Depressed no more!

May 15, 2023December 27, 2022

Ketamine Infusion Risks

Ketamine is a medication that is primarily used for pain management and as an anesthetic. It has also been used off-label for the treatment of certain mental health conditions, such as depression and anxiety. Ketamine infusions involve the administration of the medication through a vein, usually over a period of several hours.

Kisks of ketamine infusions

There are several potential risks associated with ketamine infusions, including:

Short-term side effects: Some people may experience short-term side effects while they are receiving a ketamine infusion, including dizziness, nausea, vomiting, hallucinations, and altered consciousness.
Long-term effects: There is some evidence to suggest that long-term use of ketamine may be associated with certain negative effects on the brain and nervous system, including memory loss and cognitive impairments.
Addiction: While ketamine is not considered to be as addictive as other substances, there is a risk of developing a psychological dependence on the drug.
Interactions with other medications: Ketamine may interact with certain medications, such as antidepressants and anti-anxiety medications, and may cause negative side effects.

What are some other things to consider?

Ketamine works by blocking the NMDA receptor, which is involved in regulating mood and memory. When ketamine blocks this receptor, it causes a change in brain chemistry. This can help with depression by changing the way your brain works to reduce feelings of sadness and hopelessness. It has proven to be effective in treating mild to moderate depression. It’s a safe option for those who have not responded to traditional treatments, and it’s easy to administer.

Ketamine infusion centers are often understaffed and are run without a medical professional onsite to assure patient safety. Other centers skimp on offering guidance and therapy onsite to patients who may be experiencing a bad “trip.”

Finally, cost is not a minor consideration. With ketamine infusions NOT being FDA approved for treatment of depression, anxiety, OCD, PTSD, insurance companies are under no obligation to cover the high-costs of these regular, sometimes life-long treatments.

We recommend for our patients to explore Spravato, an FDA approved alternative, administered under the care of a health professional at a Certified Spravato Treatment Center.

Author's Message

David Boguslavsky, MD is an experienced and dedicated family physician with an interest in mental health who has been practicing medicine for almost 2 decades.

If you are suffering from Major Depression, and have failed to see your depression lift despite 2 antidepressants tried, Spravato therapy maybe right for you. This, insurance-covered ketamine therapy for depression has helped thousands of patients just like you. To learn more about the costs of Spravato, esketamine’s effectiveness, potential side effects, or to simply take the next step towards feeling better, please reach out to us, we would love to help!

April 30, 2023December 27, 2022

Overview of various depression treatments

Depression is a common and serious mental health disorder that affects millions of people around the world. It is characterized by persistent feelings of sadness, hopelessness, and loss of interest in activities that were once enjoyed. Depression can interfere with daily functioning and can lead to a variety of physical and emotional problems. If left untreated, depression can become severe and can even be life-threatening.

There are several different treatments available for depression, and the most effective treatment will vary depending on the individual and the severity of their symptoms. Some common treatments for depression include:

Benefits of Spravato

Antidepressant medication: Antidepressant medication is a common treatment for depression. These medications work by adjusting the levels of certain chemicals in the brain that are responsible for mood and emotions. Antidepressants can take several weeks to start working, and it may take some trial and error to find the right medication and dosage for each person.

Psychotherapy: Psychotherapy, also known as talk therapy, involves talking to a trained therapist about your thoughts, feelings, and behaviors. There are several different types of psychotherapy that can be effective for treating depression, including cognitive-behavioral therapy (CBT) and interpersonal therapy.

Light therapy: Light therapy involves exposure to bright light, often through a special lamp, to help regulate the body’s natural sleep-wake cycle and improve mood. Light therapy is often used to treat seasonal affective disorder (SAD), a type of depression that occurs during the winter months when there is less natural sunlight.

Exercise: Regular physical activity can help improve mood and reduce the symptoms of depression. Exercise has been shown to increase the levels of endorphins, which are natural mood-boosting chemicals in the brain.

Self-care: Self-care strategies, such as getting enough sleep, eating a healthy diet, and engaging in activities that you enjoy, can help improve mood and reduce the symptoms of depression.

