Finally, after 18 failed ketamine treatments, I found one that worked!
Ketamine infusion therapy has revolutionized our understanding of depression and rapidly gained national attention as a remarkably effective new therapy many mood disorders including anxiety and PTSD. Many well-respected scientists and researchers from around the world have been impressed by how rapidly effective it is. Even for those people who have not responded to any conventional antidepressant therapy in the past, a ketamine infusion can often relieve symptoms within hours following a single session.
Yet, despite its remarkable success, there are some people who may not see rapid or long-term benefit with ketamine. But that may be changing. Recent discoveries in precision medicine and newer, more effective, ways of administering it are enabling this innovative new therapy to rapidly relieve symptoms of depression and produce remarkable improvements even in patients who have not previously responded. One such person is Brad.
“Every day I had to act “normal” … and it was draining”
Brad is a 45-year-old successful healthcare recruiter in Chicago who appeared, by all accounts, to be happy and successful. Few people knew that he had been plagued by crippling depression and anxiety since his early teens because he had become very skilled at “acting normal” so that no one would know.
Like most people who suffer from depression, Brad had seen several psychiatrists over the years and had tried a long list of therapies including psychotherapy, cognitive behavior therapy and multiple antidepressants and mood stabilizers.
Not long-ago Brad consulted with a new psychiatrist to see if there was anything else that might help him. During that meeting, his new doctor reviewed some of Brad’s past medical history and suggested several medication adjustments that could be made but said that he had tried almost everything available.
“Antidepressant just weren’t helping, I needed to try something different”
A few weeks later when Brad saw him again, he reported that there was no change in his symptoms with the adjustments and in fact, he actually felt worse than ever. It was at this point that his psychiatrist offered him his last available alternatives – “you can try either electroshock treatment (ECT), transcranial magnetic stimulation (rTMS), or ketamine infusions”.
Brad was reluctant to undergo ECT due to the potential for memory loss he learned about, so he considered TMS. After reviewing some of the TMS material and talking to some people who had it performed, he learned that TMS, although covered by his insurance, was not as effective as he had hoped, so he chose to try ketamine. Once the decision was made, he diligently researched his options for treatment locally and found a well-known doctor in Chicago who was offering ketamine infusions.
Committed to explore this new alternative, Brad noticed that that after 4 or 5 treatments he felt a little better, but that the improvement in his mood only lasted a few days before he was depressed and anxious once again. His new doctor at the ketamine clinic then suggested that he continue the treatments in hopes that it might last longer. Brad agreed and had 13 more ketamine treatments, but unfortunately did not see any significant long-term benefit. He found himself as depressed and anxious as ever.
Is there anything better than ketamine?
Not to be discouraged, Brad felt ketamine might still be helpful. After all, nothing else he tried helped and he didn’t want to undergo electroshock treatments. So, he continued researching ketamine and discovered that there was a newer, more effective form of ketamine-based infusion called RESTORE. Intrigued by the possibly ketamine may still be effective for him, he called us.
In my initial discussion with Brad I asked what his ketamine experience was like. He said that it was “weird” but not too strange, as he was alert most of the time and could converse with friends. But the problem was, it only seemed to lessen his symptoms minimally and the improvement only lasted for a few days to a week. Then he asked if what we did was different than the infusions he had, and if could it help?
Yes, I said, the RESTORE program is different in many respects from a conventional ketamine infusion and that we may be able to help, but that I would need more information before we could make any determination. We talked on the phone for a while longer and I explained how the RESTORE program differs from conventional ketamine infusions.
Why RESTORE works when ketamine may not
I explained that the first step in our program was to look very closely at a person’s genetic, metabolic and medication profile to determine if they are in the optimal state to benefit from an infusion. But, in addition to metabolic optimization prior to therapy, the RESTORE infusion itself is unique in important ways. To begin, I told him, RESTORE utilizes combination of ketamine combined with magnesium to make it more effective than ketamine alone. Magnesium, I explained, acts as a synergistic agent, or cofactor, which also works at the same NMDA receptors sites as ketamine and is necessary for an optimal response, but that it must be given at the correct time and in the correct ratio to have maximal effect.
