Ketamine treatments can be rapidly effective for patients who are suffering from treatment
resistant depression. However there is a subset of patients who don't respond.
I want to go over seven reasons why this may be the case. #1 medications. The most commonly
known medications that decrease the effectiveness of ketamine are lamotrigine and benzodiazepines.
So these two can interfere with the effect and decrease its effectiveness. And this
could be one reason why. #2 is the appropriate dose. You neither want too much or too little ketamine.
Think of an upside down u-shaped curve. And the optimal amount is right there
at the peak where it's the optimal dose. I like to call it the "Goldilocks amount"
and at our clinic we custom tailor each infusion to get that right dose that's going to give you
the maximum amount of benefits for each session. #3 is preparation. A lot of ketamine treatment
clinics don't talk about the importance of preparation. This is crucial. What we feed
our minds will play an impact on the ketamine experience. So for example, if one were to watch
a horror movie the night before the ketamine session that's definitely going to impact
your experience tremendously. So at our clinic we recommend patients prepare for at least five days
prior to the infusion and throughout the series of infusions so that they're in the right mindset for it.
#4 is the set & the setting. The "set" refers to the mindset and the intention that one has
prior to receiving the ketamine infusions. I like to think of the intention of setting the GPS
coordinates before going on a long road trip. And it's really important to know exactly where one
wants to go and what one wants to achieve during the session. The other factor is the "setting."
Where is the clinic at? How do you feel when you're there? What does it smell like? What is the
music that's being played? Are you checking social media as you're getting your ketamine infusions?
All of these things will play a factor in the ineffable experience of the ketamine treatment,
And as you know ketamine does create these non-ordinary states of consciousness
and you want to be in the right "set" with the right "setting" as you receive the IV ketamine treatments.
#5 is the integration and what I mean by integration is what happens in between the
sessions and after the sessions. I kind of like to think of integration as doing the homework
that one knows in their heart that needs to be done. And this may look like quitting alcohol.
It might look like starting to exercise. It might look like journaling, meditating, etc.
But for each individual person it's going to be a unique integration and it could also include
talking with the therapist. Talking with a coach. Talking with an integration specialist
to really create the maximal benefits from the ketamine treatments. Although ketamine treatments
are great it's just one part of a holistic approach. #6 is the number of sessions.
Some people will get dramatically better after one or two sessions. Whereas for other people it can take
four to five to six even before they notice a difference. I like to think of plants. When you
plant a seed in the ground it's going to take some time for that to grow and mature.
Getting ketamine treatments are not like an on-and-off switch, where all of a sudden it changes.
I would say it's more like a gradual process of a plant growing. You wouldn't plant a seed and
come back the next day and expect for it to have sprouted. But if you water it. Give it plenty of
sunshine and fertilizer then it'll gradually slowly grow, much like the neurons and the
synaptic connections of the brain. #7 we wish that ketamine treatments were 100% effective for 100%
of the population. But this is simply not the case. Studies have shown that about 30 to 40% of people
are non-responders. And at our clinic we do have a slightly higher rate of improvement up to 81% of
patients but still it's not 100. And we don't know why and it might be due to individual differences.
It might be due to genetic differences. But it is what it is. And so if that is the case and you
fall into one of these seven categories don't lose hope. There are many options. Ketamine is simply
one tool in the arsenal of mental health. You have other treatments like ECT, transcranial
magnetic simulation, EMDR, different medications that are coming out. And because there's so much
research happening right now this is a crazy amount of innovation happening in mental health.
So keep your eyes open. Keep your ears open. Don't lose hope. Ketamine is an
amazing medication but know that it's not 100% effective and there might be multiple
reasons why this is the case. Thanks so much for watching the video and I'll catch you next time.