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Ketamine Therapy

Ketamine Therapy may be right for those who have been chronically suffering, or for those suffering from newer symptoms with little to no relief with other traditional methods.

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Ketamine Therapy Q&A

What is Ketamine Therapy?

Ketamine is now an “off-label” treatment for various chronic “treatment-resistant” mental health conditions and chronic pain. Ketamine is a Schedule III medication that has long been used safely for surgical anesthesia and procedural analgesia and now may also be effective for the treatment of depression, alcoholism, substance dependencies, OCD, PTSD, and other psychiatric diagnoses as well as for existential, psychological, and spiritual crises and growth. Often, it has been used after other treatment approaches have been unsuccessful.

Who is a candidate for ketamine therapy?

Before participating in ketamine treatment, you will be carefully interviewed to determine if you are eligible for ketamine therapy. This may include but is not limited to medical history, a physical exam, review of your medical/psychiatric records, a psychiatric history and administration of brief psychological tests to assess your state of mind. Pregnant women and nursing mothers are not eligible because of potential effects on the fetus, or nursing child. The effects of ketamine on pregnancy and the fetus are undetermined, and therefore, it is advisable to protect against pregnancy while exposing yourself to ketamine or in the immediate aftermath of its use. Uncontrolled hypertension is a contraindication to ketamine use as the substance may cause a rise in blood pressure. A history of heart disease may make you ineligible to participate. Information on ketamine’s interaction with other medicines is only partially available and it will be assessed as to your eligibility for ketamine therapy. Ketamine should not be taken if you have uncontrolled personality disorders or untreated hyperthyroidism. There have also been reports of some decrease in immune function in patients receiving large surgical doses of ketamine. Ketamine has an extensive record of safety and is commonly used at much higher doses for surgical anesthesia, without compromising vital signs or causing respiratory depression.

Ketamine therapy has been shown in clinical research to help reduce or alleviate symptoms of the following conditions:


- Chronic Migraine Headaches

- Connective Tissue Disorders

- Chronic Low Back Pain

- Chronic Neck Pain

- Cluster Headaches

- Neuropathic Pain

- CRPS and/or RSD

- Fibromyalgia

- Trigeminal Neuralgia

- Central Pain Syndromes related to stroke or trauma

- Diabetic Neuropathy

- Post-herpetic neuralgia

- Chronic Pelvic Pain

- Chronic Lyme Pain

- Spinal Cord Injury Pain

- Multiple sclerosis pain

- Ehlers Danlos (EDS)

- Rheumatoid Arthritis

- Opioid Induced Hyperalgesia

- Cancer Pain Syndromes

- Phantom Limb Pain


- Seasonal Affective Disorder (SAD)

- Severe Depression

Severe PTSD

- Anxiety Disorders

- Bipolar Disorder

- Drug Addiction Rehab


- Eating Disorders including binge eating, bulimia, and anorexia

- Intermittent Explosive Disorder for impulsivity and irritability

- Social Anxiety Disorder

- Autism spectrum disorder for social and depression symptoms

- Parkinson’s disease and Alzheimer’s disease for depression and memory loss

How is it administered?

Ketamine was approved by the FDA for use as in anesthesia several decades ago, but more recently, sub-anesthesia dosages of ketamine have been used for therapeutic and palliative purposes. The administration of ketamine in lower, sub-anesthetic doses to address pain, depression, or other psychiatric diagnoses is a newer, off-label use of ketamine. Ketamine can be administered for therapeutic use by intravenous, intramuscular (IM), oral, and intranasal routes.

How does it work?

The current, most probable, understanding of ketamine’s mode of action is as an NMDA antagonist working through the glutamate neurotransmitter system. This is a very different pathway than that of other psychiatric medications such as SSRIs, SNRIs, lamotrigine, antipsychotics, benzodiazepines, etc. Ketamine is classified as a dissociative anesthetic. Dissociation may cause a sense of disconnection from one’s ordinary reality and usual self. You may experience mild anesthetic, anxiolytic, antidepressant, and potentially, psychedelic effects. Ketamine may be administered intramuscularly, intravenously, intranasally, and orally to produce its effects. Repeated usage may provide a sustained and cumulative effect. This may well include a positive change in outlook and character contributing to a ‘transformative’ response. Depending on the dose and method of administration, the period of duration may last from 1 hour to 3 hours or more. We expect relaxation and conscious awareness throughout the experience and do not expect people to become unconscious at any time. This should lead to a disruption of the patterns of negative thoughts and feelings that are contributing to a lower quality of life or dysfunction. Pain may also be temporarily gone or greatly diminished. It is our view that this exploration of other states of consciousness is singularly impactful. We highly recommend everyone have a trusted provider, counselor, or therapist to help process the experience before and after sessions.

How long will it take before I might see beneficial effects?

You may experience positive changes in pain levels, mood, behavior, and perceptions during treatment, in the aftermath, and in the days and weeks that follow. We hope that the ketamine experience not only provides a positive experience during the treatment but that you also gain insight about yourself and the world around you that will help you navigate through life more gracefully.

Who is NOT a candidate?

- Personality disorders

- Uncontrolled blood pressure

- Cardiovascular disease

- Arrhythmia

- Unstable psychology

- Poor response to ketamine in the past

- Allergy to ketamine

Ketamine Therapy may be right for those who have been chronically suffering, or for those suffering from newer symptoms with little to no relief with other traditional methods.

We believe that in the right setting, ketamine can be a powerful and effective treatment alternative for those who have not had success with traditional means such as medication (including NSAIDs, opiates, anxiolytics, anti-depressants, and more), talk therapy, and other common interventions.

Here at Interventional Orthopedics of Washington, we serve patients across the Pacific Northwest who need alternatives for pain relief. Dr. Otono Silva and his team take a compassionate, individualized approach to help patients improve their lives for the long run.

If you’ve tried a variety of treatments for pain, depression, anxiety or PTSD, but have had little success, Ketamine Therapy may be the solution you’re looking for. Give our office a call or click the “Book Appointment” button if you’d like to be evaluated for potential treatment.

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1515 116th Ave NE, Suite 202,

Bellevue, WA 98004

Otoño Silva, MD

Fax: 425-326-1667



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