Best pain management for chronic pain

Virginia Infusion Therapies

Ketamine For Chronic Pain

Chronic pain can be debilitating as well as demoralizing. Understanding and treating patients with chronic pain is complicated, by a variety of different pain syndromes, causes, medications and medical conditions. When first and second-line drugs such as opioids, anticonvulsants, or antidepressants fail to provide satisfactory pain management for chronic pain, third-line drugs such as ketamine, has been shown to help. Ketamine can help in treatment of many pain syndromes such as chronic pain syndrome treatment. Pain relief rates depend on the pain condition, but approximately two thirds of patients have a meaningful response.

Ketamine Infusion Therapy has been shown to Improve the Symptoms of Depression in up to 70% of Patients after even a Single Treatment

Chronic Pain

What Pain Conditions can be helped by Ketamine Infusion Therapy

  • Migraine Headaces
  • Fibromyalgia
  • Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy
  • Chronic back and neck pain
  • More uses are under investigation

How does Ketamine work to decrease Chronic Pain?

As a noncompetitive antagonist of the N-methyl-d- aspartic acid receptor, ketamine produces profound regulatory effects on ascending nociceptive pain transmission.  As is the case with many neuropathic pain agents, transient antagonism at the receptor level may not fully explain the mechanism of neuropathic pain relief observed. Ketamine also modifies descending inhibitory pathways through activation of areas involved in regulation of pain, including the anterior cingulate cortex, orbitofrontal cortex, insula and brainstem, in healthy volunteers, receiving low-dose ketamine infusions.

What does this mean?

Ketamine blocks the pain receptors, producing significant pain relief.

treatment of chronic pain

Why is Ketamine Considered one of the biggest breakthroughs the treatment of chronic pain conditions?

Ketamine has the ability to treat some patients with affected by chronic pain conditions as well as “treatment resistant” major depression in a matter of minutes! 70% of patients will see some improvement in their symptoms after only a single infusion.

This improvement is temporary; but progressive improvement tends to be seen after several treatments. The ability to produce immediate results is a major breakthrough in the treatment of both conditions as most patients prior to the introduction of Ketamine suffered without many alternatives

Finally, a medication has been found to decrease pain levels without the use of narcotics.




What is the response rate to ketamine infusion for chronic pain?

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.

How Does Ketamine Work?

Researchers aren’t exactly sure the mechanism of how Ketamine infusions work, however it has been shown to help regenerate synaptic connections between brain cells that are damaged by stress, after even a single administration.  It is believed that at lower doses, Ketamine acts as a neurotransmitter antagonist ( GluN2B ) in the brain. This area of the brain is the focus of treatment for depression, anxiety, PTSD and chronic pain conditions.  Up to 70 % of patients treated with Ketamine for conditions ranging from Major Depression, Anxiety, PTSD, and chronic pain conditions show immediate improvement.  The immediate relief is in stark contrast to the slower methods of antidepressants medications and talk-therapy.  Ketamine is commonly used in the emergency room and operating rooms for anesthesia.  Read more on how you can take the first steps towards health and wellness.

Ketamine Molecule

Virginia Infusion Therapies

The Premier Ketamine Clinic in Northern Virginia

Virginia Infusion Therapies is one of the the first Ketamine Clinics in Northern Virginia, and the first clinic in Loudoun County to provide Ketamine infusion therapy for the treatment of Major Depression and Pain Conditions.  The clinic was established by four physicians in Loudoun who, through their professional experiences in medicine and their personal family experiences with depression, recognized that there are major problems in the recognition and treatment of depression.  They recognized that Major Depression, Post-Traumatic Stress Syndrome, and some pain conditions are often medical emergencies that requires treatments that are more effective…  and more effective IMMEDIATELY.   

Are You Ready To Schedule Your Free Consultation?

Request your free 15 minute phone consultation and speak with a clinician about ketamine infusions and how we can help you live your happiest, healthiest life.

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. 

Some Of Our Happy Customers

I can't tell you how happy I was that I found you guys. I was down to my last few wishes when I was told about Ketamine. It has saved my life!
I wanted to write and tell you that your clinic has changed my daughter's life. It has changed the lives of our whole family and we are extremely grateful. Nothing else worked to help Heidi feel better.

What can you expect from your ketamine treatment?


Your Ketamine Infusion experience begins with a consultation that will make sure that you are an appropriate candidate that will improve your symptoms of pain.  We will take you through the induction process as well as the maintenance process to keep you free of your pain symptoms.  

FAQs about your ketamine appointment

Some more information about your Ketamine Visit

More FAQs about Ketamine

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.


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.