Why I Recommend Ketamine Infusions: A Doctor's Perspective on Managing Depression and Pain

As a chronic pain and interventional specialist, I frequently work with patients who feel as though they've exhausted every option. They've tried countless medications, undergone various therapies, and yet continue to suffer from unrelenting pain. For some patients, IV ketamine infusion therapy has opened the door to meaningful relief—especially in certain cases of treatment-resistant depression and refractory neuropathic pain. While results can vary, many experience a noticeable improvement in the short term, and we work closely with each individual to develop a personalized plan for maintaining those benefits.

Why Consider Ketamine Infusion Therapy?

Ketamine was originally developed as an anesthetic, but in recent years, its low-dose infusion protocols have shown promising results in helping manage certain chronic pain conditions such as Complex Regional Pain Syndrome (CRPS) and refractory cases of neuropathic pain. When administered properly, ketamine infusions can work rapidly—often within hours to days—to alleviate symptoms that have persisted for years.

For patients who haven't responded to traditional antidepressants or pain medications, ketamine offers a different mechanism of action. Rather than acting primarily by altering serotonin or norepinephrine levels, ketamine modulates glutamate—the brain's primary excitatory neurotransmitter—through NMDA receptor antagonism. This, in combination with ketamine's other mechanistic actions, provides a new pathway for central pain processing and synaptic plasticity.

Isn't Ketamine Addictive?

This is one of the most common questions I receive, and it's an important one. While ketamine can be misused recreationally at high doses, addiction liability in medically supervised, low-dose protocols is low and clinical consensus indicates that the development of ketamine use disorder in these settings is uncommon.

Each infusion is performed in a monitored environment with trained staff and strict protocols. In fact, emerging research suggests that ketamine may actually help treat substance use disorders by enhancing neuroplasticity and disrupting addictive patterns. In my experience, with proper screening, monitoring, and follow-up, the risk of addiction in therapeutic ketamine use is low.

What Does the Research Say?

Numerous studies have supported the use of IV ketamine for treatment-resistant depression, showing a rapid reduction in suicidal ideation and depressive symptoms in patients who otherwise did not respond to standard therapies. For chronic pain, while the exact mechanism remains unknown, ketamine infusions are hypothesized to modulate sensitization in the central nervous system, leading to pain relief where other medications have failed.

Clinical evidence supports ketamine's efficacy in:

Treatment-resistant depression (including bipolar depression)
Suicidal ideation
Neuropathic pain syndromes
CRPS (Complex Regional Pain Syndrome)
Post-operative pain management

In my clinical practice, I've seen ketamine infusions dramatically improve quality of life for patients who were otherwise trapped in cycles of pain, fatigue, and hopelessness.

The Ketamine Infusion Protocol

We follow a carefully structured, evidence-based protocol for pain:

Population:

Adults with CRPS, certain neuropathic pain syndromes, or chronic pain who have not responded to conventional therapies.

Dosage & Administration:

Dosing is individualized and is considered sub-anesthetic.
Infusions are administered in a quiet, medically supervised setting with continuous monitoring.
A typical course includes 4-5 infusions over 1-2 weeks, followed by as needed infusions.

Monitoring & Adjustments:

We closely monitor vital signs, mental status, and treatment response throughout. Protocols may vary slightly depending on patient diagnosis and comorbid conditions.

What Should Patients Expect During and After an Infusion?

During a ketamine infusion, most patients remain awake but enter a mildly dissociative or dream-like state. This can feel relaxing, emotional, or introspective. You are always monitored by medical staff, and the experience typically fades shortly after the infusion ends.

Side effects are usually mild and may include:

Nausea
Temporary dizziness or disorientation
Mild increase in blood pressure
Fatigue post-infusion

These effects are transient and generally resolve within an hour or two. Serious side effects are rare when ketamine is used appropriately.

How Quickly Will I Feel Relief?

For depression, many patients begin to notice improvement within 24 to 72 hours after the first or second infusion. This early response is one of the most unique aspects of ketamine compared to traditional antidepressants, which can take weeks to begin working.

For chronic pain, the response may take longer. Relief tends to build gradually over the full course of treatment, especially in conditions like CRPS where pain sensitization is deeply entrenched.

How Long Do the Effects Last?

For mood disorders, the effects of a full series of ketamine infusions can last anywhere from several weeks to several months. To maintain these benefits, many patients return for additional infusions, typically spaced every 2-3 months depending on their individual response.

In chronic pain patients, relief is most robust in the first few weeks after an initial series. Pain trajectories are heterogeneous and long-term efficacy ultimately remains uncertain.

Is Ketamine Infusion Therapy Safe?

Yes. Ketamine has been used in operating rooms and emergency settings for decades. When used in the doses appropriate for psychiatric and pain conditions, and administered in a controlled medical environment, it has a very favorable safety profile.

We perform a comprehensive medical evaluation before starting therapy and monitor closely during every session. Your safety is our top priority.

Final Thoughts

Ketamine infusion therapy is not a one-size-fits-all treatment; however, for appropriately selected patients, it can offer meaningful benefits. In my clinical experience, ketamine has provided a path forward for individuals who have not found relief with other therapies—helping restore not only symptom control, but also a sense of hope and possibility.

Whether for treatment-resistant depression, chronic pain, or other hard-to-treat conditions, IV ketamine infusion represents a promising tool in modern medicine.

If you're in the Metro Atlanta area and are wondering whether ketamine infusion therapy is right for you or a loved one, we're here to help. Contact InterSpine Pain and Wellness Center to schedule a consultation and take the first step toward relief.