The benefits of using Ketamine alonside TMS
You had mentioned that you use Ketamine here also for treating depression and anxiety, so I’m curious, what kind of indications do you use Ketamine for and do you use it in conjunction with TMS and why?
So we use ketamine at Redemption Psychiatry. We’ve been doing it for the past year. Trying to stay on the cutting edge of things, we’ve found that the research is robust enough to say this is worth bringing to our patients but it really stands to reason that using ketamine – which helps to improve the interconnectivity in the neurons – complements in a very positive way, complementing the effect of TMS treatment because we’re working on the frequency of the overall activity of the neurons. So if we can improve the connectivity, and we can improve and alter the frequency, then we’re working on the two main aspects that we need to have a good solid communication.
The brain’s communication, so that it is functioning optimally, is going to definitely rely on whether, if it’s overactive that we can inhibit that overactivity and if it’s underactive that we can stimulate it, but if it’s not connected that’s a much harder thing to deal with and so we found that ketamine helps to improve that connection. But the long-term results – and that’s a big thing that I think is really difficult in any ketamine clinic – is that people have really great results but then they want to make sure that maintains and sometimes, it can be very difficult to have to come in and get maintenance treatments for ketamine, certainly with costs and time. So if we follow up ketamine infusions or do them simultaneously with TMS, it’s absolutely the best treatment that we’ve seen.
A lot of times, talking with patients in order to help them understand what would be the most optimal for them, you have to keep giving your personal experience in trying to help them to understand what you see day in and day out, the improvements that you see, but you can’t really communicate that any better than to tell them. If I were in the same situation, if I try to picture everything that you’re going through and used all of my knowledge to say, well what would I do for myself, what would I prescribe for my parent, my brother or sister, my child, my wife and I would say we would do a series of ketamine infusions along with the TMS for the best outcome. And I believe that hands down, that is absolutely the most effective. If you say, people that have all the money, all the time in the world, it’s no object, would you offer them something different, would you tell them to do anything different? No, I would say you do a series of TMS and ketamine together for the best outcome.
Do you do the ketamine treatment the day before they start TMS or a couple of days or a week before, what’s the usual workout?
One of the best things to do is to start getting a kind of priming treatment where you start the ketamine a couple of days before TMS, starting with the TMS after the first week. In the first couple of days to a week, they get another ketamine infusion and so we should be getting through with the ketamine infusion within the first three weeks, the first half of the treatment and then finishing the last two, three weeks of TMS.
Do you space the treatments between the treatments so that they come in one day and do ketamine and then they come in the next day and do the TMS?
So usually we’ll do the TMS treatment a little bit before the ketamine, get the TMS treatment that day and then follow it up and get the ketamine infusion, sometimes right away, sometimes a little bit later in the evening.