Ketamine/rTMS

Micheal Pollan’s new book, “How to Change You Mind,” marks a new chapter in the evolution of psychiatry, and a particular area of interest for us here.

Indeed very promising work is being conducted at NYU, John’s Hopkins, and the VA system, where psychedelics are being used to markedly reduce depression, anxiety, PTSD, and more generally help people once again appreciate the miracles that surround us each day. While psychedelics will require some time for further trials to confirm their efficacy, the data thus far is strong, and the effects lasting; a “cure,” in some instances.

Ketamine has long been used in children, soldiers, and most recently, the successful rescue of a soccer team trapped in an underwater Thai cave. While not a true psychedelic, ketamine has a long and safe track record as an anesthetic, owing to its minimal effects on heart beat, breathing and blood pressure, which is why it is so often used in urgent situations in the field. In our work, we often use 1/4 of the dose needed for anesthesia, adding even further safety benefits.

For patients with significant depression, which has not responded to at least 2 different classes of antidepressants, ketamine offers a glimmer of hope. While the exact mechanism of ketamine is unknown, it is theorized to generate a “glutamate burst,” and may also act on the opiate system. Currently, ketamine is “off-label” or not FDA approved to treat depression – although drug trials are currently underway to change this, given its remarkable benefit. The net effect is a rapid improvement in mood and at times in suicidal ideation, within days, or even hours, rather than the typical 4-6 weeks required for a typical anti-depressant to work.

At SiliconPsych, we offer an oral version of this medication, in a comfortable and relaxing, non-clinical setting, with close medical supervision. We believe in set and setting. You’ll be given an optional eye cover, relaxing music, and guidance if needed, to make the experience as beneficial as possible. Therapy is optional, you can talk, or just sit back and relax!

Advantages:

  • Minimal side effects
  • High safety profile (minimal effect on breathing, heart rate)
  • Potential for rapid improvement in mood

Interested in exploring ketamine treatment?

Repetitive Transcranial Magnetic Stimulation (rTMS)

is the use of external magnetic fields to change the activity of the brain. This is a painless, side effect free procedure, which can improve mood for patients who have not fully recovered with medication, or have had intolerable side effects. rTMS can also be used to augment medication and therapy, for added results. Used off label, this treatment has been used to improve pain, bipolar depression, and also to enhance cognition and mental ability.

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