• Frequently Asked Questions

The more patients know about ketamine therapy, the better informed you are to decide if treatment is the right choice for you. We have included some frequently asked questions about ketamine infusion therapy. We want to alleviate any misperceptions or mysteries about the efficacy of the drug in treatment.

At MPH, we aspire to create an environment where every patient feels safe and comfortable. Our clinic is designed to be an attractive, well-appointed medical facility. We want it to feel less like being ‘at the doctor’ and more like you are with friends or family.

Field Anethesia

The History

Ketamine was first synthesized in 1962 by Calvin L. Stevens, a professor of Chemistry at Wayne State University in Detroit, MI. After a lot of very promising research, ketamine was first introduced in controlled human testing in 1964, demonstrating ketamine’s short duration of action and reduced behavioral toxicity, making it a favorable choice over others as a dissociative anesthetic.  Another benefit of ketamine was that is doesn’t lower blood pressure or breathing rates. This, in turn, led to the FDA’s approval in 1970.

Some Americans may know ketamine as a field anesthetic that was used extensively during the Vietnam war to help wounded soldiers on the battlefield. Medics were able to administer ketamine quickly and successfully under difficult circumstances with few adverse side effects. Ketamine is now used daily in U.S. operating and emergency rooms as anesthesia for painful procedures.  It is also the most common anesthetic in third world countries and is listed as one of the World Health Organizations “Essential Medications” due to the high safety profile of this medication.

FAQs

On a basic neurochemical basis, it is an N-methyl D-aspartate (NMDA) receptor inhibitor.  Blocking the NMDA receptor allows for modulation of glutamate (an excitatory neurotransmitter) and ultimately increases levels of Brain-derived neurotrophic factor (BDNF) and mammalian target of rapamycin (m-TOR), which create protein synthesis in neurons.

Many ketamine experts consider this process a “reset” button for the brain, just like you would reset your computer.  A ketamine infusion allows the unhealthy neuronal pathways that are constantly “on” in your brain to turn off for a period of time.  One can consider all the unhealthy thoughts that continuously occur – such as automatic negative thoughts, obsessive thoughts, anxious thoughts, persistent pain – as these unhealthy pathways.  When your brain comes back “on-line”, you can then access the more healthy pathways or loops in your brain.

Simply put, ketamine works by shutting down overactive neurons while improving the healthy function of the existing neurons. In addition, ketamine improves neural connectivity in the brain that enhances daily, healthy brain function.  Ketamine helps a patient restore executive control of their thoughts and emotions.

Michigan Progressive Health requires a $250 in-person office consultation. This sixty-minute office visit will give ample time for the patient to meet our providers, review risks and benefits of ketamine, answer all questions, and get adequately prepared for the initiation series of ketamine infusions. We are committed to providing each patient with the right tools and resources for success- part of this is presenting alternative therapies that may either compliment or be done instead of ketamine therapy.

To provide you with the highest quality care, maintain confidentiality, and avoid restrictions imposed by insurance companies, we are not in-network with any insurers and collect the full fee at time of service. This allows us to spend more time and direct more attention to you and your care, rather than to meeting insurance company requirements. 

If you have coverage for out-of-network providers, as is typically offered by PPO insurance plans, you might be able to receive some reimbursement for your treatment, though this is not guaranteed and is determined by your insurance provider. After your treatment is rendered, we will provide you with a Superbill at your request that you can submit to your insurance. Payment is due at the time of your visit via cash, check, or credit card.

The cost of each infusion is $500. The number of infusions will differ depending on the patient’s condition and response to initial treatment.

Consultations to begin the treatment process are $250 and require a 50% deposit.

Follow-up Office visits are $150.

MPH Pricing 2023 (Click Here)

MPH looked into many healthcare financing options and chose Walnut as the best option for patients. More information can be found at www.hellowalnut.com 

Please contact MPH with more questions regarding financing.

Ketamine treatment occurs in two steps – “Initiation” and “Maintenance”.

The vast majority of our patients are treated with 6-8 treatments over 3-4 weeks during the initiation phase.

The maintenance period consists of “boosters” – which are typically a single treatment. The first booster is typically scheduled 2-3 weeks after your last initiation infusion. After that, every patient varies, but the average length between boosters is 4-6 weeks.

We find that our patients work with us anywhere from 6 months to 2 years.

