Tennessee Ketamine
Intramuscular (IM) Ketamine is an off-label medical treatment that uses a fast-acting injectable form of ketamine to treat severe, treatment-resistant depression (TRD), severe anxiety, PTSD, and acute suicidal ideation. Unlike oral antidepressants or TMS, which act slowly or use magnetic energy, IM Ketamine delivers a precise dose of liquid ketamine directly into a large muscle (usually your arm or thigh), allowing for rapid absorption into your bloodstream and brain.
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How does IM Ketamine work?
Ketamine is believed to work on your brain's glutamate system rather than the monoamine system (serotonin, norepinephrine, dopamine) targeted by standard antidepressants.
As an NMDA receptor antagonist, ketamine blocks specific brain receptors, triggering a rapid increase in glutamate release. This process stimulates the production of brain-derived neurotrophic factor (BDNF), which acts like "fertilizer" for your brain cells. Over a period of hours to days, this promotes synaptogenesis—the growth of new connections between synapses that have withered due to chronic stress or depression.
How is IM Ketamine different from psychiatric medications?
Standard psychiatric medications must be taken orally every day, take 4 to 8 weeks to work, and focus on keeping chemical levels steady. IM Ketamine is administered periodically in a clinical setting and begins changing brain chemistry almost immediately. Many people feel a reduction in severe depressive thoughts or suicidal ideation within hours to a couple of days after an injection.
Conditions Treated
IM ketamine is primarily used as a robust, rapid-acting treatment for Treatment-Resistant Depression (TRD) and more. TRD is defined as depression that has not improved significantly after trying at least two different classes of antidepressant medications at adequate doses.
It is also explored and sometimes used for:
- Major Depressive Disorder (MDD) with acute suicidal ideation
- Bipolar Depression (when standard treatments fail)
- Post-Traumatic Stress Disorder (PTSD)
- Suicidality
What are the steps involved to get IM Ketamine?
- Comprehensive Screening: A physician or psychiatric provider will evaluate your mental health history, physical health, and medical history (including cardiovascular health) to ensure ketamine is safe for you.
- Pre-Treatment Preparation: You will receive guidelines on fasting before your session (usually avoiding food for 4 to 6 hours and liquids for 2 hours) to minimize the risk of nausea.
- Informed Consent & Setting: Your treatment provider will review what to expect during the session, set intentions for your experience, and create a calm, supportive setting (often with eye masks and relaxing music).
What is it like to receive IM Ketamine?
Receiving IM Ketamine is a structured, closely monitored clinical experience:
- The Injection: A trained physician/clinician administers a quick shot into your shoulder (deltoid) or hip (gluteal muscle). This will be given as two injections (one dosage split into two smaller injections) spaced 15 minutes apart to smooth out the experience.
- The Onset and Experience: Within 3 to 5 minutes after the first injection, you will begin to feel the effects. At the 15 minute mark, your physician/clinician will evaluate you and determine if you can receive the second half of your dosage. After your injections, you will lie back in a reclined chair in a comfortable, quiet room. The experience often includes deep physical relaxation, altered sensory perception, and dissociation (a feeling of floating, dream-like detachment, or shifting perspectives on your thoughts).
- Monitoring: Medical staff monitor your vital signs (blood pressure, heart rate, and oxygen levels) throughout two hours.
- Recovery and Schedule: The acute dissociative effects wear off after about 90-120 minutes. A typical initial series consists of 6 treatments over a 2 to 3-week period, followed by maintenance booster sessions as needed.
- Post-Treatment Restrictions: You cannot drive or operate machinery for the rest of the day. You must have a trusted friend, family member, or ride service take you home.
How long will IM Ketamine keep symptoms away?
The rapid relief from an initial IM Ketamine session often lasts anywhere from a few days to several weeks. Completing a full series of 6 sessions helps solidify these brain changes, extending relief for weeks to months. To maintain results over time, most people schedule periodic "booster" injections (e.g., once every few weeks or months) based on their individual symptom pattern.
Disclaimer: All treatments are administered by licensed medical professionals. A full psychiatric and medical evaluation is required prior to your first treatment.
Physician Recommended.
Patient Preferred.
Dr. Cochran at The Neuroscience and TMS center has served as my psychiatric care physician for the past 5 years. I have made tremendous progress while seeing her. She is attentive, thorough, and professional. I refer her to everyone I know in need of psychiatric care because I trust her and her staff completely. I am very thankful to be a patient of the Neuroscience and TMS center.
-CL
This hands down is the BEST doctor’s office I've ever been to. Not just on a psychiatric level, but just a medical setting in general. I love Dr. Becker and I'm beyond grateful that I found him. He is very personable and just one of the easiest people to talk to. And the front desk is great too and that goes a long way! So yes, 5 stars! I recommend this to anyone who needs to find a good and relaxed environment for psychiatry.
-MM
Mary is wonderful. She understands my medical condition and truly cares. She listens and comforts you in time of need. She is a true human being and doesn’t treat you like a number. She is very professional and knows her stuff.
-AC
Ali was amazing. We have searched for help for years for our son. It was nice for her to listen but then give great advice!! We are in the process of implementing her parenting plan and It is not easy but we can already see a difference!!
-ER
This was a great treatment for me. I have completed TMS therapy numerous times b/c I keep getting better and better. I suffered a traumatic brain injury and was steered towards TMS and it has helped me tremendously…This team knows what they are doing and I’m happy I had the opportunity to do this.
-JP
The staff are 100% committed to the clients’ health and well-being. They find solutions tailored to the individual’s needs and goals. If I could leave 10 stars, I would. ⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️⭐️
-HH
Everyone from Dr. Becker on down has done an outstanding job. Professional and caring that is hard to find in medicine today and you guys provide both!! And, Emily is a real gem as the TMS tech.
-EPC, MD [VUMC]