Time Commitment
Ketamine infusions work very quickly — often within hours — to ease depressive symptoms. The relief from Ketamine, in 99% of cases, will be felt more quickly than TMS. TMS fast and safe for adolescents For the average patient, ketamine infusion therapy consists of a series of six infusions spaced out over the course of two or three weeks, so the time frame is could be 2 weeks or almost the same This initial treatment is followed by a long-term maintenance phase that includes occasional booster infusions as needed. While TMS also has a maintenance phase it is not standard to do a maintenance dose for every TMS patient.
Once a patient reaches the maintenance phase, it is quite varied how often they will need these “booster” infusions. Some patients prefer to get 1 or 2 infusions per month in order to proactively prevent the resurgence of their depression. Others come back for their booster infusions 3 or 4 months after the completion of their initial 6-12 infusions. The length of your treatment session will depend on your condition. A ketamine infusion for depression may take as little as 45 minutes, while treatment for other conditions may take several hours.
Treatment Considerations
You should fast before each ketamine infusion, and certain medications may also need to be discontinued temporarily before you undergo ketamine treatment. Once your infusion ends, you’ll have time to recover before going home. Doctors will check that your vital signs return to baseline levels, and will ensure that you’re no longer experiencing dissociative effects before they release you. You should also avoid driving or strenuous activity for about 48 hours after your infusion. What to Expect During Ketamine Therapy. TMS has no recovery time and no fasts are required.
Ketamine therapy has unique side effects, such as dissasociation. The most common side effects would be simply describes as feeling off, strange, or loopy: participants of a study reported feeling strange, weird/bizarre; feeling spacey; feeling woozy or loopy; dissociation; floating; visual distortions; difficulty speaking; and numbness. Ketamine therapy is not covered by insurance, unlike TMS. TMS also has unique side effects and qualifying conditions so I reccomend speaking to a medical and psychiatric professional if you are concerned. Ketamine and Insurance
Overall Efficacy
Several studies indicate that over half of people with TRD achieve significant symptom relief after a single infusion, and many more find relief after two or three infusions. With TMS you need much more than one day to feel anything, but after a full course of 30 days about 70% of patients will achieve remission and that can be lifelong or up to a year. Long term studies show that over 50% of people with repeated ketamine infusions show a cumulative and sustained antidepressant effects. Reductions in depressive symptoms were maintained in patients through once-weekly infusion [maintenance dose]. Studies show the relief is less long term than TMS and requires maintenance doses to keep up with depressive symptoms. Ketamine Therapy Pros & Cons
To sum up, if you need fast relief and have the money to get a treatment without insurance, I would recommend Ketamine Therapy. If you prioritize affordable care with long term efficacy, I would reccomend TMS. If you want both fast-acting and long-lasting treatment, a combined approach may be best for you if you can afford it.
Combined Therapies
"Over 90% of patients we’ve treated with this approach in our clinic were able to reach some form of remission, whether that be returning to work, not being on disability or repairing broken relationships,"says Dr. Best, a Board Certified psychiatrist with additional training in psychopharmacology, brain imaging and TMS. Can You Do Them Both? Using both TMS and Ketamine combines the fast relief of ketamine with the long term remission possible through TMS, to make a very effective treatment for those who have treatment resistant depression and need both fast and long-term relief.
Patient experience [podcast] Mad Genius: Ketamine, TMS, and my new brain
If you are interested in reading about the differences between TMS & ECT, this is a great article.
Ketamine is a safe and effective drug that has been utilized in a variety of medical settings for the last 50 years. It has been placed in the World Health Organizations list of Essential Medicines because of its effectiveness and safety profile. Ketamine Thearpy is widely used as an anesthetics and sedative in both the perioperative and emergency room setting and is also widely used in the pediatric population to treat pain.
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