Recommendations for Going to a Ketamine Clinic
A friend who has chronic migraine was migraine-free for the first time in years the week she had ketamine infusions at an in-patient headache center. She describes that week as one of her happiest memories with her husband and daughter. But it’s only a memory for her, not an ongoing treatment because the clinic was three states away from her home and ketamine infusions weren’t available in her hometown.
Since then, ketamine clinics have been popping up all over the country, so people like my friend—or those who haven’t had the chance to try ketamine yet—may have another shot at relief. But how reputable are these clinics? And how can someone best prepare for an experience at one?
Ketamine clinic guidance for migraine relief
While I don’t have firsthand experience, I helped another friend, whom I’ll call Janie, find a ketamine clinic and went with her to her first appointment. The place looked professional, but left me feeling uneasy—they barely gave Janie any information on the phone and the doctor she saw before the infusion wasn’t forthcoming and didn’t answer questions satisfactorily. Her experience prompted me to create this guidance for anyone thinking about going to a ketamine clinic.
Talk to your headache specialist before you go to a ketamine infusion clinic
Most infusion clinics aren’t affiliated with medical centers. The patients have a wide range of health issues, so the center’s physicians may have limited knowledge about migraine. It’s a good idea to get input from a person who knows both migraine and your health history so you can get their input on ketamine and how it impacts migraine. You should also always tell your headache specialist about any other treatments that you do so they can provide you the best possible care.
Have an appointment at the clinic at least one day before your first infusion
Your nerves will be on high-alert right before the infusion. It’s better to go to an appointment with a clear head where you can ask all the questions that you have and can have time to do more research before the infusion, if necessary. Bring a loved one, if possible, to help you remember all the questions you want to ask.
Ask what other medications are available if you need them
This clinic said they could add Ativan to the IV if the treatment because stressful or could give Compazine in case of nausea. It’s good to know ahead of time what medications you might need and discuss what alternatives are available if you can’t take a certain one.
If you hallucinate, try to go along with it
Ask the clinic staff what to expect and how to manage hallucinations if you have them. If they don't have suggestions, keep in mind that the recommendations for drugs like psilocybin and LSD is to go along with the trip. Let your thoughts wander and accept them, rather than fighting them*. I told Janie this and it helped with many of her hallucinations. (*And/or ask for a sedative to help manage them!)
Take a close loved one with you for your infusions
At least for your first infusion, but all of them, if possible. I was only able to go with Janie the first time. For all the others, she was alone in a little curtained-off room. She had a call button to reach the staff (if she could remember to use it) and they checked in on her every 15 minutes. But that’s not the same as having someone who cares about you there to talk to you and help you through difficult thoughts. In one of her treatments, Janie relived the most traumatic experience of her life in a terrible way. She didn’t have a loved one there with her and the staff didn’t happen to check on her, so she wasn’t even able to get Ativan to calm her down.
Have an appointment with a behavioral health provider scheduled for soon after your treatment
You may not need it, but it’s better to have it in place in case you do. Janie not only relived this traumatic experience, but had some revelations about the close relationships in her life. While they may ultimately prove helpful for her to make positive changes, they were harrowing in the first two weeks of her ketamine treatments. The behavioral health provider on staff wasn’t able to provide any counseling and could only give Janie a referral to an outside therapist, who was booked for weeks.
Read "How to Change Your Mind" beforehand
This isn’t strictly necessary, but could be helpful. This book by Michael Pollan is about psychedelic drugs and their use in medicine. While ketamine isn’t discussed in the book, hallucinations during medical treatments and the careful way that researchers take care of patients while using psychedelics are. Knowing this information could make the experience with ketamine easier. (Though the trips described in the book are high-dose and likely to be much more intense than anything a relatively low dose of ketamine would bring about.) I especially recommend the book if you aren’t inclined to have an interest in recreational drugs and don’t have exposure to what hallucinations are like.
Those are my recommendations as an observer. If you’ve tried ketamine infusions, please share your experience and advice in the comments below.
When was your last migraine check-up?