Ketamine Infusion Therapy from Dr. Thomas Leverone
Ketamine infusion therapy, also called low dose ketamine infusion therapy, is available from Dr. Thomas Leverone at multiple sites in Los Angeles, California and near San Francisco, California. Ketamine infusion therapy from Dr. Leverone is available as one day, three day, five day, or ten day treatments. Ketamine infusion therapy from Dr. Leverone costs $2000.00 per day and is performed on an outpatient basis for the treatment of chronic pain. The therapy is also available as a treatment for clinical depression as a simplified version of the infusion at a cost of $1000.00 per treatment. Complete details are explained on this website.
Use this website to schedule your ketamine infusion therapy for chronic pain or clinical depression with Dr. Leverone.
Ketamine infusion therapy is available to any qualified chronic pain patient via this website.
Ketamine infusion therapy has been very successful in treating chronic pain. Many chronic pain syndromes are caused by up-regulation of NMDA receptors in the brain. Ketamine is an NMDA receptor blocker. In chronic neuropathic pain syndromes, when ketamine is used to block the receptors, this can cause the receptors to down-regulate, effectively resetting them to normal levels. Think of it as sort of a “rebooting” of the brain.
If you have found this website you probably already know about neuropathic chronic pain and ketamine. If you want information about ketamine the drug, or its use in treating chronic pain, please utilize the search engine of your choice on the internet. Ketaminetherapy.com will serve as supplemental information, mainly pertaining to the treatment protocols available from Dr. Leverone and staff. We currently offer ketamine infusion therapy for all forms of neuropathic chronic pain including Reflex Sympathetic Dystrophy, or RSD; Complex Regional Pain Syndrome, or CRPS; Fibromyalgia; and Lyme Disease. There are other chronic pain diagnoses which may also benefit from ketamine infusion therapy if there is a neuropathic component. If your doctor diagnoses you with any form of neuropathic chronic pain, ketamine therapy may be beneficial. Please be aware that in order to receive ketamine from Dr. Leverone you must be referred by your doctor who follows you for your chronic pain. Click Physician Referral Form on this site and print a copy for your chronic pain doctor to complete, then fax it to the numbers listed.
Any decision to undergo ketamine infusion therapy must be made by the individual patient only after a thorough investigation of the drug and the treatment. The information provided here is not to be construed as advice or suggestion, or as advertising or marketing, but is additional information which may be beneficial in helping patients decide on ketamine infusion therapy.
It should be recognized that ketamine infusion therapy has absolutely no guarantee of success, regardless of the provider. Individual response may vary. It is entirely possible to undergo ketamine infusion therapy and have no positive beneficial results accrue. The decision to proceed with ketamine infusion therapy must be recognized as purely elective, each patient must make his/her own decision to voluntarily proceed even knowing it may have no benefit. A major determining factor will be whether your diagnosis of reflex sympathetic dystrophy, complex regional pain syndrome, fibromyalgia, or lyme disease is accurate, and whether any treatable factors have indeed been adequately treated in advance.
It may be mentioned just as a matter of fact that Dr. Leverone has treated a very large number of patients with ketamine infusion therapy, and the vast majority of patients have had positive results, ranging from complete relief of chronic pain to markedly decreased pain and markedly decreased requirement for medication to control their reflex sympathetic dystrophy, complex regional pain syndrome, fibromyalgia, or lyme disease. A large number of patients have realized complete relief of their chronic pain and have been able to completely wean themselves from opiate narcotic medications altogether.
There is also no way of guaranteeing the duration of any relief obtained through ketamine infusion therapy, regardless of number of treatments or the provider. The duration of relief is extremely variable and may indeed only last for a short period of time, especially with only one day of infusion therapy.
The greatest predictor of success from ketamine infusion therapy is a correct diagnosis. It must be recognized that if the diagnosis leading to a decision to use ketamine infusion therapy is in any way incorrect, or if any identifiable precipitating causes of neuropathic chronic pain are not adequately treated in advance,there may be no noticeable benefit whatsoever from ketamine infusion therapy. While there are many excellent pain management physicians, based upon the information received, it is possible that Dr. Leverone may request a further, more precise workup before scheduling treatment to be certain of a treatable diagnosis. Dr. Leverone is associated with a number of qualified pain specialists from UCLA and Cedars Sinai Hospitals, and referrals can be made to these physicians. Dr. Leverone reserves the right to decline scheduling ketamine infusion therapy if the referral appears uncertain or incorrect and the patient is unwilling to have further diagnostics.
Most patients treated by Dr. Leverone who do indeed experience relief of chronic pain after ketamine infusion therapy report that the duration of chronic pain relief is adequate. However, a few patients experienced excellent relief from chronic pain after ketamine infusion therapy, but a rapid return of the early symptoms, and subsequently arranged ketamine infusion therapy for a series of days. These patients then reported adequate duration of chronic pain relief. Again, this is not a sales or marketing tool, but a report of experience. The number of ketamine infusion treatments you will receive will be chosen by you after discussion with your pain management physician. However in many cases the number of ketamine infusions chosen will also be dictated by finances. In our experience with ketamine infusion therapy, more is better. The greater the number of ketamine infusions, and the greater the dose of ketamine given with each infusion, the greater the results. However, not every chronic pain patient can afford three or five ketamine infusions. Therefore, Dr. Leverone tailors the dosage to each individual patient based on a number of factors, but always attempting to maximize the dosage while minimizing any negative side effects. Safety is the primary concern. Even for single day ketamine infusion treatments, Dr. Leverone will calculate the maximun safe dosage for the patient to yield the greatest chance of chronic pain relief. Utilizing this approach has resulted in a great many successful single day ketamine infusion treatments.
