FAQ
IV LIDOCAINE & KETAMINE
LIDOCAINE & KETAMINE
Empowering Your Health with
Elite Infusion Therapies
At Elite Infusion Therapies, we offer advanced pain relief solutions that utilize Lidocaine and Ketamine therapy. Our experienced staff will take the time to understand your unique health history in order to develop an individualized treatment plan that is tailored to meet your specific needs.
Our therapies have proven to be effective for a range of conditions, including chronic pain, depression, anxiety, PTSD and more. Let us be your partner in creating a healthier, happier you today. Together we can move mountains!
Referral Suggested
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Elite believes in collaboration with the community and thus requests either a referral from the provider managing your symptoms or that they have knowledge of you seeking this care. If you do not have a provider, we can help you find one!
Collaboration with your clinical providers is essential to ensuring your safety and achieving the best outcomes.
Common Lidocaine Questions
Lidocaine:
Get Relief
How does lidocaine work for pain?
Lidocaine is a medication that blocks the sodium channels on nerves, thereby decreasing pain signals in the brain and spinal cord. Lidocaine also reduces self-generated nerve activity, often associated with chronic pain. There is a growing body of evidence regarding the effectiveness of this medication for chronic pain conditions.
How do I to prepare for a Lidocaine infusion?
• Do not eat 2 hours before your scheduled infusion time.
• Do not drink 30 minutes before your scheduled infusion time.
Wear comfortable clothing. Wear clothing that allows easy access to your elbow, for IV placement.
How long does it take?
The infusion takes about 60 minutes and then you are monitored 10-30 minutes after the infusion. Plan to be at the clinic for about 1.5 hours for each infusion.
Do I need a driver?
Yes! You are not to drive the remainder of the day. Your driver does not need to remain in the building during the infusion but staff will confirm you are leaving with a trusted driver.
What happens after my infusion?
You should not engage in activities requiring complete mental alertness and motor coordination for the day. After a night of restful sleep, you can resume these activities. It is recommended you have a follow-up with the physician who referred you within 1-3 weeks of your first infusion.
How will I know it’s working?
For pain disorders, relief is often felt immediately, if you are a responder.
The duration of response varies, but repeat infusions are often needed.
What if I feel I did not respond?
You may need a few infusions to get therapeutic benefit. If after 2-3 infusions you do not experience pain relief, Lidocaine infusions should be discontinued. You can then explore other treatment options at Elite Infusion Therapies, or with your Pain provider. Contact our clinic for more information.
Ketamine Treatment Dose and Timing
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Treatment Dose and Timing
Mood Disorders: Initiation of ketamine therapy includes, 2 treatments per week for 3 weeks. Maintenance is most often needed every 4-8 weeks after initiation.
Pain Disorders: Initiation of ketamine therapy includes 4 infusion in 4 consecutive days. Maintenance is most often needed every 4-8 weeks after initiation. Some patient's will be able to go longer between doses.
Common Ketamine Questions
Ketamine:
The Ultimate Pain Relief
Am I a candidate for Ketamine infusions?
If you have any of the indications listed on the infusion page, you may be a candidate.
You will either need a referral from a provider managing your condition or your care will be discussed with that provider prior to initiation of this therapy.
Certain medical conditions preclude your ability to have ketamine infusions. These include certain heart conditions, certain endocrine disorders, psychiatric disorders (ex acute mania), severe liver disease, pregnancy, glaucoma or recent ocular surgery, intracranial pathology (ex tumors, aneurysms), active seizure disorder, inability to tolerate the infusion in a reasonable time frame, sensitivity to ketamine, history of drug or alcohol abuse and active use.
How do I to prepare for a Ketamine infusion?
• Do not eat 4 hours before your scheduled infusion time.
• Do not drink 2 hours before your scheduled infusion time.
Wear comfortable clothing. Wear clothing that allows easy access to you elbow, for IV placement.
How long does it take?
Mood disorders: The infusion takes about 50-55 minutes and then you are monitored 30-60 minutes after the infusion. Plan to be at the clinic for about 2 hours for each infusion. Often, with repeat infusions, you are at the clinic for 60 minutes or less for mood infusions.
Pain disorders: The infusion takes about 4 hours and you are monitored for 30-60 minutes after the infusion. Plan to be at the clinic for 5-6 hours for each infusion.
How will I feel during the infusion?
You will be given some premedication, through you IV, before the infusion begins for nausea and relaxation. Ketamine therapy will then begin and you will be closely monitored for side effects. Your vitals will be continuously monitored.
Most people find the experience of ketamine a pleasant one. There is often a feeling of “mind-body” disconnect, ”, a feeling of “floating” or “lightness” or fatigue. Sometimes people experience temperature changes (feeling cool), numbness in toes or around mouth, perceptual disturbances (ex time going slower/fast, changes in colors/textures), blurry vision. Significant side effects are rare. These would include unwanted hallucinations, feeling too disconnected, high blood pressure.
*If unwanted side effects occur or your blood pressure increases too much, the infusion is discontinued. Symptoms often dissipate within 10-15 minutes. If side effects were not severe, the infusion can be restarted at a lower rate.
Do I need a driver?
Yes! You are not to drive the remainder of the day. Your driver does not need to remain in the building during the infusion but staff will confirm you are leaving with a driver.
What happens after my infusion?
You should not engage in activities requiring complete mental alertness and motor coordination for the day. After a night of restful sleep, you can resume these activities.