What are some other options?

Spravato (esketamine) is a prescription medication that is used in combination with an oral antidepressant to treat adults with treatment-resistant depression. Treatment-resistant depression is defined as depression that has not responded to at least two other antidepressant medications.

Spravato is a form of ketamine, which is a fast-acting medication that works by increasing the levels of certain chemicals in the brain that are involved in mood regulation. It is administered as a nasal spray and is usually taken in conjunction with an oral antidepressant.

Spravato is typically used in patients who have not responded to other treatments, such as antidepressant medications and psychotherapy. It is generally not recommended as a first-line treatment for depression due to its potential for abuse and the need for close monitoring by a healthcare provider.

It’s important to note that no single treatment is right for everyone, and it may take some time to find the treatment that works best for you. It’s also important to work closely with a healthcare provider to determine the most appropriate treatment plan. If you or someone you know is struggling with depression, it’s important to seek help from a healthcare provider or mental health professional.

Author's Message

David Boguslavsky, MD is an experienced and dedicated family physician with an interest in mental health who has been practicing medicine for almost 2 decades.

April 15, 2023December 26, 2022

Ketamine and anxiety: Is there a role?

Ketamine, a fast-acting anesthetic, has been shown to be effective in the treatment of anxiety disorders. While it has traditionally been used in medical settings as an anesthetic, recent research has found that it can also be effective in treating anxiety when given in smaller doses.

Benefits of ketamine for anxiety

Anxiety is a common mental health disorder that can be debilitating and interfere with daily life. It is characterized by excessive worry and fear, and can manifest in various forms such as generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder.

Ketamine works by inhibiting the NMDA receptor, a type of glutamate receptor in the brain. This leads to an increase in the release of neurotransmitters such as serotonin, dopamine, and norepinephrine, which can improve mood and reduce anxiety.

Can Spravato help my anxiety disorder?

One study published in the American Journal of Psychiatry found that a single intravenous (IV) dose of ketamine significantly reduced symptoms of anxiety in patients with treatment-resistant GAD. Another study published in the Journal of Clinical Psychiatry found that repeated doses of ketamine administered over a period of time were effective in reducing symptoms of anxiety in patients with treatment-resistant GAD.

However, it’s important to note that while ketamine may be effective in reducing anxiety in the short term, more research is needed to determine its long-term effectiveness and safety. Ketamine is also a controlled substance and should only be administered by a trained medical professional.

In conclusion, while ketamine shows promise as a treatment for anxiety, more research is needed to determine its long-term effectiveness and safety. It is important to work with a mental health professional to determine the best treatment plan for anxiety, which may include a combination of medication, therapy, and lifestyle changes.

Author's Message

David Boguslavsky, MD is an experienced and dedicated family physician with an interest in mental health who has been practicing medicine for almost 2 decades.

March 30, 2023December 26, 2022

Learn about depression

Depression is a common and serious mental health condition that affects people of all ages and from all walks of life. It is characterized by feelings of sadness, hopelessness, and a lack of interest or pleasure in activities that were once enjoyable. Depression can also cause physical symptoms such as changes in appetite, sleep patterns, and energy levels.

The exact cause of depression is not fully understood, but it is believed to be a combination of genetic, environmental, and psychological factors. Some people may be more vulnerable to developing depression due to their genetics or life experiences, while others may develop the condition after experiencing a significant life event or trauma.

Depression is treatable

There are a few steps you can take to help manage depression on your own:

Get regular exercise: Exercise can help improve your mood and reduce feelings of stress and anxiety.
Practice good sleep hygiene: Getting enough sleep is important for your physical and mental health. Make sure to establish a regular sleep schedule and create a relaxing bedtime routine.
Eat a healthy diet: A healthy diet can help improve your mood and energy levels. Make sure to eat a balanced diet that includes plenty of fruits, vegetables, and whole grains.
Practice mindfulness: Mindfulness involves being present in the moment and paying attention to your thoughts and feelings without judgment. It can be a helpful tool in managing depression and reducing stress.
Seek support: It’s important to have a strong support system when you’re struggling with depression. Talk to a trusted friend or family member, or consider joining a support group.