For patients with mood disorders, Michigan Progressive Health uses a daily text program to monitor your mood and help decide on timing between infusions.

No, you do not need a referral for treatment here at Michigan Progressive Health.   We evaluate each patient on a case by case basis.  We recommend bringing any records you might have from your psychiatrist, therapist, PCP or pain specialist.  

We do require patients with Major Depression with Psychosis, Bipolar I Disorder and Schizoaffective disorder to have an established relationship with a psychiatrist before starting treatment.

You will be greeted by our office staff and asked to fill out a short questionnaire. The doctor will perform a physical exam. The doctor will start an IV and place you on monitors. We will help you get comfortable and then begin the infusion.  During your infusion you will have your blood pressure, heart rate, oxygen level and breathing monitored.  Typically the infusion lasts one hour, and we monitor you for 15 to 30 minutes after the infusion.

Hydrating the day before an infusion can be very helpful in starting IVs smoothly, as dehydration can make it difficult to gain IV access. Abstain from alcohol/cannabis/substances 24 hours before and after an infusion. Take your medications as you normally would unless otherwise specified by one of our providers. Think on an intention for the treatment session. Our therapists have some intention setting resources if requested. If possible, do not plan on any activities that have the potential to be intense or stressful before or after the treatment as well.

 

A full and accurate medication and allergy list, and any diagnostic/treatment information from prior physicians. It is recommended that you bring a family member or trusted friend to help you understand if ketamine is right for you.

Please do not have anything to eat four hours prior to your infusion appointment or have anything to drink two hours prior to your appointment.

No. You should continue to take all your medications as scheduled, including your medications for pain and depression. You may find a decreased need for these meds after your infusion; however, you should work with your doctor to wean off these medications instead of stopping quickly.

Comfortable, loose clothing.

How ketamine feels mentally and emotionally is very hard to describe as this varies between patients, and no two infusions will feel the same. Multiple factors can influence an infusion such as current life events/stressors, your choice of music, who sits in the room with you during an infusion, and what intentions you set before your infusion starts. Physical sensations that are common include numbness/tingling in the face and extremities, feeling as though you are floating and/or moving even though you are still, difficulty with speech and coordination, blurred/fuzzy vision, and a heaviness in the body. Some patients may experience nausea/vomiting, drowsiness, dizziness, headache, and increased urination as side effects which our staff are trained to manage.

There is no right or wrong way to experience a treatment. Everyone finds what suits them best (be it lighting, music, supportive others, etc.) and allows them to relax into the session as they progress through their treatment plans.

 

This varies from patient to patient. Some people appreciate knowing their support person is right next to them if needed. Others find it easier to settle into the infusion without others in the room. Until you find your preference, you can start with whatever you think will work best for you. During the infusion, we can always ask your supportive other to leave or come back to the room as needed.

Yes, with some stipulations. Discuss with front desk staff and/or providers for more information

To start, one of our nurses will take you back to your treatment room, obtain vitals (blood pressure, heart rate, oxygen saturation), and place an IV. For IM/oral sessions the nurse will just take vitals. Once the nurse is finished, the provider will enter to discuss treatment. You will always see a provider before a session starts. The nurse will then administer the ketamine and any other medications that may be needed. IV infusions usually run over 50-60 minutes. IM/oral session lengths vary depending on dose and the individual’s response to ketamine. Once the IV infusion ends, 15-30 minutes of recovery time is given to relax and allow the ketamine to wear off. More recovery time is given if needed. Afterward, the nurse will obtain one last set of vitals, remove the IV, and the session is complete.

Press the call button and a nurse will come in to check on you. If you are visibly anxious on the monitor, the nurses will enter the room to check in with you as well. They can serve as someone to talk to, take you through grounding/breathing exercises, or if possible address the cause of your anxiety (change music, change lighting, adjust speed of the infusion, etc). If no other anxiety reducing techniques work, we do have medications to reduce anxiety that are given IV (or IM for IM/Oral sessions) and start working quickly. It is every patient’s right to stop the infusion at any time if it becomes too overwhelming. For patients who may need extra support, our therapists on staff can sit in during a treatment session if scheduled in advance.

We have multiple nausea medications we can use if needed, either as premedication before the infusion, during, after, or tablets we can send home in case of nausea later in the day. A key role in preventing nausea/vomiting is to abstain from food 4 hours and beverages 2 hours prior to an infusion.