Mood Disorders Questions
Ketamine
Mood disorders - It is recommended that you are in close contact and have a plan for your next mental health appointment after each infusion. Either same day visit or within a few days of infusion. Sometimes if you have a mixed anxiety, depression disorder you may feel increased anxiety as depressive symptoms lesson. This is why therapy is so important, as therapy will help navigate those changes.
What if I feel I did not respond?
For mood disorders:
According to ASKP3, this is a not uncommon comment from patients. ASKP3 recommends continuing with treatment as ketamine has effects on neuroplasticity, helps with restfulness, and unconscious priming.
Neuroplasticity, is the brain’s ability to form and reorganize synaptic connections, especially in response to a new experience. You may not notice the effects immediately.
Unconscious priming occurs when an individual's exposure to a certain stimulus influences their response to a subsequent prompt, without any awareness of the connection.
Pain Disorders Questions
Ketamine
Pain disorders - It is recommended you have a follow up with your pain doctor within a couple weeks of ketamine initiation and then as needed based on you and your provider.
How will I know it’s working?
For Pain:
For certain mood disorders, change is felt immediately; 20-30% of patient’s have a delayed response; 20-30% never respond.
For pain disorders, relief is often felt immediately.
Duration of response varies, but repeat infusions are often needed.
Some studies show that CRPS has a great chance of long lasting effects.
How will I know it’s working?
For Pain:
For certain mood disorders, change is felt immediately; 20-30% of patient’s have a delayed response; 20-30% never respond.
For pain disorders, relief is often felt immediately.
Duration of response varies, but repeat infusions are often needed.
Some studies show that CRPS has a great chance of long lasting effects.
Common Misconceptions
Common Misconceptions
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Is this a form of getting “high”? Answer: NO!
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Mild dissociation is part of the process of ketamine treatment. However, it is not a form of getting high and doses used are much lower than what is abused as a street drug.
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Ketamine should work immediately, correct? Answer: Depends
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For mood disorders 20-30% respond immediately, while 20-30% never respond.
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For pain disorders, ketamine often works immediately if you are a responder. Often notice after you initiation series.
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Ketamine is a last resort? Answer: No
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For depression – FDA approved nasal spray after failure of 2 medications
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Resources
ASKP3 is an excellent resource for patients who are interested in ketamine for mood disorders.
Visit: https://www.askp.org/patients/
Wilkowska, et al. Ketamine in Bipolar Disorder: A Review. Neuropsychiatr Dis Treat. 2020; 16; 2707-2717. Doi: 10.2147/NDT.S282208.
Parikh et al. The future of Ketamine in Treatment of Teen Depression. :1 Apr 2021https://doi.org/10.1176/appi.ajp.2020.21020172.
Phillips, et al. Single and Repeated Infusions for Reduction of Suicidal Ideation in Treatment-Resistant Depression.
PMID: 31759333 PMCID: PMC7021716 DOI: 10.1038/s41386-019-0570-x.
Phillips, et al. Single, Repeated, and Maintenance ketamine Infusions for Treatment Resistant Depression: A Randomized Controlled Trial. PMID: 30922101 DOI: 10.1176/appi.ajp.2018.18070834.
Albott, et al. Efficacy, Safety, and Durability of Repeated Ketamine Infusions for Comorbid Posttraumatic Stress Disorder and Treatment-Resistant Depression. J Clin Psychiatry. 2018 May/Jun.
White, Tracie. The Pros and Cons of Ketamine for Obsessive-Compulsive Disorder.
Murrough, Perez, et al. “Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions in Treatment-Resistant Major Depression” Biological Psychiatry 2013 Aug 15; 74(4): 250–256.
Feder, Parides et al. “Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial.” JAMA Psychiatry. 2014 Jun;71(6):681-8.
Williams, et al. Attenuation of antidepressant effects of ketamine by opiodi receptor antagonism. AM J Psychiatry.
PAIN
Correll, Maleki et al. “Subanesthetic ketamine infusion therapy: a retrospective analysis of a novel therapeutic approach to complex regional pain syndrome.” Pain Medicine. 2004 Sep;5(3):263-75.
Patil S, Anitescu M. “Efficacy of outpatient ketamine infusions in refractory chronic pain syndromes: a 5-year retrospective analysis. Pain Medicine. 2012 Feb;13(2):263-9.
Cohen, Bhatia, et al. consensus guidelines of the use of intravenous ketamine infusions for chronic pain from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine and the American Society of Anesthesiologist. Reg Aneth Pai Med. 2018; 43:521-46.
Williams NR, et al. NMDA antagonist treatment of depression. Curr Opin Neurobiol.2016;36112-7.
Sleigh, et al. Ketamine-more mechanism of action than just NMDA blockage. Trends. Anaesth Crit Care. 2014; 4:76-81.
Pacheco, et al. Central antinociception induced by ketamine is mediated by endogenous opioid and mu- and delta-opioid receptors. Brain Res. 2014; 1562:69-75.
Schwartzman, et al. Outpatient intravenous ketamine for the treatment of complex regional pain syndrome; a double blind placebo controlled study. Pain. 2009;147:107-15.
Koffler, et al The neurocognitive effects of 5 day anesthetic ketamine for treatment to refractory complex regional pain syndrome. Arch Clin Neuropsychol. 2007;22:719-29.
Abd-Elsayed, et al. Infusion Therapy. Springer. ISBN 978-3-030-17477-4.