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Getting Started

Virginia Infusion Therapies

What to Expect

Consultation

Consultation

Your initial phone consultation will be with one of our doctors. You will be asked about your clinical history, medications, and appropriateness for ketamine infusion therapy.

First Treatment

First Treatment

Your first treatment will be scheduled, after the phone consultation. The infusion will generally take from one to two hours. You will need a ride home.

Initiation

Initiation

Research has shown that a loading dose is required. In our experience most patients will need 2 treatments per week ( each takes about 1 hour ) for 2 weeks for a total of 4 treatments. Pain patients will need 3 treatments per week ( each takes about 4 hours ) for 2 weeks for a total of 6 treatments.

Maintenance

Maintenance

Your Infusion specialist will customize a maintenance schedule for you, based on your response to the loading doses. This is generally between 2 weeks and 3 months (75% of patients need maintenance infusion therapy every 4 weeks).

Ketamine Infusions for Depression

$ 500
/ Per Infusion
  • 40 min to 1-hour ketamine infusion for the treatment of major depression.
  • Plan to be at our ketamine clinic for a up to 2-hours.
  • Please come prepared with a friend or family member who can drive you home; refrain from driving, operating heavy machinery or signing documents for 24-hours after ketamine infusion.
  • Ketamine infusions are effective in up to 70% of patients suffering from Major Depression

Ketamine Infusions for Pain

$ 1600
/ Per Infusion
  • Each Ketamine Infusion for pain takes about 4 hours
  • Plan to be at our ketamine clinic for a up to 5 to 6 hours
  • Please come prepared with a friend or family member who can drive you home; refrain from driving, operating heavy machinery or signing documents for 24-hours after ketamine infusion.
  • Ketamine infusions are effective in up to 70% of patients suffering from a crhonic pain condition
  • Ketamine infusions can provide pain relief for up to 3 months post-infusion.

Free Consultation

Your Ketamine Infusion experience will begin with a complimentary telephone interview. If we agree that you are a good candidate, you will be invited to make a infusion appointment.

You will need to fill out the forms in the “patient portal”

Your First Ketamine Infusion

For Depression

Infusions for major depression, PTSD, postpartum depression, suicidal thoughts, anxiety and other disorders will range anywhere from 40 minutes to an hour. You will enjoy a comfortable recliner in a quiet environment. We encourage you to bring some soothing music, on your own device with headphones. This creates the perfect environment for you to begin your journey to feeling like the happier person you want to be. You will find that we will make every effort to make your experience at Virginia Infusion Therapies safe, soothing, and comfortable.

Your First Ketamine Infusion

For Pain Conditions

Our protocol is to perform three infusions over a one week period. Each of these infusions is approximately 4-hours in length. This allows us to deliver a dose of medication that will help with your pain, while minimizing any adverse side effects. You will find that we make every effort to make your experience at Virginia Infusion Therapies safe, soothing, and comfortable.

If you do not respond significantly after 3 ketamine infusions, you will be considered a non-responder. In this case it is unlikely further doses will be of benefit to you.

After Your Infusion

Following your treatment, you will need to stay with us until you recover from the infusion, before going home. You will remain in the comfortable reclining chair until it is determined by your doctor that you are safe to leave. You will need a ride home after the infusion (You can not drive until the next day). The process, including infusion and recovery, will take approximately one and half hours (90 minutes) from start to finish. Out of state patients without a car are encouraged to call Uber or other ride to return to their hotel. Many of our out-of-state clients stay at the Lansdowne Resort Hotel and Spa where they can follow up with a soothing massage.

Lansdowne Resort Hotel and Spa, 44050 Woodridge Pkwy, Leesburg, VA 20176 Ph 703-729-8400 (Not affiliated with Virginia Infusion Therapies). 

How Do You know if your Infusion Ketamine Treatment is Working?

While the success rate of ketamine is notably high, it doesn’t work for everyone. Fortunately, in most circumstances, it only takes three infusions to determine whether or not you will benefit from this therapy. If there is not an adequate response after three infusions, we typically recommend discontinuing ketamine therapy.

