The 4 Ways Your Patients Can Respond To Ketamine Treatments

Wouldn’t it be nice to have a crystal ball to know exactly how your patient will respond to their ketamine infusion? While we don’t have a crystal ball nor a magic mirror, we do have experience. Since we opened our clinic in 2018, we noticed each patient falls into one of four categories based on their response to the ketamine: early responders, late responders, standard responders, and non-responders. In this blog we’ll discuss each one!

Early Responders

Let's look at the first category. Notice how the graph above rapidly goes up then tapers out at the end. We call these patients Early Responders because within the first one to two treatments, they're getting significant benefits. Whether it's a drop in their depression, PTSD, or pain scores. 

As a ketamine doctor, treating patients who are dealing with challenging experiences is not uncommon. Read our blog “How To Help Your Patients Through Challenging Ketamine Infusion Experiences” to learn more.

Standard Responders

In this graph above, you’ll notice that the blue line is just a straight diagonal line. This is what we call the Standard Responder. Usually within two to four treatments, we’ll gradually notice an incremental improvement in their symptoms. In other words, with each infusion treatment, there is a stepwise improvement.

Late Responders

The third category is Late Responders. What you'll notice in this graph is that the patients don't receive a significant or noticeable benefit initially. Progress is slow and steady. Then at the 4th-6th infusions, that's when the patient notices significant improvement in symptoms. 

Non-responders

Finally, let's look at this fourth category, which is essentially a flat graph at the bottom. These are the Non-responders. They aren't noticing any improvement despite the multiple infusions in the initiating six infusion series. Although ketamine therapy is quite effective, it doesn't work in some cases. Some studies are reporting anywhere from 20 to 30% of patients. These patients, even with ketamine therapy, don’t receive any significant benefit from their treatment.

Understanding that there will be non-responders is one of the things to expect as a ketamine doctor. Read our blog “10 Things to Know When Being A Ketamine Specialist” to know what else you can expect!

This graph above helps you compare all different cases. You can see the various responses and the benefits over time depending upon whether someone is an Early Responder, Late Responder, Standard Responder, or Non-responder. 

In Conclusion

Although everyone does indeed respond to ketamine differently, you also play a vital role in making your patient’s ketamine experience as transformative as possible. You can do this by creating the right set and setting, and arranging proper integration after the experience, and having your patient set an intention before the treatment.

While it’s important for your patients to practice acceptance regardless of the outcome, we encourage you to do the same. There will be times when treating a patient can be challenging. There will also be times when your patients may be disappointed with the outcome. We invite you to be open to all the different types of responses we just mentioned and know that you did your best as a ketamine specialist.

Common Related Questions:

Don’t I just need to give a higher dose of ketamine to get a better response from my patients?

As you probably are aware of, typical initial dosing for mood disorder treatments start at 0.5 mg/kg and then is increased, depending upon the effect on vitals signs and the patient’s response to treatment. Higher doses (like in the setting of treatment of PTSD) will more likely lead to non-ordinary states of consciousness, which may result in a more potent, profound, and prolonged effect.  

But more doesn’t always mean better. The higher the dose of ketamine, the more likely the patient can have side effects or an adverse effect. We’ve observed that for some patients at high doses, they may have a challenging and difficult experience (i.e. panic attack) or they don’t remember anything at all. On the other hand, some patients don’t need a high dose to have a transformational and healing effect. Each patient is different, so a tailored dose specifically for that person is needed to achieve the maximal benefits. 

How can I help my patient have a good ketamine experience?

Communication is key, and communicating what to expect during a ketamine infusion and how they and you can address those things, will put the patient at ease. Letting them know that nervousness before the infusion is normal, and they may experience nausea or dizziness and that you can provide medications to ease it. 

Communicating and even over-communicating what to expect and how you are there to help them is a win-win. It will put the patient at ease, and also increase the likelihood of a smoother infusion for you. Preparing your patient and having protocols in place minimizes worry on your part and allows you to focus on supporting your patients having a transformative experience. 

What can I do as a ketamine specialist to help my patients have the best response to their treatment?

Remember, you are a physician first, a ketamine specialist second. Meaning, continue to be diligent about taking a full and complete medical history. But on top of that, talk with your patient about lifestyle factors that can affect their healing and recovery such as their social connections, exercise, sleep, stress management, and diet. Ketamine can catalyze change in your patients life, but it's their day-to-day life where new stressors and traumas can occur. Learning to maximize what they do in between sessions with integration of their ketamine experience is also helpful too. 

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As a ketamine specialist, it’s important to be aware that each patient responds differently to ketamine. In this blog, we talk about the 4 types of responses your ketamine patient can have during their treatment.

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