TMS THERAPY
FDA-cleared, non-medication depression treatment
Medically reviewed on by
Regional Medical Director Greater St. Louis
Maybe it’s your first time trying ketamine therapy for depression. Or maybe, you’re seriously considering it and are curious about the process. Either way, you may be wondering, “What does ketamine feel like?” While treatment can affect everyone differently, there’s a general idea of what you can expect during and after your ketamine therapy. When it comes to ketamine for depression, there are two main treatment methods: intravenous (IV)
ketamine therapy and
esketamine nasal spray. Each of these treatments can have a slightly different effect on the body.
During a ketamine injection, you may feel dizzy or disconnected from your surroundings, almost as though you are floating. Your mind may wander to strange, dreamlike places, and you may feel deeply relaxed but awake. You may also feel warm, groggy, and nauseated. Some patients vomit during or after IV ketamine therapy. If you routinely get sick during car rides or while taking new medications, then mention that to your ketamine provider.
The first dose may affect you the most and produce “trippy” effects, but as your body gets used to the ketamine during subsequent injections, you may feel less drastically different during treatment. Some people may not feel much different from usual, even during their first treatment.
Ketamine can affect memory, and you may not remember much about your ketamine treatments after you finish them. Think of how it feels to wake up after a vivid dream. Even if you experienced a good or interesting dream, the details seem to slip away before you’re fully awake, leaving you with a blurry memory of your time during treatment.
A standard dose of ketamine for depression is 0.5 mg/kg over 40 minutes. Ketamine IV therapy providers may begin at a lower or higher dose and run the IV for longer or shorter, depending on your symptoms and what they feel is best. Ketamine IV therapy isn’t FDA-approved for depression, which is why there’s no official protocol for dosage.
You’ll have a needle inserted in your arm for the duration of your ketamine IV injection anywhere from approximately 40 minutes or an hour. Since most ketamine IV patients return for multiple treatments per week during the beginning of a treatment plan, your injection site may become sore.
After the IV is removed, you’ll remain at the center for observation until your provider determines that it’s safe for you to be released.
Esketamine nasal spray can also make you feel dizzy, profoundly relaxed, and dissociated from the space around you. Instead of an IV injection, your provider will show you how to spray the esketamine in your nose. The spray may drip down the back of your throat, and it might leave you with a metallic taste for a while..
Some people have shared feeling only minor symptoms in the hours after an esketamine nasal spray treatment, while others report feeling symptoms more strongly. Regardless of how you feel, your SPRAVATO® treatment center must be certified by the SPRAVATO® Risk Evaluation and Management Strategy (REMS) program, and each center must follow the appropriate protocol set out by the FDA and REMS.
This means that even if they don’t feel too drowsy or altered, patients must remain at the treatment center for at least two hours after taking SPRAVATO®. During the 2-hour period, the clinic staff observes each patient’s reaction to the medication and helps ensure a safe treatment experience.
After each patient is cleared to leave, they must be picked up and driven home by someone else. This safety precaution is in place because esketamine can make you feel sleepy and drowsy for the remainder of the day. Patients should not drive or operate any machinery until the next day.
Regardless of which type of ketamine therapy you take, the aftereffects can be similar: you might feel drowsy, slightly drunk, and a little bit “out of it.” Therefore, it’s a good idea to block time to rest and relax after leaving the REMS site.
After a full night’s rest, however, these side effects should be gone. The benefits to your mind, however, are just beginning. Some patients report feeling improvement in depression symptoms just hours after esketamine treatment. Ketamine IV therapy can also lead to rapid improvement of symptoms. Other patients find that it takes a few treatments to feel better.
Because the induction period for both ketamine IV and SPRAVATO® means you’re getting two treatments per week, there’s a good chance you’ll feel better just one to two weeks after starting ketamine treatment. To help assess how well the medication is working, SPRAVATO® patients are given depression scales to fill out before each session.
Unlike IV ketamine for depression, esketamine nasal spray is FDA approved for treatment resistant depression (TRD) and major depressive disorder with suicidal ideation (MDSI). This means that no matter how you feel after ketamine-based treatment at a SPRAVATO® REMS-certified location, you can rest assured that proper protocol will be followed. It also means that treatment is covered by insurance. Ketamine IV therapy, on the other hand, is not.
Greenbrook TMS is REMS-certified to provide SPRAVATO® treatment. We offer
esketamine nasal spray consultations to help you learn whether you’re a fit for SPRAVATO®. If you’d rather not deal with how you feel after ketamine treatment, we also offer transcranial magnetic stimulation (TMS), a medication-free, FDA-cleared depression treatment. Learn
how TMS works.
Whether you come for TMS or esketamine nasal spray, your Greenbrook TMS Care Team will guide you through each step of treatment and make sure you feel comfortable throughout.
Schedule a free consultation today to start your journey of relief from depression.
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