If you do not respond significantly after 3 ketamine infusions, you will be considered a non-responder. In this case it is unlikely further doses will be of benefit to you.

 

How Many Ketamine Treatments Will I need and How Often?

Initiation Treatments for Depression( 4 treatments total ) 

  • 2 treatments the first week
  • 2 treatments the second week
  • Our Ketamine infusion specialists will monitor your improvement and manage the dose of Ketamine during these sessions, to provide you maximum benefit.

Initiation Treatments for Pain Conditions ( 3 treatments total ) 

  • 3 treatments the first week.  Each treatment is approximately 4-hours in length.
  • Our Ketamine infusion specialists will monitor your improvement and manage the dose of Ketamine during these sessions, to provide you maximum benefit.

Maintenance Evaluation and Treatment for Depression/other Conditions

  • The first maintenance evaluation treatment ( 5th treatment overall ) begins 2 weeks after the last initiation treatment.
  • The second maintenance evaluation treatment ( 6th treatment overall ) is given 3 weeks after that.
  • After this time we will see you solely based on your clinical response to therapy (75% of patients need maintenance infusions every 4 weeks).
  • The interval between future maintenance treatments will depend on how long you feel good, after your maintenance interval evaluation treatments. If you feel good for only one week, then you will need maintenance treatments once a week. If you feel good for 3 weeks, you may need maintenance treatments once every 3 weeks. We can try to extend treatments up to 4 week intervals, or even longer, depending on your response.

Minimizing the costs are very important to us. Multiple touch points are required in the early stages of your treatment to evaluate how the dose, duration, and maintenance intervals for future treatments.

Maintenance Evaluation and Treatment for Pain Conditions

Depending on how long you feel good after your initiation treatments, you will require a maintenance infusion.  This typically ranges between 1-3 months and is dependent on the person.  We will stay in communication to help figure out what your particular pain relief duration is.

Minimizing the costs are very important to us. Multiple touch points are required in the early stages of your treatment to evaluate how the dose, duration, and maintenance intervals for future treatments.

Should I stop my medications before my treatment with Ketamine?

Absolutely Not. You may find in time, with the help of your psychiatrist or other managing physician, a decreased need for some of your medications, but this is not the norm. We do not encourage you to change any medications for pain until you get on maintenance Ketamine therapy and in direct consultation with your pain management, psychiatrist or other managing physician. Failure to continue your current medication regimen, could compromise your Ketamine response and potentially put you in danger of worsening your condition. We will need to correspond with your provider before you make any medication changes.

Should I stop continue my medications after my treatment with ketamine?

Yes you should. You may find in time, with the help of your psychiatrist or other managing physician, a decreased need for other depression medications. We do not encourage you to change any medications for depression or anxiety until you get on maintenance Ketamine therapy and in direct consultation with your psychiatrist or managing physician. Failure to continue your current medication regimen, could compromise your Ketamine response and potentially put you in danger of worsening your condition. We will need to correspond with your provider before you make any medication changes.

How successful is Ketamine infusion treatment?

Ketamine infusion treatment is successful and immediate after only one treatment in about 70% of patients. The relief after the first treatment, however, can be only hours to days. Research has determined that the depression-relief can be extended like many drugs by increasing the number and dose of early treatments before determining a maintenance treatment regimen.

For Pain patients, patients will need three, approximately 4-hour infusions in the first week. Depending on your response after the third infusion, a maintenance plan will be customized individually for you. Maintenance Ketamine infusions for pain syndromes, are every 1-3 months, depending on your response to therapy.   

Data is limited on immediate response and duration across all pain syndromes.  Pain relief rates depends on the pain condition being treated. However about ⅔ of patients have meaningful benefits.  Some patients may have significant pain relief and can even be pain free for 6 months or more.

What to expect during ketamine infusion and how to minimize side effects ?

Shortly after you arrive here at Virginia Infusion Therapies, you will be escorted back to our infusion room. You will be with seated in a comfortable reclining chair and soft lighting.  Prior to this, you will be asked to empty your bladder before the infusion starts.  You will not be able to get up and walk to bathroom during the infusion. A bedside commode for women and a bedside urinal for men will be provided if necessary.

