ketamine has been used medically for over 50 years and has an excellent track record for safety. Continued research for this drug has found it to be useful for multiple disorders, including depression, suicidality, PTSD, CRPS, neuropathy, chronic pain, and several other conditions.NOVA health Recovery LLC, directed by Dr. Christopher Sendi, in Alexandria, Virginia, offers infusions of Ketamine to patients that are appropriate candidates for such treatment after careful screening. We offer these infusions in the safety and comfort  of a monitored environment. The process takes about an hour, and depending on the situation, may require several infusions over a few weeks.

 Is Ketamine right for me?

Patients who have been diagnosed with treatment resistant depression are candidates for ketamine infusion therapy. This includes patients with major depressive disorders, post-partum depression, bi-polar depression and severe anxiety states. When a patient has not responded to in-patient therapy, medicine, or other forms of treatment, Ketamine infusions should be considered as the next step.

Ketamine treatments are not for those with mild depression, situational depression, or mood swings. Severe depression is often the result of Post-Traumatic Stress. This stress does not have to be the result of “war wounds”, but can arise from neglect, abandonment, bullying, sexual abuse, or severe depravity during the developmental years. The depression is often not manifest for a decade or more following the trauma. Ketamine infusion therapy can successfully treat post-traumatic stress and subsequent depression.

Patients with recurrent thoughts of suicide, who need immediate mood stabilization, will most often benefit from Ketamine infusion therapy.

 Depression

If you are visiting this website you are most likely dealing with a major depressive disorder (MDD) that has not responded to other medication. Many of you will have had trials of all the available antidepressants. Some of you have had ECT and /or TMS with no significant improvement in your condition. Chances are that you can no longer function at home, work or school, and find even small tasks, like showering, insurmountable.

Periods of depression are common mood disorders that most people face from time to time.  They follow life events and disappointments that impact us deeply.  These kinds of depression are generally short lived and respond to psychotherapy, conventional drug therapy or simply tincture of time. They are not crippling. But, lifelong MDDs are something different, and are more likely associated with suicidal thoughts and attempts.

Over the past five decades, antidepressant research and medications have revolved around the regulation of three neurotransmitters; serotonin, dopamine and norepinephrine. Together, they represent about 15% of the brain’s neurotransmitters. Much more prevalent is the neurotransmitter glutamate, which has only recently begun to receive attention as instrumental in treating mood disorders. It is via the glutamate system and two important receptors, NMDA and AMPA receptors, that ketamine works to relieve depression. It does so by turning back on BDNF production. The BDNF then leads to repair of the damaged neurons with regrowth of the important dendrites and synapses needed to achieve a normal mood. Animal models show us that the repair can begin in a matter of hours after the administration of ketamine. This process of brain repair is called neuroplasticity, and ketamine facilitated neuroplasticity offers great hope for patients with MDD who have not responded to other treatments.

Ketamine has also demonstrated effectiveness in :

  1. Persons with neuropathic pain that is not well controlled with injections, nerve blocks, or prescription pain medication. Examples of this kind of pain are trigeminal neuralgiacomplex regional pain syndrome (CRPS), or reflex sympathetic dystrophy(RSD), phantom limb painpost-herpetic neuralgia, and someheadaches.
  2. Persons with chronic back and neck pain no longer responsive to any form of treatment.
  3. Persons with other debilitating musculoskeletal and joint pain

FAQS:

What is Ketamine?

Ketamine was first, and still is, an important human general anesthetic agent. It has been used in hospitals for the past five decades and has a proven record of safety. More recently it is being used to treat neuropathic pain and the symptoms of PTSD. The small doses and methods of administration used to treat psychiatric patients differ greatly from those used in hospitals.
Ketamine is on the World Health Organizations’s list of “Top 10 Essential Drugs”.

Is this treatment FDA approved?

