Low-dose Ketamine Therapy
Ketamine, discovered in the early 1960s, is an anesthetic drug that has been used since about 1970 in both human and
veterinary clinical applications. For a number of reasons, including the emergence of newer drugs for anesthesia,
the use of ketamine as an anesthetic declined. However, due to its unique properties and newly discovered clinical
uses, ketamine is increasingly being used for treatment of chronic pain and depression.
Management of Chronic Pain
is leading edge medicine for the management of chronic pain. It functions as a strong NMDA receptor antagonist that
eliminates pain hypersensitivity in patients with neuropathic pain and several other types of chronic pain.
Ketamine works by blocking the nerve channels that cause intense pain while allowing the nerves themselves to
function normally. It has proven effective in relieving both neuropathic pain as well as other types of chronic
Neuropathic pain is pain that results from damaged nerve fibers and presents as shooting and burning pain,
tingling and numbness. Some common causes of neuropathic pain include:
Back, leg, neck, and hip problems
Facial nerve problems
HIV infection or AIDS
Other types of chronic pain include:
Somatic pain—dull and aching pain present in the skin, tissue or muscles
Visceral pain—dull and aching pain associated with the internal organs
Another type of pain that may be managed by ketamine is postoperative pain, for which low doses of ketamine
reduce the use of morphine and result in less nausea and vomiting after surgery.
While several NMDA antagonists are available today, ketamine is considered to be stronger than the others. Ketamine
is associated with such side effects as drowsiness, dizziness, dissociative feelings, and even hallucinations, so it
must be administered at low doses under the supervision of a qualified physician. When used for treatment of chronic
pain, ketamine is administered in three-hour sessions for five consecutive days, mimicking the protocols used for
inpatient pain management.
Ketamine is delivered via intravenous infusion. It is safely administered in low doses by SIR’s
anesthesiologists who are board-certified in both anesthesiology and pain medicine by the American Board of
Anesthesiology. They have demonstrated knowledge and clinical judgment in the diagnosis and treatment of all pain
The principles of pain medicine
The anatomical and physiological basis of pain perception
The psychological factors that modify the pain experience1
1 The American Board of Anesthesiology
SIR’s anesthesiologists adhere to strict protocols set forth by academically renowned Wake Forest University,
and they evaluate patients interested in receiving ketamine therapy per these protocols to determine if they are
In recent years, clinics have opened up across the country for the sole function of distributing ketamine for pain
relief, and it is becoming a lucrative business. Sarasota Interventional Radiology (SIR), headed by Gerald E.
Grubbs, MD, board-certified and fellowship-trained pain management specialist, is not one of those clinics but
rather is a professionally owned and operated medical facility. Established in 2003, SIR uses advanced technology
for unparalleled diagnosis and treatment of many diseases and offers the latest in minimally invasive procedures
that meet the highest standards for exceptional clinical quality, cost efficiency, and patient satisfaction. SIR may
offer other pain-relieving treatment options in the event that ketamine is not appropriate therapy for a particular
Treatment for Depression
officially termed clinical depression or depressive disorder, is a real illness that interferes
with daily life and normal functioning. Contrary to the belief that some hold, depression is not a character flaw or
personal weakness that can be overcome by “snapping out of it” or “getting over it.” Many
factors contribute to depression, including genetics, brain chemistry, medical illnesses, life events, and
relationship issues. Clinical depression usually requires treatment by a physician, psychologist, or psychiatrist.
Standard therapies to treat depression include prescribed antidepressants and/or psychotherapy (cognitive-behavioral
therapy, interpersonal therapy, and problem-solving therapy). These are important and viable therapies that can
improve even the most severe cases of depression, especially when treated early. In some cases of clinically
diagnosed depression, however, standard therapies alone may not work. In these cases, ketamine is an additional
therapy that may result in significant improvement.
Ketamine is an anesthetic drug that has been shown to be effective in patients who suffer from depressive conditions,
OCD (Obsessive Compulsive Disorder)
PTSD (Posttraumatic Stress Disorder)
Severe or Unipolar Depression
Ketamine as treatment for depression and mood disorders has been on the rise, particularly at ketamine clinics that
are increasing in numbers across the country. Sarasota Interventional Radiology (SIR) is not one of these pop-up
clinics, but rather is a state-of-the-art outpatient medical facility established in 2003. At SIR, ketamine is
safely administered in low doses by SIR’s board-certified anesthesiologists who adhere to strict protocols
established by academically renowned Wake Forest University and follow the consensus statement guidance on ketamine
use issued on March 1, 2017, by medical experts in the field of psychiatry.
Ketamine is generally administered in four to five sessions over a ten-day period, each session lasting about one
hour. Patients receiving ketamine may realize some improvement within 24 hours. Ketamine treatments last for about
six months, after which booster sessions are recommended. Although ketamine is extremely low risk, it occasionally
results in mild side effects that resolve quickly.