Ketamine can be life-changing for people struggling with depression, anxiety, PTSD, or chronic pain; especially when traditional treatments haven’t worked. At Nervana Medical, safety is the foundation of everything we do. Our protocols are designed to protect your health, monitor your progress, and help you get the most out of your treatment.
Here’s an inside look at how we keep ketamine treatment safe, effective, and personalized.
Step 1: Your Ketamine Consultation
Every patient starts with a one-on-one consult.
We talk about:
- Your symptoms
- Your mental health history
- Your goals
- Any concerns about treatment
This helps us understand whether you’re ready to begin a series or whether you’d benefit from additional preparation such as therapy, integration work, or starting with lozenges.
Step 2: Medical Review & Exam
Your safety matters, so we check:
- Blood pressure
- Heart health
- Liver and kidney function labs if necessary
- Medications that may interact
- Mental health history
- Height and Weight (used for accurate dosing)
We also review your mood surveys, PHQ-9, GAD-7, and suicide risk to measure your baseline symptoms and trend progress. It is important these are answered with insight.
Step 3: Lab Work (When Needed)
Some patients need lab testing before starting ketamine, especially if they have a history of liver or kidney issues.
For those who use ketamine lozenges long-term, we recommend:
- CMP once a year (liver & kidney function)
- Urinalysis once a year (to screen for rare bladder irritation)
We also often recommend:
- Vitamin D
- Vitamin B12
- Iron
- Magnesium
- Hormone testing
Low levels in these areas are extremely common and can worsen depression and anxiety.
Step 4: Your Treatment Series
Studies demonstrate the most efficacious results come from a series of 6 sessions (IV or IM) over 2–3 weeks.
This creates the strongest and most reliable therapeutic response.
After this, we move into your personalized maintenance plan:
- 1–4 sessions per month with a taper thereafter, some people may not require any additional maintenance post series.
- Lozenges may be an option for ongoing support
- “Drug holidays” (short breaks) help prevent tolerance
Our goal is always the lowest effective dose and frequency
Step 5: Monitoring at Every Visit
Whether you’re doing IV, IM, or lozenges at home, we monitor (or if you’re at home we recommend you to monitor):
- Blood pressure
- Heart rate
- Oxygen levels
- Mental status
- Your symptom scores
- Any side effects
We watch for patterns in your progress and adjust your plan as needed.
Step 6: Watching for Rare Long-Term Side Effects
Ketamine is generally safe, but long-term use can sometimes cause (generally seen in high doses used recreationally not medically):
- Memory or concentration issues
- Bladder irritation
- Liver enzyme changes
- Reduced benefit over time
These are uncommon ;but we check in regularly so we can catch anything early.You’ll always have an open line of communication with your provider.
When We Hit Pause
We may temporarily stop treatment if you develop:
- Blood in urine or bladder pain
- Significantly elevated liver enzyme results
- Very high blood pressure during treatment
- New cognitive symptoms
- Worsening mental health
- No longer responding to treatment
Your safety comes first.
Why Nervana Medical Is Different
- Every treatment is overseen by trained medical providers
- We use evidence-based screening and monitoring
- Integration and mental health support are available
- We emphasize whole-person wellness, including vitamins, hormones, and lifestyle factors
- Your plan is customized ; not one-size-fits-all
Ketamine can be transformative, and when it’s done safely and intentionally, the outcome is even better.