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Ketamine Infusions for Treatment Resistant Depression


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I am pleased to inform patients that I now offer management for treatment-resistant psychological disorders with low-dose ketamine infusion therapy. This therapeutic method has shown to benefit those who suffer Major Depressive Disorder (MDD), Post-Traumatic Stress Disorder (PTSD), Bipolar Disorder, and/or Generalized Anxiety Disorder unresponsive to conservative measures. To initiate therapy, I require a referral from an established psychiatrist and will respectfully abide by their treatment plan for psychiatricKetamine Infusions management. I also request that patients complete a PHQ-9 assessment in-office to help determine whether this treatment is an appropriate option for their present condition. Low-dose ketamine is a non-FDA approved method to address psychiatric health, however consistent and successful results following extensive clinical trials support that patients who suffer treatment-resistant depression greatly benefit from monitored therapy.

Ketamine is an anesthetic used to address treatment-resistant symptomatology that is associated with chronic pain syndrome as well as various psychological disorders. As mentioned earlier, it is non-FDA approved for psychiatric symptomatology, but a widely accepted analgesic for chronic pain unresponsive to most traditional therapies. The benefit of low-dose ketamine over alternative analgesics is credited to successful delivery of effective anesthetic qualities without prolonged sedation or respiratory depression. Ketamine was first introduced in the 1960’s as a safer alternative to the anesthetic phencyclidine. Anesthesiologists and other pain physicians began using ketamine at subanesthetic levels (a dose lower than what would cause anesthesia) for patients who suffered treatment-resistant neuropathic pain and responded poorly to traditional methods of treatment. Medical use of ketamine has widely expanded among physicians due to the successful outcomes observed during treatment in addition to recently discovered solutions that address psychotropic side-effects.

Treatment protocol includes administering a ketamine drip at an escalating dose while frequently monitoring a patient’s vital signs and level of consciously. The two accepted methods of clinical therapy include short-term infusions and prolonged infusions. Short-term exposure is shown to provide significant analgesia during administration only, while prolonged treatment with routine infusions over 4-14 days will provide more long-term relief for up to 3 months. As a controlled substance, the use of ketamine must be closely monitored and administered by a certified medical professional with experience. Individuals who abuse ketamine and/or engage in recreational use of other illicit substances often display health risks that are associated with high and recurrent ketamine exposure. The consequences of ketamine misuse include psychedelic symptoms, nausea, vomiting, cardiovascular stimulation, renal dysfunction, or bladder complications. Expansive research and evidence supports that patients who undergo monitored therapy in clinical settings will respond well and tolerate treatment with minimal risk for these side effects. If psychotropic symptoms are experienced during administration, benzodiazepines can successfully and safely reduce these side-effects. Not all patients require the use of benzodiazepines during infusion therapy, but management for potential discomfort is available if needed.

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Portland Pain And Spine Providers

Dr. Carl Balog Physician

Dr. Carl Balog is Board-certified in anesthesiology, interventional pain management, and addiction medicine with substantial clinical management and consultative experience. He is the CEO/Medical Director of Cornell Surgery Center and has been on the Board of Managers since its inception. In his off time, Dr. Balog enjoys classical music, local cuisine, Dragonboating, and travel.

As the son of a judge and a registered nurse, Joseph Knaus has had a lifelong passion for helping people. After becoming a Gerontological Nurse Practitioner in 1998 and later a Family Nurse Practitioner in 1999 in Missouri, Joseph relocated to Oregon in 2000, and has been practicing in the field of pain management for the past 14 years. An eternal student, when Joseph is not helping his patients, he is often studying new and alternative healing methods from the typical healthcare model.

Joe Knaus