If in the middle of an infusion you need to use the restroom, one of the nurses will pause the infusion and walk with you to the restroom while holding the IV bag. The infusion can be restarted as soon as you return to the room. In an IM/oral ketamine session, a staff member will walk with you as well. We have wheelchairs in the clinic if needed (but rarely necessary).

Once an infusion ends we give patients a 20-30 minute recovery period. By the end of that time, most patients feel well enough to leave the clinic. If more recovery time is required, it is given until patients are able to make the journey home. We recommend reserving the rest of the day to recover from residual effects from ketamine treatment. By the following morning, patients are able to return to their normal activity level without issue.

This varies from patient to patient depending on factors such as diagnoses, severity of symptoms, therapeutic work in addition to ketamine treatment, level of support being received, current life events, etc. Some patients may see some improvement after 1 treatment, some may notice improvement after 6.

MPH strongly recommends that our patients have an active ongoing relationship with a licensed therapist.  Studies have shown that ketamine is more effective when given in the context of therapy.  We do understand that many patients have tried multiple therapy modalities without success prior to seeking treatment with us.  We’ve built a strong and trusted network of mental health professionals that understand ketamine treatment who we can refer you to.

No. Your thinking may be impaired for up to 24 hours, and we require you to have someone to drive you home BEFORE starting the infusion.  We also ask that you refrain from operating heavy machinery, avoid strenuous activities, do not watch small children or sign/enter into legal contracts for the next 12 hours.

The time between infusions varies from patient to patient. Much of it depends on response to treatment, severity of symptoms, and how long patients are able to tolerate without treatments. For example, one patient may require 2 infusions a month, others may require 1 infusion every 3 months.

Yes, MPH is quite comfortable treating teenagers with treatment resistant mood disorders.  We do require our pediatric patients to be working with a therapist and the treating physician must approve of ketamine therapy before treatment can be started.

The patient must have their psychiatric medication prescriber send a referral through our website for the patient to start the treatment process.  The MPH team will then reach out to the provider to determine if the patient might be an appropriate candidate for ketamine therapy.  Our team is happy to share supporting literature with your child’s treatment team.  If it is agreed that your child might benefit from ketamine, our patient coordination staff will reach out to schedule a consultation.

For your infusion there are pillows, blankets, noise-canceling headphones, speakers, iPods in every room with Spotify, eye masks, candles, and projector lights. Complimentary snacks and beverages are available in the clinic waiting room after your infusion has finished.

Currently MPH offers legal psychedelic treatment in the form of ketamine assisted therapy.  We are awaiting the final results from stage 3 FDA trials for MDMA and Psilocybin and hopefully will offer those treatments as they become legal.

Integration involves the practice of processing and making meaning of ketamine experiences to help bring about long-term change. This can involve incorporating these lessons into your life with a therapist, group therapies with other patients, actively working on behavioral change you wish to make, engaging in mindfulness practices (yoga, meditation, etc), and/or creative expression. We offer integration sessions with our therapists as well as free group therapy sessions.

Providers can prescribe medications but this is determined on a case-by-case basis. In some instances, MPH will coordinate care with your other healthcare providers.

Any severe hypertension, chest pain, evidence of street drug abuse (cocaine, amphetamines or opiates) or manic symptoms during your physical exam will prohibit you from receiving Ketamine.

There is no added cost if you require any additional medications (such as for anxiety, nausea, headache, etc) before, during, or after your infusion.

We offer a military discount of 10% for both active and previous service. All other discounts for services are case-by-case and based on need. Those who qualify are determined by the providers and office management.

Once you come in for your initial consultation, we require that you leave a card on file in case of missed appointments or charging for virtual visits. We accept cash and check as well and unless specified otherwise, we will always use the card on file for payments. We accept all cards except CareCredit® (unless it has a Visa® or Mastercard® logo on the card).

We will give you a call if you are 10 minutes late to ensure that you are coming to your appointment. We will do our best to accommodate tardiness, but if you will be more than 15 minutes beyond your scheduled time we may have to reschedule your appointment and you may be charged 50% of the appointment cost depending on the circumstance. If it will not impact other patient’s appointments, we will do our best to fit you into the schedule.

At this time, once the initiation series of infusions are complete, at-home ketamine can be an option for those that qualify. Not every patient is a candidate for at-home ketamine.