Oral and Sublingual Ketamine for depression | Northern Virginia Ketamine Infusion Center | Home therapies using ketamine to treat depression in Virginia | Ketamine therapy for PTSD, Depression, Anxiety

ORAL and Sublingual Ketamine for Depression 

Where can I find Oral and home Ketamine therapies? Contact NOVA Health Recovery in Alexandria, Virginia

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Recent clinical trials and metanalysis recognize the efficacy of Ketamine infusions and therapies in the treatment of resistant depression: 

Efficacy of ketamine in the rapid treatment of major depressive disorder: a meta-analysis of randomized, double-blind, placebo-controlled studies 

And 

Opinion: Can We Stop Suicides? (New York Times 2018) 

At NOVA Health Recovery Ketamine Infusion Center, (Alexandria, Virginia), we have found the incredible effectiveness of ketamine infusions for a rapid relief of depression with a transition to Sublingual, home-based ketamine therapies for follow-up. We have found that doses for infusions between 0.5 mg/kg and 1 mg/kg to provide the best response and that repeated infusions are effective and safe: 

Double-blind, placebo-controlled, dose-ranging trial of intravenous ketamine as adjunctive therapy in treatment-resistant depression (TRD) supports the doses of 0.5-1 mg/kg IV 

And  

Rapid and longer-term antidepressant effects of repeated ketamine infusions in treatment-resistant major depression –  Ketamine was associated with a rapid antidepressant effect in treatment resistant depression (TRD) that was predictive of a sustained effect. The effect could wear off, on average at 18 days. There was a 70% response rate. Repeated infusions could be used to maintain effect. 

Maintenace of ketamine infusions is a way to maintain the durability of depression responses: 

Maintenance Ketamine Therapy for Treatment-Resistant Depression Maintenance ketamine treatments may be an effective way of maintaining treatment response in some ketamine responders. 

 As part of our maintenance between infusions, or to lengthen the period of needing the infusions, we utilize oral and sublingual ketamine. An article recently addressed concept as well: 

Sublingual Ketamine: An Option for Increasing Accessibility of Ketamine Treatments for Depression? 

Sublingual Ketamine has a 30% availability (versus oral ketamine at 20%): 

Plasma concentration profiles of ketamine and norketamine after administration of various ketamine preparations to healthy Japanese volunteers 

The issue with sublingual ketamine is that the doses used need to be higher, to 1.5 mg/kg dosing ranges, and this can maintain effectiveness of the antidepressant response. A systematic review using oral ketamine recognized its value in treating depression, but many of the studies used lower doses than they should have: 

Oral Ketamine for Depression: A Systematic Review In this review, efficacy was seen in 2-4 weeks with oral ketamine and the dosages and frequency of administration were variable (ie, 0.5-7.0 mg/kg 3 times daily to once monthly), with most studies providing dosages of 1-2 mg/kg every 1-3 days.  

However, sublingual ketamine used at higher doses (1.5 mg/kg) can also be rapidly effective and can be used to help maintain the response to therapy. 

Why is this important? It is cheaper and patients can maintain themselves with fewer infusions. Also, per may studies, symptoms may return around 18 days (about 2 and a half weeks) after the last infusion: 

Single-dose infusion ketamine and non-ketamine N-methyl-d-aspartate receptor antagonists for unipolar and bipolar depression: a meta-analysis of efficacy, safety and time trajectories 

And  

Rapid and longer-term antidepressant effects of repeated ketamine infusions in treatment-resistant major depression 

Daily oral ketamine has demonstrated efficacy in decreasing depression and anxiety in hospice care patients as well (at 0.5 mg/kg daily): 

Daily oral ketamine for the treatment of depression and anxiety in patients receiving hospice care: a 28-day open-label proof-of-concept trial 

Next-Step Treatment Considerations for Patients With Treatment-Resistant Depression That Responds to Low-Dose Intravenous Ketamine 

Although studies are being conducted regarding different administration routes for ketamine, many centers have used oral and SL ketamine with monthly ketamine infusions with excellent success as a maintenance therapy for depression and bipolar disorder.  

Contact NOVA Health Recovery Ketamine Infusion Center if you are interested in ketamine therapies for depression using IV or home-based oral and nasal spray regimens. 

NOVA Health Recovery is a Ketamine Treatment Center in Fairfax, Virginia (Northern Virginia Ketamine) that specializes in the treatment of depression, anxiety, bipolar disorder, OCD, and chronic pain such as CRPS, cluster headaches, and fibromyalgia using Ketamine therapies, both infusion and home-based ketamine nasal spray and oral tablets. We also offer addiction treatment services with Suboxone, Vivitrol, and Sublocade therapies for opiate addiction as well as alcohol treatment regimens. Contact us at 703-844-0184 or at this link: NOVA Health Recovery Ketamine Infusion Center N 

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