Equally important was the fact, I said, that the older and simpler infusion protocol has also been updated to a more sophisticated and improved 3-stage variable rate infusion. Utilizing this approach, the RESTORE protocol achieves higher and more targeted optimized blood levels and maintains them for a longer period of time.
By optimizing the blood levels in this way, I said, the RESTORE infusion program not only achieves higher effective serum concentrations of the parent molecule – ketamine, but it also achieves higher concentrations of the critical secondary metabolites of ketamine known as HNK (Hydroxynorketamine) and DHNK (Dehydronorketamine). This is important because higher levels of these metabolites cause an increase production and release of something known as BDNF (brain derived neurotrophic factor), and it is the increased presence and activity BDNF that actually contribute to the long-term improvements seen with ketamine.
All of this, I explained, does not even address the remarkable therapeutic benefits that can occur from the positive psychological experience during an infusion. By optimizing the serum concentrations in the way that we do, each person has the best opportunity to gain personal insights, understanding and a new perspective that can sometimes greatly aide in the recovery process. Although the RESTORE program is much more involved and complex than a conventional ketamine infusion, the results are certainly worth it, I said.
Getting ready for RESTORE
After our lengthily discussion, Brad felt a renewed sense of optimism about trying infusion therapy again and told me that he wanted to proceed. I then asked if he had undergone any laboratories studies prior to beginning ketamine. I also asked about his current medications and a little about his genetic background to obtain a better picture of who Brad was as a person.
Following our initial talk, I asked Brad to arrange to send me some of his physicians notes and whatever lab tests had been done so that I could review them before we spoke again. Brad agreed and said that he would arrange to send several of his physician treatment notes and all of the labs that were available in the next few days.
When they arrived, it became very apparent to us why his ketamine infusions weren’t helpful. In Brad’s, case we found several critical issues that needed to be addressed before considering resuming infusion therapy. In Brad’s case, we found that he suffered from very low testosterone levels and that he did not convert folate, a critical element in the production of serotonin, dopamine and norepinephrine, into an active form. In addition, his doctor had prescribed a medication known as Lamictal to help stabilized Brad’s mood. Unfortunately, Lamictal has been found to have a very negative effect upon the way in which ketamine works.
After reviewing the records, we then arranged with Brad to have his testosterone and folate methylation issues corrected quickly. In addition, Brad’s physician had agreed to begin lowering his Lamictal dose slowly over a two-week period prior to his planned infusion. Now he was is in a much better position to benefit from our program.
Trying something new… again
Once he arrived, Brad was anxious to get started with the 3-day program. After the first infusion, he and his wife already noticed a remarkable improvement in his mood. He was more engaging, talkative and seemed much less anxious than before. He was also surprised about how much more pleasant the experience was while having the infusions. During the infusion session, Brad said, that he felt as though he could see his life from a more objective point of view. He had realized that he was holding on to a lot of negative thoughts and behavior patterns that were not helpful, and he was able to let go of them without any difficulty.
Almost immediately, he felt lighter and more connected to himself, his family and the world around him. Encouraged by the early response, he was looking forward to his next day’s session. As we continued, Brad progressed very rapidly, and each infusion experience was better than the last. By the time we finished his third and final session, he was almost a completely different person.
“I was able to enjoy life again!”
Brad has continued to do very well since RESTORE. He is back to work with more energy and enthusiasm than before. He enjoys his life, his family and is getting out much more now with friends. He tells us that his resiliency to stress has improved and he no longer becomes irritable under daily stresses.
He continues to see his therapist and finds the sessions much more helpful and productive than before. He sees his life from a new and expanded perspective, free from the constant repetitive negative thoughts that he once had. He continues to see us too, but only once or twice a year for follow up RESTORE infusions when he feels he needs them.
Brad had a very rapid and robust response to the RESTORE infusions, and while we cannot guarantee that everyone will do as well as Brad, we can promise and guarantee that we will do everything possible to ensure the best possible improvement for all of our patients.
If you would like to learn more about the RESTORE Infusion Program or the Ketamine Research Institute, please give us a call 800-850-6979 or visit our RESTORE Infusion website – www.restoreinfusion.com or the Ketamine Research Institute website – www.ketamineinstitute.com for more information.