Infusion Therapies

What is Ketamine Infusion Therapy?

Premier Anesthesia & Pain is committed to providing you with a satisfying and efficient patient experience. Ketamine is often used to treat depression, anxiety, OCD, PTSD as well as chronic pain.  A plan of care will be tailored to your specific needs depending on the nature and severity of your symptoms. If you need, we have consulting pain management physicians to assist in your care and follow-up.

Premier Anesthesiology and Pain
Premier Anesthesiology and Pain

What to Expect

After your initial inquiry to us and enrolling in the treatment protocol, we will ask you to complete a few questionnaires for health and medication screening. You will also complete a standard depression score assessment. If there are certain medications that can affect the ketamine infusion's response, we will ask your prescribing physician to review your history and advise on managing those. You will be asked to arrive at the center with a prearranged ride home because of the potential lingering effect for a few hours after the infusion. You should not have any solid food for at least 4 hours before the infusion and no liquids for 2 hours. You can bring headphones and music and we recommend calming music.

Upon arrival, you will check-in and then be taken back to the private infusion room. There, a nurse or the anesthesiologist will start your IV and start the infusion. You may get medication for nausea in the IV. You will be comfortably reclining or laying down for the 45 minutes duration of the infusion and we will have a blood pressure cuff and other standard monitors on you that we will watch closely. For chronic pain treatment, the infusion will last up to 4 hours.

After the infusion starts, you will almost immediately feel a little drowsy and will start feeling "free" or "floating". You will most likely not sleep and we will adjust dosing if you feel agitation or any other untoward feelings although this is rare. Once the infusion is over, the effects may last for a few more minutes. We will have you recover for around 30-45 minutes and you will then be free to take your ride home.

Your length of response to the infusion will vary from patient to patient but will increase with subsequent treatments. After the first series of six infusions for depression, you may have relief of symptoms for 1-2 months and for as much as 6 months. We will then schedule single booster infusions as needed to control your symptoms.

What is NAD+ ?

  • NAD+ (Nicotinamide adenine dinucleotide) is a vital coenzyme found in all living cells.
  • Its key role is in converting nutrients into cellular energy (ATP), which is essential for cell health and functioning. It also supports DNA health and repair.
  • NAD+ levels decline with age…as much as 50% between age 20 years and 50 years.
  • When NAD+ levels decline, energy transfer in cells breaks down, leading to mitochondrial dysfunction and that results in many of the physical symptoms of aging.
  • NAD+ is an important in regulating your circadian rhythms and hence sleep cycle.
  • NAD+ fuels the activity of sirtuins (SIRT). These are proteins which induce the formation of new mitochondria and keeps them running smoothly.
  • SIRT1 & SIRT3 enhance cell survival in various stressful conditions and moreover promote the growth of neurons. They are also linked to longevity.
  • SIRT1 directly regulates mood and behavior through NHLH2 transcription factor

Interestingly, it has been demonstrated that NAD+ availability decreases over age and with stress, reducing sirtuin activities. This ultimately leads to mitochondrial dysfunction and the ill effects that come with it such as cellular damage and death.

An increase in intracellular levels of NAD+ directs cells to adjust to ensure survival, including increasing energy production and utilization, boosting cellular repair, and coordinating circadian rhythms.

Premier Anesthesiology and Pain
Premier Anesthesiology and Pain


Inflammation and stress cause damage to your DNA, which conclusively leads to cell death. When we consume unhealthy foods, breathe in pollutants, and are exposed to toxic chemicals or stressors, our cells are at risk. With plentiful amounts of NAD+, your cells can activate SIRT, which prevents and corrects DNA damage. NAD+ battles aging by activating these sirtuins, specifically SIRT1 and SIRT3. The sirtuins contribute to longevity by favorably controlling gene expression and allow your cells to live longer, healthier lives ultimately leading to a better quality of life for you.