Next steps

If you or a loved one is experiencing symptoms of depression, it’s important to seek help from a mental health professional. They can help determine the best course of treatment and provide the support and guidance you need to manage your condition and improve your quality of life.

Author's Message

David Boguslavsky, MD is an experienced and dedicated family physician with an interest in mental health who has been practicing medicine for almost 2 decades.

March 15, 2023December 26, 2022

Esketamine for TRD/Treatment Resistant Depression

Ketamine, a medication originally developed as an anesthetic, has gained attention in recent years for its potential as a treatment for depression. It is believed to work by inhibiting the reuptake of the neurotransmitter glutamate in the brain, leading to an increase in the neurotransmitter’s availability and potentially leading to improvements in mood.

Ketamine has been shown to be effective in reducing symptoms of depression in both short-term and long-term studies. In some cases, it has been found to provide rapid symptom relief within hours of administration, making it a potentially useful option for individuals with severe, treatment-resistant depression who need quick symptom relief.

Benefits of Spravato

In addition to its potential as a treatment for depression, ketamine has also been studied for its use in other mental health conditions, including post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and anxiety disorders. It has shown promise in reducing symptoms of these conditions, though further research is needed to fully understand its potential and appropriate use in these areas.

There are several different ways that ketamine can be administered for the treatment of depression. It can be given intravenously (through a vein) in a hospital or clinic setting, or it can be administered as a nasal spray (under the brand name Spravato) in a doctor’s office. The nasal spray option allows for more flexibility in treatment, as it can be self-administered under the close monitoring by a healthcare provider.

What are the potential side effects of Spravato?

Despite its potential benefits, ketamine is not a first-line treatment for depression and should only be used in individuals who have not responded to other forms of treatment. It is also not appropriate for everyone, as it carries the risk of side effects and abuse potential. Common side effects of ketamine may include dizziness, nausea, and hallucinations.

In conclusion, ketamine has shown promise as a treatment for depression, particularly in individuals with treatment-resistant depression. It can provide rapid symptom relief and has also been studied for its use in other mental health conditions. However, it is not a first-line treatment and should be used with caution, as it carries the risk of side effects and abuse potential. It is important to work with a healthcare provider to determine if ketamine is an appropriate treatment option.

Author's Message

David Boguslavsky, MD is an experienced and dedicated family physician with an interest in mental health who has been practicing medicine for almost 2 decades.

February 28, 2023December 26, 2022

Spravato and health insurance

Spravato is a prescription medication used to treat depression and treatment-resistant depression. It is a nasal spray form of the drug esketamine, which is a chemical cousin of ketamine. Spravato is designed to be used in conjunction with an oral antidepressant and is typically administered in a healthcare setting under the supervision of a healthcare provider.

Spravato & Health insurance

Health insurance coverage for Spravato can vary depending on the specific plan and policy. Some insurance plans may cover the cost of Spravato as a prescription medication, while others may not. Patients should check with their insurance provider to determine the specific coverage for Spravato under their plan.

It is important to note that Spravato is a relatively new medication and may not be covered by all insurance plans. Some insurance plans may require prior authorization before coverage is granted, while others may have specific restrictions or limits on the amount of medication that can be covered.

Commercial plans from Aetna, Horizon BC/BS of NJ, and Medicare all universally cover Spravato, and we find them easiest to work with in terms of getting the treatments covered by health insurance.

Other costs of treatment

In addition to insurance coverage, the cost of Spravato can also be affected by factors such as the patient’s deductible and copayment. Patients should consult with their healthcare provider and insurance provider to understand the potential costs and any potential financial assistance options that may be available.

Overall, it is important for patients to understand their insurance coverage for Spravato and to work with their healthcare provider and insurance provider to ensure that they have access to the medication they need. Patients should also be aware of any potential out-of-pocket costs and financial assistance options that may be available to help offset the cost of treatment.

Finally, consider the cost of transportation to/from your Spravato Treatment Center, as you may be too impaired after your treatment to operate a vehicle.

