Ketamine: How long is a course of treatment and how do I maintain remission?

When choosing a method of treatment for your depression, it is important to consider timing. Antidepressants take about 4-6 weeks to work, and you usually remain on them for up to a year after your depression improves. Since antidepressant medications are usually taken daily, patients must be willing and able to be compliant to this regimen, which can be difficult. TMS, or transcranial magnetic stimulation, involves 36 daily sessions administered over 6-8 weeks. The ketamine treatment protocol is a little less time consuming, and may be a good option if you are looking for immediate relief of severe depressive symptoms. At Principium Psychiatry, all treatment methods are preceded by an initial evaluation, during which one of our providers will assess you and your symptoms to see if you are a candidate for ketamine therapy or another one of our treatment options.

Our ketamine treatment protocol involves two phases: the loading phase and the maintenance phase. In the loading phase, patients get 2-3 infusions per week for 2-4 weeks, with the total number of infusions usually falling between 6 and 12. This loading phase is to help you achieve a significant (>50%) decrease in symptoms or even complete remission from your depression. You may start feeling an improvement after 1 or 2 infusions, but it is important to fully complete the loading phase in order to achieve optimal symptom reduction that lasts.

After completion of this phase, your treatment becomes even more personalized – we encourage patients to keep in touch with us and let us know when they feel their depression creeping back in so we can schedule another few infusions: This is known as the maintenance phase. This entails 2 infusions over the course of one week in order to maintain remission and keep your symptoms at bay.

Once a patient reaches the maintenance phase, it is quite varied how often they will need these “booster” infusions. Some patients prefer to get 1 or 2 infusions per month in order to proactively prevent the resurgence of their depression. Others come back for their booster infusions 3 or 4 months after the completion of their initial 6-12 infusions. Each person’s depression is different, therefore each ketamine treatment plan is highly personalized to optimize mood and achieve remission.

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