NOVA Health Recovery Ketamine Infusion Center (Virginia Ketamine Infusion Therapy for Depression)

Depression is the leading cause of disability in people between the ages of 15 –44. Major depression is a common debilitating disorder affecting 10%–15% of the population per year. Despite advances in the understanding of the psychopharmacology and biomarkers of major depression and the introduction of several novel classes of antidepressants, only 60%–70% of patients with depression respond to antidepressant therapy. 

Of those who do not respond, 10%–30% exhibit treatment-resistant symptoms coupled with difficulties in social and occupational function, a decline in physical health, suicidal thoughts, and increased health care utilization. According to the findings from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, 50%–66% of patients with depression do not recover fully on antidepressant medication and one-third of patients do have a remission of their depressive symptoms.

Scientists think that in people with clinical depression, certain neurotransmitters may be out of balance. One option for treating depression is prescription drugs that affect the levels of certain chemicals that brain cells use to communicate, called neurotransmitters. These options are sometimes called antidepressant medications. Some types of antidepressant medications that are available include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs). 

These medications affect levels of serotonin, among other neurotransmitters to produce their effect. Other options for treatment include psychotherapy, Transcranial Magnetic Stimulation (TMS), and ECT (Electroconvulsive therapy).

Despite these advances, many therapies do not work well in a significant percentage of the population and produce their effectiveness very slowly. In a landmark 2000 study published in Biological Psychiatry, Robert Berman and colleagues at the Yale School of Medicine demonstrated that ketamine had quick-action antidepressant properties on people with treatment-resistant depression. 

Further investigations by Carlos Zarate showed that a single infusion of ketamine produced robust improvement in depression in 71% of the test subjects and remission in 29%. Further work by Carlos Zarate using was showcased in the JAMA 2017 article in which the ketamine experience of rapid antidepressant effects was reviewed in an interview.

Ketamine has produced rapid reductions in depression in treatment-refractory patients in numerous studies and has performed well when other interventions had minimal impact. This has been experienced in our ketamine center as well. For more information, links to ketamine in the media are available to download:

Post-traumatic stress disorder (PTSD) is a chronic and disabling condition arising after exposure to a severe traumatic event, characterized by persistent reexperiencing, avoidance, and hyperarousal symptoms. In the general population, prevalence has been estimated at 7.8%, with higher rates in trauma-exposed populations, particularly among survivors of interpersonal violence. Standard therapies used in depression do not work for PTSD, including selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and other medications. These treatments are associated with significant levels of nonresponse and persistent residual symptoms in the few that do respond.

One of the first randomized trials demonstrating ketamine’s effectiveness in PTSD was in a study by Dr. Feder in June 2014. The study was designed after the recognition that a medical record review of a large sample of burned servicemembers found a significantly lower prevalence of PTSD among patients who received ketamine during post-trauma surgical procedures than among those who did not. This study demonstrated significant improvements in multiple domains in PTSD symptoms and depression that lasted several weeks and beyond. Ketamine has been shown to rapidly increase the number and function of synaptic connections in the prefrontal cortex, rapidly reversing behavioral and neuronal changes resulting from chronic stress and trauma-related memories. This data provided the first randomized, controlled evidence that NMDA receptor modulation could lead to the rapid clinical reduction of core PTSD symptoms in patients with chronic PTSD

Here are some symptoms of PTSD that you can use to screen you or your family members:
Persistent avoidance of distressing memories, thoughts, or feelings about or closely associated with the traumatic events or of external reminders (i.e., people, places, conversations, activities, objects, situations)

Two or more of the following:

•  Inability to remember an important aspect of the traumatic events (not due to head injury, alcohol, or drugs)
•  Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” “The world is completely dangerous”).
•  Persistent, distorted blame of self or others about the cause or consequences of the traumatic events
•  Persistent fear, horror, anger, guilt, or shame
•  Markedly diminished interest or participation in significant activities
•  Feelings of detachment or estrangement from others
•  Persistent inability to experience positive emotions

Two or more of the following marked changes in arousal and reactivity:

•  Irritable or aggressive behavior
•  Reckless or self-destructive behavior
•  Hypervigilance
•  Exaggerated startle response
•  Problems with concentration
•  Difficulty falling or staying asleep or restless sleep

Also, clinically significant distress or impairment in social, occupational, or other important areas of functioning not attributed to the direct physiological effects of medication, drugs, or alcohol or another medical condition, such as traumatic brain injury.

If you or a loved one is suffering from these symptoms, seek help from a therapist if you have not done so already. Ketamine infusions are an excellent choice to help control your symptoms to gain back your life.