Author's Message

David Boguslavsky, MD is an experienced and dedicated family physician with an interest in mental health who has been practicing medicine for almost 2 decades.

February 15, 2023December 26, 2022

Ketamine and PTSD

Ketamine is a medication that has been used for a variety of medical purposes, including as an anesthetic and a pain reliever. In recent years, there has been interest in the use of ketamine as a treatment for post-traumatic stress disorder (PTSD).

PTSD is a mental health condition that can develop after a person experiences a traumatic event, such as a natural disaster, a car accident, or military combat. Symptoms of PTSD can include flashbacks, nightmares, anxiety, and avoidance of triggers that remind the person of the traumatic event. These symptoms can have a significant impact on a person’s daily life and can be difficult to treat.

Benefits of Spravato in PTSD treatment

There is some evidence to suggest that ketamine may be effective in reducing the symptoms of PTSD. A number of studies have found that ketamine can be effective in reducing symptoms of depression, which is often comorbid with PTSD. In addition, ketamine has been found to have rapid antidepressant effects, which may be particularly beneficial for people with PTSD who have not responded to other treatments.

However, it is important to note that the use of ketamine for the treatment of PTSD is still considered experimental and is not approved by the Food and Drug Administration (FDA) for this purpose. More research is needed to fully understand the potential risks and benefits of using ketamine to treat PTSD.

All gain, no pain?

Some of the potential risks of using ketamine for the treatment of PTSD include:

Side effects: Ketamine can cause a range of side effects, including hallucinations, dizziness, and drowsiness.
Dependence: ketamine has a potential for abuse and dependence, and long-term use can lead to addiction.
Unknown long-term effects: because ketamine is not approved for the treatment of PTSD, the long-term effects of using it for this purpose are not fully understood.

It is important for individuals considering using ketamine for the treatment of PTSD to carefully weigh the potential risks and benefits in consultation with a healthcare provider. It is also important to note that ketamine should not be used as a substitute for evidence-based treatments for PTSD, such as cognitive-behavioral therapy or medications like selective serotonin reuptake inhibitors (SSRIs).

Author's Message

David Boguslavsky, MD is an experienced and dedicated family physician with an interest in mental health who has been practicing medicine for almost 2 decades.

January 30, 2023December 26, 2022

All about depression

Depression is a common but serious mental health condition that can have a significant impact on an individual’s ability to function in daily life. It is characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities that were previously enjoyable. Depression can also manifest as physical symptoms such as changes in appetite or sleep patterns, fatigue, and difficulty concentrating.

Multiple Causes of Depression

There are many potential causes of depression, and it can occur at any age. It may be triggered by a difficult life event such as a break-up, loss of a loved one, or financial stress, but it can also be caused by underlying medical conditions or hormonal imbalances.

If you are experiencing symptoms of depression, it is important to seek help. There are many treatment options available, including therapy, medication, and lifestyle changes. Therapy, such as cognitive behavioral therapy, can help individuals learn coping skills and identify negative thought patterns that may be contributing to their depression. Medications, such as antidepressants, can help to regulate the chemicals in the brain that affect mood. Making lifestyle changes, such as getting regular exercise, eating a healthy diet, and practicing stress management techniques, can also be beneficial in managing depression.

Depression for life?

It is important to remember that seeking help for depression is not a sign of weakness. It takes courage to admit that you are struggling and to take steps to improve your mental health. If you are struggling with depression, know that you are not alone and that there is hope for recovery. There are resources available to support you on your journey towards better mental health, including hotlines, support groups, and mental health professionals. Reach out for help and take the first step towards feeling better.

Author's Message

David Boguslavsky, MD is an experienced and dedicated family physician with an interest in mental health who has been practicing medicine for almost 2 decades.

January 15, 2023December 26, 2022

Ketamine and Depression: What’s the connection?

Ketamine is a medication that has been used for decades as an anesthetic in medical procedures. In recent years, it has also been studied for its potential use as a treatment for depression.

