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Southern Ketamine Clinics

We Can Help Break the Cycle

1212 Hendersonville Rd | Asheville | NC 28803

2768 Georgia Rd | Franklin | NC 28734

209 Hospital Dr | Highlands | NC 28741

Frequently Asked Questions

Why should I choose Southern Ketamine Clinics?

You should choose Southern Ketamine Clinics because you will receive the safest monitored infusions and warm, compassionate care. You are never left alone in the room. We are all highly trained and experienced anesthesia providers and ketamine has always been an anesthesia drug. We are more comfortable administering higher doses of ketamine which hopefully gives you more longevity in between boosters. Most importantly, however, is that we have one of the best response rates to treatment not only in North Carolina but in the country.

What do you treat?

Anxiety, depression, bipolar disorder, suicidal ideation, PTSD, acute and chronic pain, migraines, and neuropathy.

How are you different?

We’re different because we actually follow the science. We studied the research and protocols and have based our practice on doing seven infusions over four weeks. This is to “reset” the brain. Because we are anesthesia providers, we are much more comfortable in administering higher doses of medication. Research tells us that by following the research protocols, 70% of the population is going to respond positively to a dose range of .3 MG/KG to .6 MG/KG. We generally start everyone at .6 MG/KG and titrate the dose as needed to tailor each treatment to the individual patient. We have a 90% positive response rate. I believe that ongoing studies will tell us we need to be giving more of the drug. We are also different because we stay with each patient during each infusion. Patients find that very comforting and they feel safe.

What do you mean by following the science?

All scientific studies are based upon an IV administration of ketamine. We know that with IV you have 100% bioavailability of the drug to the brain. IV administration compared with IM injection bioavailability decreases to 70%, with nasal ketamine bioavailability decreases to 30%, and with oral lozenges bioavailability is a 10%. The data is clear that the patient needs to receive enough ketamine to cause disassociation, which is an altered state of consciousness or awareness. That cannot be achieved using lower doses or less bioavailable forms of Ketamine. Also, attempting talk therapy at the appropriate doses to cause dissociation is not fruitful and lowering the dose and/or bioavailability in order to maintain conscious thought and communication does not achieve the dissociative state which is the purpose of Ketamine. The science is clear that there are 24 hours of brain plasticity after an infusion meaning the brain and cognition is receptive to talk therapy during that window.

Why are your prices the lowest in town?

We attempt to keep our prices down simply so that we can help more people by making treatment more affordable. There are no shortcuts. Our set price covers all the medications, disposables, monitoring, IV supplies and Providers salaries. This is a medical clinic. We do not try to sell you on our services, add on services for an additional charge, or take you into an environment where immediate medical care is not available if needed.

Is there a sliding scale?

Not at this time.

Is there somewhere I can get charity pay?

Some of our clients have gotten assistance through outside agencies but that is highly variable.

Why do I need to be monitored?

Ketamine is an anesthesia drug with both desired effects and side effects. We monitor you because Ketamine can increase heart rate as well as increase blood pressure and for some individuals it can increase anxiety. When we are in the room monitoring your vital signs, we can treat all these side effects with various IV medications.

What is the background of the person treating me?

We are all certified registered nurse anesthetists with many years of experience. We all have been utilizing ketamine in the operating room at higher dosages, so we are accustomed to its side effect as well.

Why use higher dosing?

When we first started the clinic, we followed the data in the studies which included dosing from .3 mg/kg to .6 MG/KG. We noticed about 70% response rate (the national average) at our clinic and thought this could be better. At that time, we began starting everyone at .6 MG/KG and then would increase dosing tailored to the patient. We started having higher success rates. It is my opinion that psychiatry offices dose in the box of .3 MG/KG to .6 MG/KG because they are not as comfortable handling the side effects of the anesthesia drug.

Can my therapist be present during these treatments?

Your therapist is more than welcome to attend the sessions with you. As we increase your dosing for deeper disassociation you will not be able to carry on conversation. You have 24 hours of brain plasticity after each infusion, and we encourage patients to receive counseling during that window. This means that your brain is receptive to different ways of thinking.

What is the process when I arrive?