The physician will answer all the questions you have. Next, a small IV will be placed for the ketamine infusion.  We will monitor your heart rate, blood pressure, and oxygen, using a state-of-the-art monitor and you will be observed for any signs of adverse side effects. During the infusion you will be able to communicate with the physician and family, but may have difficulty with any conversations. We do not encourage conversations, as your experience will be enhanced in a quiet environment.  You are strongly urged to bring soothing music and your headphones to make the experience even more enjoyable.

Shortly after the infusion starts, you may start feeling strange and possibly have an “out of body” experience.  You may also experience some blurred vision, double vision, decreased coordination, and mild dizziness.   You can still talk and communicate your needs.  These effects are the normal and expected response to the dissociative effect of ketamine.  Having the music helps you stay connected to reality and decreases any fears you may have.  During the infusion, the physician or nurse will try to minimize stimuli in the room and give you your space, but will be immediately available for any questions or concerns.

Ketamine will heighten your senses and make you feel like you are in a dreamlike or illusionary state.  Please note that during the infusion you will not process information in the usual way.  Therefore, you may patient feel anxious. Medication is available to help during the infusion, if it is necessary.

Near the end of the infusion you may feel nauseous, due to the blurry and double vision associated with the infusion.  Closing your eyes may help stop or diminish the nausea feeling.  Medication is available if this occurs. Remember, you are being treated by Board Certified Emergency Medicine Physicians and we are trained to deal with any complications that may occur.

After the infusion we will monitor you for approximately 1 to 1.5 hours or until we feel you are safe to be able to get up and walk around safely. Even though the majority of the side effects of ketamine resolve at the end of the treatment, some studies have shown minimal effects lasting up to 4 hours after infusions.

We ask that  you don’t eat any solids or non clear liquids for 4 hoursor drink clear liquids for 2 hoursbefore appointment as you are getting a sedative medication.  Failure to comply with this requirement could potentially require us to cancel you infusion for the day and reschedule you for another day.  There will be a $100 cancelation fee if this happens.  Please setup a ride back home or to your hotel room.  You may not drive or use heavy machinery for 24 hours after the infusion. 

Meet Your Doctors

jay kugler ketamine infusions

Jay Kugler, DO

Dr. Jay Kugler board certified in both Emergency Medicine and Family Medicine. He has worked as an Emergency Physician in Northern Virginia since 2002.  Dr. Kugler completed his undergraduate degree at San Diego State University, Osteopathic medical school at the University of North Texas HSC, and residency in Pontiac, Michigan. 

pranav virmani ketamine infusions

Pranav Virmani, MD

Dr. Pranav Virmani is a board certified Emergency Medicine physician who has been treating patients in Northern Virginia since 2002. He graduated medical school with Alpha Omega Alpha honors from Howard University Medical School and completed his residency at Christ Hospital and Medical Center in Emergency Medicine in 2002.

marwan jaber ketamine infusions

Marwan Jaber, MD

Dr. Marwan Jaber is a board certified Emergency Medicine physician in Northern Virginia since 2007. He earned his medical degree at SUNY Downstate in New York; and completed his residency in Emergency Medicine at Henry Ford Hospital in Detroit, Michigan. 

FAQs about your ketamine appointment

More FAQs about Ketamine

Some more information about your Ketamine Visit

Learn more about ketamine

30 minutes before first session to get paperwork done, answer any further questions and get setup for procedure.

15 minutes prior to subsequent sessions to answer any questions and set up for procedure.

You need to stop eating and drinking prior to your visit.  Stop all solid foods and non-clear liquids 4 hours prior to your procedure; stop all clear liquids 2 hours before your appointment.

Accordion Content

We will review you chart, answer any further questions, place IV and monitor your vital signs.  Please make sure to use restroom prior to the infusion, as will not be able to get up and use bathroom, during the infusion, due to decreased coordination.  A urinal for men and a bedside commode for women will be available if necessary.

We will review you chart, answer any further questions, place IV and monitor your vital signs.  Please make sure to use restroom prior to the infusion, as will not be able to get up and use bathroom, during the infusion, due to decreased coordination.  A urinal for men and a bedside commode for women will be available if necessary.