The exact mechanism by which ketamine works to improve symptoms of depression is not fully understood, but it is believed to act on certain neurotransmitter systems in the brain that are involved in mood regulation. It is thought to increase the availability of the neurotransmitter glutamate, which can lead to an improvement in mood.

Ketamine & Depression

Ketamine has shown promise in the treatment of depression, particularly in individuals with treatment-resistant depression, or those who have not responded to other forms of treatment such as antidepressants and talk therapy. Several studies have demonstrated the effectiveness of ketamine in reducing symptoms of depression, including suicidality, within hours of administration. It is thought to have a rapid onset of action, which can be beneficial for individuals who are experiencing severe symptoms and need quick relief.

There are several different ways in which ketamine can be administered for the treatment of depression. It can be given intravenously (IV), intranasally (as a nasal spray), or orally (as a tablet). The method approved by the FDA is nasal, Spravato, which is also the only one covered by medical insurance.

Risks & benefits?

There are several potential risks and side effects associated with the use of ketamine for the treatment of depression. These may include hallucinations, dissociation (feeling detached from one’s body), increased heart rate and blood pressure, and potential for abuse and dependence. It is important to carefully consider the potential risks and benefits with a healthcare provider before starting treatment with ketamine.

Ketamine is not currently approved by the US Food and Drug Administration (FDA) for the treatment of depression, but it is sometimes used off-label for this purpose. It is important to note that the use of ketamine for depression is still considered experimental and more research is needed to fully understand its effectiveness and long-term safety.

In conclusion, ketamine has shown promise as a treatment for depression, particularly in individuals with treatment-resistant depression. It has a rapid onset of action and has been shown to be effective in reducing symptoms of depression. However, it carries the risk of side effects and abuse potential, and its use for the treatment of depression is still considered experimental. It is important to carefully consider the potential risks and benefits with a healthcare provider before starting treatment with ketamine.

Author's Message

David Boguslavsky, MD is an experienced and dedicated family physician with an interest in mental health who has been practicing medicine for almost 2 decades.

January 1, 2023December 26, 2022

Spravato for Chronic Depression: Is it right for you?

Spravato (esketamine) is a medication that is used as a treatment option for individuals with treatment-resistant depression. It is administered as a nasal spray and is typically used in combination with an oral antidepressant.

There are several potential benefits to using Spravato for the treatment of treatment-resistant depression.

Benefits of Spravato

Rapid onset of action: One of the main benefits of Spravato is that it can provide rapid symptom relief for individuals with treatment-resistant depression. It works by inhibiting the reuptake of the neurotransmitter glutamate in the brain, which can lead to an improvement in mood within a few hours of administration. This can be particularly useful for individuals who are experiencing severe symptoms and need quick relief.
Effectiveness in treatment-resistant depression: Many individuals with treatment-resistant depression have not experienced relief from other forms of treatment, such as antidepressants and talk therapy. Spravato has been shown to be effective in reducing symptoms of treatment-resistant depression in clinical trials.
Can be used in combination with other treatments: Spravato is typically used in combination with an oral antidepressant, which can enhance its effectiveness. This allows individuals to potentially receive the benefits of both medications, leading to a more comprehensive treatment approach.
May improve functional impairment: Depression can significantly impair an individual’s ability to function in daily life. Spravato has been shown to improve functional impairment in individuals with treatment-resistant depression, allowing them to better perform daily tasks and engage in activities they enjoy.

Right choice for everyone?

It is important to note that Spravato is not a first-line treatment for depression and should only be used in individuals who have not responded to other forms of treatment. It is also not appropriate for everyone, as it carries the risk of side effects and abuse potential. It is important to discuss the potential benefits and risks with a healthcare provider before starting treatment with Spravato.

In conclusion, Spravato can offer significant benefits for individuals with treatment-resistant depression, including rapid symptom relief, effectiveness in treatment-resistant depression, the ability to be used in combination with other treatments, and the potential to improve functional impairment. It is important to work with a healthcare provider to determine if Spravato is an appropriate treatment option.

Author's Message

David Boguslavsky, MD is an experienced and dedicated family physician with an interest in mental health who has been practicing medicine for almost 2 decades.