You will be greeted by our front desk and make payment at that time. We won’t ask for payment after you have been given mind altering medication. We will encourage you to empty your bladder before we take you back to the treatment room. The metabolites of ketamine can be an irritant to the bladder and the majority of patients have an urgency to empty their bladder at the end of the infusion. If you empty your bladder prior to treatment, we know that your bladder is not full, but it is the metabolites of the ketamine. You will have a brief conversation with your provider where you can ask questions. We will gladly answer any questions and address any concerns you may have. We then place an IV using pediatric size needles and begin your infusion. An anti-nausea drug is given along with a small dose of anti-anxiety medication if needed. We place monitors on you where we can monitor blood pressure, heart rate, and your O2 saturation. Music is played in the background, but you are welcome to listen to your own music. A blanket is offered, and the room lights are dimmed. We will stay with you the entire time. Once we turn on the infusion pump it takes 8 to 10 minutes for you to feel the effects of the ketamine and you will continue to feel those effects the next hour. When you hear the infusion pump alarm it simply means that your bag is empty. At that time, you will gently come back to active consciousness. When we feel you have adequately recovered, we will remove your monitors and remove your IV.

Do I get assigned a therapist?

We encourage all patients to maintain their present therapist. Once patients arrive to us, they have usually had years of therapy and are comfortable with their therapist.

Why does someone need to take me home?

Ketamine is an anesthesia drug and is cognitively impairing. While you may feel fine (or great!) your judgment may still be impaired. That is why you are not allowed to drive.

Why do I need a referral?

The referral needs to come from a provider with prescriptive authority. They are not writing a prescription for your ketamine but are referring you to our clinic. That would include an MD, DO, PA, or a nurse practitioner. We receive referrals from all specialties of medicine.

Do I need to take off work for each treatment?

The first infusion seemingly affects patients more profoundly than the infusions going forward. Most clients will return home, have a quick meal, maybe a short nap and are able to return to work. Of course, this depends upon what your job is if you would feel comfortable doing that.

Why do I need seven treatments?

Again, it is about resetting the brain. We recommend seven infusions over four weeks. You have three infusions in week one, two infusions in week two, and then weekly infusions for the following two weeks. If you think about your brain as a marble rolling in a groove for depression, we give ketamine, and it knocks the marble out of that groove onto level ground and it will roll and roll. The marble will eventually go back and reset to the groove of depression because that is the way your brain has been tracking for years. Ketamine is simply knocking that marble out of the groove again and again and again until it doesn’t reset.

What is the success rate, and how is it measured?

National studies have told us that 70% to 71% of the population respond to ketamine infusion therapy. The studies are based upon dosing from .3 MG/KG -.6 MG/KG. We generally start everyone at.6 MG/KG and titrate up tailoring to each patient. Each patient will complete a Beck Depression Inventory scale prior to beginning the induction series. We will reassess prior to your seventh infusion. Tracking this data at our clinic we have seen a >90% response rate.

Does insurance cover these treatments?

In the past two years there have been a few insurance companies who have begun covering these infusions in part or whole. We require our patients to pay for the infusions upfront. At the end of the induction series or at the end of a booster we will supply you with a super bill. The super bill has the appropriate CPT codes that the insurance company needs, and you can supply this information to your insurance. Any monies that they are going to reimburse comes back directly to you.

How long does the treatment take?

We book each individual patient for 90 minutes. We do the infusion over 45 minutes and then it takes approximately 20 to 30 minutes for patients to feel like they can walk back to the lobby and go home.

What can I expect afterwards?

The two most common side effects to ketamine are nausea and headache. We administer an antinausea medication to everyone and headache is usually treated with Tylenol or Advil. People feel much more sedated and sleepy after the first infusion and generally will eat a meal and spend the day watching TV or napping. As people continue during the induction series they often find that they are less fatigued and able to get back to life more quickly. In the beginning of the process it is not uncommon for people to experience ups and downs in mood. But as you continue, those ups and downs will become less steep and less often.

Will I need to come back after the series?

That is the million-dollar question. At the end of the induction series we have people step away and assess if they feel ketamine has been a benefit. If the answer to that question is yes, we advise people that if the feelings that made you seek us out start emerge you come back for a single infusion. This process can vary from three weeks to 12 months. We never know when someone will need to return. What we find is that because we dose higher patients are not back is often, and as they continue in the process they will be able to space their booster infusions farther and farther out.