Used mostly as an anesthetic or analgesic (pain reliever) by anesthesiologists, at lower doses, ketamine (also known as esketamine when given in nasal spray form) has been shown to rapidly and effectively reduce and relieve symptoms of treatment resistant depression that may or may not be accompanied by anxiety. This outpatient office-based treatment method has two phases: an induction phase (the amount of time required for your body to acclimate to ketamine in it) and a maintenance phase.
During the first phase, ketamine is administered in the office intranasally twice weekly for four weeks (weeks one to four) for a total of eight treatments. At the end of week four, the individual is evaluated to determine the need for continued treatment in the maintenance phase.
During the maintenance phase, ketamine is continued once weekly for four more weeks (weeks 5 to 8. Then, from week 9 onwards it is given every 2 weeks or continued once weekly. The dose frequency is individualized to the lowest frequency needed to maintain the best response to this therapy. Each treatment is monitored in our office for 120 minutes. The most common side effects include dissociation, dizziness, nausea, sedation and blood pressure elevation. Most of these side effects are short lived and resolve during the 120 minutes observation period.