Not yet. Over the past two decades dozens of studies in prestigious medical centers and The National Institute of Mental Health have proven ketamine’s safety and efficacy in treating major depressive disorders, anxiety, obsessive compulsive disorders and suicide ideation. Yet, without very large controlled studies generally required by the FDA to get approval for any psychiatric drug, approval has been delayed. Since ketamine is a generic drug, no pharmaceutical company will spent the hundreds of millions of dollars required for such a study. Efforts are being made to create a national registry of the outcomes of the thousands of patients treated by ketamine providers across the country to date. This data will be used to expedite FDA approval. In the meantime, ketamine is being used “off label”, as is true with many other medications prescribed by physicians.

Will I be treated as an outpatient?

Yes, ketamine infusions for depression are outpatient procedures requiring no hospital admission.

Do I need a referral from a psychiatrist?

No, while referrals from any mental health care provider are welcome and encouraged, an initial phone interview with one of our doctors can determine if you are a good candidate for ketamine therapy.

Is ketamine used to treat all patients with depression?

No, mild to moderate depression is successfully treated by mental health professionals with drugs and psychotherapy. The treatment of severe depression is more difficult and requires a higher level of care, such as ECT, TMS, and now ketamine therapy. Ketamine infusion therapy is reserved for those patients with severe depression that is considered otherwise treatment resistant.

Is it likely that my severe depression will respond to ketamine infusion therapy?

The patients we see are all considered treatment resistant. That is, they have not responded to available antidepressant medications and in many cases have not responded to ECT or TMS. We cannot predict who will respond to ketamine, but statistically 2 out of 3 patients do show a dramatic improvement in their mood and 3 out of 4 will cease to have suicide ideation. We will know within two treatments if ketamine infusions will help you.

How many infusions will I need and how long will I feel better?

If you have a favorable response to the first two infusions, a total of six is recommended within a twelve day period. That will maximize the ketamine effect on new dendrite and synapse growth. Thereafter, patients are placed a maintenance program where they return when they feel it necessary for a single infusion booster. During the maintenance period, the duration of relief following the initial infusions and the first booster, and between subsequent single booster infusions varies between patients. The average duration of relief between booster infusions is 3 to 4 weeks. There is no way to predict what your needs will be.

If ketamine does work, will I be on it for the rest of my life?

No, right now ketamine infusion therapy is, perhaps, the most exciting and successful new treatment for severe depression. But, there are large pharmaceutical companies developing ketamine like drugs for more convenient nasal and oral administration. It may be a few years, but those drugs will become available. In the meantime, ketamine has been proven effective in most cases, and is available to you or your loved ones. Patients with debilitating severe depression with constant thoughts of self harm can not afford to wait.

How long does an infusion take?

About an hour, with an additional half hour before discharge.

Will I be asleep?

No. The dose of ketamine you will receive does not cause any loss of consciousness.

What will I experience during the infusion?

Most patients experience a mild dissociation or inner reflective experience that is generally well tolerated. If you find it unpleasant we can treat it. Within 15 minutes of ending the infusion your thinking will be clear. There are no delayed “flashbacks.”

Are there any medications that will interfere with ketamine treatment?

Yes. The benzodiazepines, such as Klonopin, Xanax, and Ativan do interfere with ketamine if used daily and at higher doses. Lamictal (lamotrigine) in doses above 100mg/day also can block ketamine efficacy.

Will I have to stop other antidepressant medications?

No, other antidepressant medications do not interfere with ketamine’s mechanism of action.

Are there any medical conditions that will exclude me from treatment?

Almost none. Uncontrolled high blood pressure or heart failure need to be corrected.

Should I be concerned about any risks or addiction with ketamine therapy?

No, ketamine has been proven safe in humans over five decades in and out of hosptials and battle fields for surgical anesthesia and trauma management. Those patients experience longer exposures and at much higher doses than those used to treat severe depression. Although it has been abused recreationally in high doses as a club drug, there is no evidence that ketamine is addictive.

How quickly can I be seen?

True emergencies, with a psychiatric referral, can be seen within a day. But, in general, five to seven days are required to get you onto the schedule. Since we are here seven days a week we can meet most patient’s scheduling needs.

What is the cost?

The fee for each infusion is $475. We do not accept any private insurance or Medicare, but will provide you with the forms to submit for reimbursement. As of now about 35-40% of patients are receiving some reimbursement, but we cannot predict if your insurance plan will reimburse you.