FAQ

Frequently Asked Questions

Many new patients have similar questions when they begin treatment with us. In this section, we’ll do our best to address common inquiries. We encourage you to contact our office if you have unanswered questions.

Ketamine and TMS are two highly effective treatments for depression and anxiety. Ketamine is particularly effective in reducing or eliminating suicidal ideation and self harm. Ketamine has also been shown to be effective in the treatment of Post Traumatic Stress Disorder (PTSD). Both treatments can also be used to treat Bipolar depression and obsessive compulsive disorder. To read more, visit our conditions page.

Please contact us for information about our rates, and reference our Insurance and Billing section for information about potential insurance reimbursement.

Please reference our Insurance and Billing section for information about rTMS costs and insurance coverage. Please contact us for details about our out-of-pocket rates for Accelerated TMS.

It can take 2-6 weeks before the benefits from TMS become noticeable, although response time is typically shorter than that of medication. We obtain weekly symptom reports to monitor response and adjust treatment as clinically indicated. We work with patients and outside treaters to assess the need for booster sessions and other longer-term treatment options. With ketamine therapy, many patients will begin to feel better within hours of the first infusion. Patients with thoughts of self–harm may notice those thoughts dissipating first. Other patients may not see any mood improvement until the next day, while others may require up to 6 or more infusions before feeling better.

Please contact us to request our New Patient Information packets. These documents contain both logistical and clinical information about each treatment, which you can use as a guide to discuss ketamine and TMS with your patients before they reach out to us.

Psychologically, everyone’s experience of ketamine is different, but many people describe similar sensations. You may feel relaxed, that you are floating, or even that you are somehow outside of your body. You may notice you have double vision or see colors more brightly than usual. Many people feel that they somehow lose a sense of self – that the past and future fade from awareness. You may feel open or vulnerable, and we encourage you to speak with our staff about what would support your feeling of safety and comfort throughout your treatment with us. A side effect of ketamine can be nausea. Intravenous or oral administration of Zofran or another anti-nausea medication can quickly relieve any nausea.
Psychiatric medications do not interfere with TMS or ketamine therapy, and there is no need to stop them. It is possible that benzodiazepines, like Ativan and valium, and the mood stabilizer lamotrigine may blunt the effects of ketamine. However, there is no definitive research demonstrating this. You should not decrease or discontinue any prescribed medication without first consulting your prescribing physician.

Ketamine infusions and TMS alleviate symptoms of psychiatric conditions such as depression, anxiety, and PTSD. Most people suffering from these conditions are good candidates for one or both of these treatment modalities, especially if the conditions are treatment-resistant. The only disorder we cannot provide treatment for is schizophrenia or other psychotic disorders. Specific adjustments are made for patients with active or recently active substance use disorders to ensure the best treatment.

Our administrative staff can help you weigh the logistical factors of each treatment modality, such as pricing, insurance coverage, and scheduling. Once you have an evaluation with the doctor, they will make their clinical recommendation about which treatment is most appropriate for you.

Unlike ECT, there is no memory loss associated with TMS or ketamine. There is some evidence that these treatments may enhance cognition.

Ketamine infusions and TMS alleviate symptoms of psychiatric conditions such as depression, anxiety, and PTSD. Most people suffering from these conditions are good candidates for one or both of these treatment modalities, especially if the conditions are treatment-resistant. The only disorder we cannot provide treatment for is schizophrenia or other schizoid disorders. Specific adjustments are made for patients with active or recently active substance use disorders to ensure the best treatment.

Our administrative staff can help you weigh the logistical factors of each treatment modality, such as pricing, insurance coverage, and scheduling. Once you have an evaluation with the doctor, they will make their clinical recommendation about which treatment is most appropriate for you.

If you are a parent or guardian initiating treatment for your minor dependent, we can work with you to start the intake process. Your dependent would need to be involved in specific steps of the intake process, such as the phone intake and psychiatric evaluation.

If you are inquiring about treatment for an adult loved one, we can provide you with plenty of information to pass along to them. Eventually, our staff would need to speak with them directly to initiate the intake process.

No. We consult directly with patients interested in pursuing TMS or ketamine, though we work closely with outside treaters whenever necessary.
Yes, to the degree that you and your patient wish. Upon receiving permission from the patient, we will collaborate with you in any way that is beneficial to your patient’s treatment.
TMS treatments have been described as having a “tapping” sensation, not unlike someone tapping their finger on your scalp. You will sit in a comfortable recliner during treatments and are welcome to listen to music, use your smartphone, read a book, or just sit peacefully for the duration of treatment.
You do not need someone to accompany you to TMS, though you are welcome to bring a companion. You do not need to have someone bring you to a ketamine infusion, but we suggest someone be available to drive you home. We advise you not to drive a car until the following morning after a ketamine infusion.
There are no food or drink restrictions for TMS. Since ketamine can sometimes cause nausea, you should not eat or drink for 4 hours before an infusion.
There is no evidence that ketamine used to treat depression leads to dependence or addiction. However, it is important to keep in mind that ketamine is known to be a substance with the potential for abuse.
There are several absolute contraindications to ketamine therapy. These include active mania, psychosis, severe hypertension, intoxication, and delirium. Some conditions require consideration or clearance from a medical specialist. Examples include hypertension, cardiovascular diseases like arrhythmias, pregnancy, breastfeeding, or raised intracranial pressure.
The primary contraindication for TMS is the presence of any metal in the brain. In rare cases TMS is known to induce seizures, however there is debate about the risk vs benefit of TMS for patients with a history of seizures. There is also debate about the safety of TMS if a pacemaker is present.

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