AccorApproximately 70% of patients will have improvement of their symptoms.  And, 10-30% can develop remission of their symptoms with continued treatment.

**IT IS EXTREMELY IMPORTANT TO UNDERSTAND THAT KETAMINE INFUSION IS NOT A CURE FOR DEPRESSION, ANXIETY, CHRONIC PAIN OR OTHER CONDITIONS, BUT IS A PART OF A COMPREHENSIVE TREATMENT PLAN.  THIS  INCLUDES CONTINUING YOU CURRENT MEDICATION AND THERAPIES.

At this time, most insurance plans DO NOT cover Ketamine infusion therapy.  However, we will be happy to provide documentation of your visits, if you think your plan will cover this therapy. Virginia Infusion Therapies does not participate or bill insurance plans.

Yes.  Please continue with all of you current therapies and treatments while receiving Ketamine infusions.  Virginia Infusion Therapies provides only the infusion therapies you need for you condition.  Your primary care doctor, mental health provider, or other specialist will need to determine if your medications should be changed or discontinued.  Making changes without consulting primary care doctor, mental health provider, or other specialist will make it more difficult to control your symptoms and may disqualify you from further treatment at Virginia Infusion Therapies. We would be happy to correspond with your providers and coordinate your care.

Ketamine infusion therapy has been found to helpful in treating a variety of medical and mental health conditions including major depression, postpartum depression, anxiety, PTSD, migraine headaches, cluster headaches and fibromyalgia.

Ketamine was initially noticed in anecdotal reports from anesthesia cases. They noticed anxiety, depression and pain improvement for some of their patient who underwent anesthesia for other reasons.  Some patients with severe anxiety, depression or intractable pain would report they had, at least temporary relief, of their symptoms.  John Krystal, MD in the 1990s, now the chair of psychiatry at Yale, as well as other investigators began to study how Ketamine could affect the neurotransmitters in the brain.  They discovered that ketamine’s interactions with glutamate produced a rapid antidepressant effect in patients with major depressive disorders.  Prior to these studies, most efforts in the treatment of anxiety and depression focused on medications that controlled serotonin and norepinephrine. These medications continue to be used and are helpful in conjunction with Ketamine therapy.

When used by appropriately trained physicians, in the proper clinical setting, the answer is YES. However, Ketamine has a potential for adverse side effects, such an nausea, vomiting, rapid heart rate, transiently elevated blood pressure and temporary “out of body experience”. In the safe hand of an appropriately trained physician, these side effects can easily be managed.

Virginia Infusion Therapies’ Board Certified Emergency Physicians have the qualifications and training to administer Ketamine in a quiet, comfortable and safe environment. We are committed to you and your well being.

Ketamine is not designed to be a recreational drug, but like other medications used to treat diseases, has been abused as a recreational drug.  As a street drug, it has been used in doses much higher than those administered for therapeutic treatment of depression, other mental health diseases, and chronic pain.

When abused chronically and at high doses, Ketamine can become psychologically addictive. It has not been shown to be physically addictive.

However, when used at therapeutic doses, current data suggests that Ketamine to treat depression, other mental health conditions, and chronic pain may be used without any long term negative effects.  This makes it a viable treatment option for patients concerned about addiction, especially from chronic use of opiates, benzodiazepines, and other medications. In addition, there are no known long term negative side effects as with other medication used to treat these illnesses.

Ketamine is not designed to be a recreational drug, but like other medications used to treat diseases, has been abused as a recreational drug.  As a street drug, it has been used in doses much higher than those administered for therapeutic treatment of depression, other mental health diseases, and chronic pain.

When abused chronically and at high doses, Ketamine can become psychologically addictive. It has not been shown to be physically addictive.

However, when used at therapeutic doses, current data suggests that Ketamine to treat depression, other mental health conditions, and chronic pain may be used without any long term negative effects.  This makes it a viable treatment option for patients concerned about addiction, especially from chronic use of opiates, benzodiazepines, and other medications. In addition, there are no known long term negative side effects as with other medication used to treat these illnesses.