Ketamine infusions involve giving a low dose of ketamine through an intravenous (IV) line to help manage certain chronic pain conditions, and in some cases treatment-resistant depression or anxiety. Ketamine is an NMDA-receptor antagonist — originally used as an anaesthetic — that can influence pain pathways and mood regulation at these low doses. Ketamine interacts with NMDA receptors in the brain and spinal cord, which helps modulate pain signalling and may reduce the inflammation associated with some chronic pain states.

This procedure may help if you have:

• Complex regional pain syndrome (CRPS)
• Fibromyalgia
• Neuropathic pain
• Chronic migraine
• Spinal cord injury pain
• Cancer-related pain
• Other severe or refractory pain conditions
• Persistent depression or anxiety that has not responded to standard therapies

It isn't possible to guarantee how any individual will respond. As a general guide:

• Onset: mood or pain relief may occur quickly for some people, but the duration of benefit varies widely between individuals.
• Course of treatment: multiple sessions may be recommended depending on the condition being treated and your response.

Ketamine infusions are generally considered safe when given under close medical supervision, though as with any medical treatment benefit cannot be guaranteed and complications can occur.

Common, minor effects:

• Dizziness or light-headedness
• Nausea or vomiting
• Headache
• Fatigue, drowsiness, or sedation
• Blurred vision
• Temporary increase in blood pressure
• Dissociation, mild hallucinations, vivid dreams, or altered perception
• Temporary confusion or difficulty concentrating

Rare, more serious risks:

• More pronounced cardiovascular changes (increased blood pressure or heart rate) requiring monitoring or treatment
• Respiratory depression (slowed breathing) — less common but possible, particularly at higher doses
• Worsening of certain psychiatric symptoms in susceptible individuals
• Bladder or urinary tract irritation, or liver changes, with long-term or high-dose use — regular monitoring is used to check for this
• Potential for dependence or misuse if not medically supervised — this is why treatment is only given in a supervised clinical setting
• Allergic reaction to ketamine or other medications used during the infusion

• Tell us if you are, or might be, pregnant, or if you are breastfeeding
• Tell us about any history of mental health conditions, including psychosis, so this can be considered before treatment
• Tell us about any allergies, and all current medications and substances you use
• Tell us about any history of heart disease, uncontrolled high blood pressure, liver disease, or bladder/urinary problems
• You will usually be asked to fast for 6 hours before the infusion starts
• Arrange for someone to drive you home afterwards, as you may feel drowsy or disoriented

• An intravenous (IV) line is placed in your arm for the infusion
• You will be provided with comfortable bedding and a private space
• The infusion is given slowly and continuously, usually across 24 hours a day
• Treatment typically continues for 3 days or more, depending on your specific treatment plan
• Your blood pressure, heart rate, oxygen levels, and mental state are closely monitored throughout by medical staff
• You may experience mild dissociation or changes in perception during the infusion — this is expected and usually manageable

• You will be monitored in a recovery area until you are ready to go home, usually 1-2 hours after the infusion ends
• You may feel drowsy or slightly disoriented after the infusion ends — this usually settles over a few hours
• Do not drive or operate heavy machinery until you are fully recovered
• Follow any specific aftercare instructions given to you by your treating team
• Regular follow-up visits will be arranged to monitor your progress and adjust treatment as needed
• Liver function tests will be arranged periodically to monitor for any effect on the liver with ongoing treatment
• Report any persistent or concerning symptoms to your treating team

Contact your GP, Total Pain Clinic, or your nearest Emergency Department if you notice:

• Thoughts of self-harm or suicide, or a significant worsening in your mood — contact Lifeline on 13 11 14, or present to your nearest Emergency Department immediately
• Chest pain, palpitations, or severe shortness of breath
• Difficulty passing urine, blood in the urine, or persistent bladder discomfort
• Confusion, hallucinations, or altered perception that persists well beyond the infusion
• Fever or feeling generally unwell

Regular follow-up visits will be scheduled to monitor your progress, response to treatment, and any side effects, and to plan further sessions if needed. Please ask your doctor any questions before you proceed; you will be asked to sign a consent form if you agree to go ahead.