Techniques of Ketamine Infusion Therapy Current techniques or treatment regimens of ketamine infusion therapy cover a wide range. At one end of the spectrum is ketamine coma, in which the patient is treated in a hospital intensive care unit, and administered ketamine in such high doses that a coma is induced. (Remember, before ketamine was used for chronic pain relief, it was used as a general anesthetic.) This technique is not yet FDA approved, therefore is not legally available in the United States, but is currently available in Mexico and Germany. If you desire ketamine coma treatment, you must locate the centers in Mexico or Germany and make your own arrangements. It should be noted that even something as extreme as coma cannot guarantee a "cure" any more than other treatment plans, and even coma patients may have recurrence of pain at some point, requiring occasional booster infusions. In fact Dr. Leverone is providing booster ketamine infusion treatments for patients from both of these coma programs. You will need to investigate the current cost of this treatment for yourself, and include such issues as travel requirements and costs. On the other end of the spectrum are centers which provide what they refer to as low dose ketamine infusion therapy. Some of these centers give such a low dose that it is unlikely that any patient will receive any long term benefit from the treatment, and likely will simply experience transient relief of their chronic pain simply due to the fact that ketamine is also a potent analgesic, and not because of any resetting of the NMDA receptors in the brain. Indeed ketamine is often given in an oral form as an adjuvant pain reliever in chronic pain management, and as an analgesic works very well. It must be remembered that prolonged exposure to ketamine can have a negative impact on the liver. Once again, it is important to research the side effects of ketamine using your search engines and discuss this with your chronic pain management physician.Dr. Leverone employs a technique initially based on the published reports by the first outpatient practitioners of ketamine infusion therapy combined with personal correspondence from them. From this starting point Dr. Leverone has further developed the techniques employed today. The current technique of ketamine infusion therapy is continually evolving and being modified by Dr. Leverone and colleagues based on results and observations, and over the course of treating a great many patients they have been able to develop a very safe and effective proprietary ketamine infusion treatment regimen. Of course, every patient may be a bit different, and the treatment will be tailored accordingly.
Dr. Leverone performs the ketamine infusion therapy on an outpatient basis, with the ketamine administered over four hours, and then the patient is recovered and discharged. If multiple ketamine infusion treatments are planned, the same sequence is repeated each day. After the final ketamine treatment, the patient will be maintained for two weeks on low dose oral ketamine which can be obtained from a local compounding pharmacy nearby. California patients can also request their own local compounding pharmacy if that pharmacy handles ketamine. If the patient is on other analgesics for control of their chronic pain, including opiate narcotics, a tapering regimen is recommended as follows: you will take all your regular pain relievers as usual for the first week after treatment. Beginning with the end of week one, cut those doses in half, then cut the remaining dose in half weekly until zero dose, or if the pain begins to return, continue to take the last dose that relieved the pain and consult your doctor. This will be explained in greater detail at the time of ketamine infusion treatment.
Dr. Leverone offers all versions of ketamine infusion therapy, including one day, three day, five day, and ten day. If ten day treatment is chosen, it is administered over two consecutive weeks with no treatment on the intervening weekend. It is up to the individual patient in consultation with their referring physician to determine how many days of ketamine infusion treatment are requested for the desired effect. As a rule, the more consecutive days of ketamine infusion received, the better the results. However, this does not mean that everyone needs to arrange ten days of treatment, as we have excellent results with our version of single day treatment, and many patients do very well with 3 or 5 day treatments as well. You and your doctor will determine how many ketamine infusion treatments you will receive, but there are also considerations of travel, lodging, and cost per day of the ketamine infusion which must be considered.During the ketamine infusion treatment and for the two weeks after, the patient must stay with a responsible party who will help watch for any problems and take care of the patient’s needs. Dr. Leverone will also request that the patient be seen by their regular chronic pain doctor at least weekly. The patient will be required to enter into a controlled substance agreement with Dr. Leverone to insure that they will not lose or abuse their oral ketamine, they will not be responsible for the care of anyone else,and that they will not engage in any activity that would be dangerous while under the influence of ketamine.
If coming from outside the area, it is permissible to fly back home usually within a day or two of ketamine infusion treatment, and complete the oral ketamine therapy at home. It mainly depends upon how the patient feels at that point, but there is no medical contraindication. Some patients may exhibit side effects from the ketamine infusion more than others, such as confusion, sedation, or nausea. While these will eventually completely disappear, in these cases it may be wise to postpone travel home. This will have to be determined by the patient and their chosen handler after ketamine infusion therapy.
Location and Personnel
Primary Treatment Location:
Center for Ambulatory Surgical Treatment (CAST)
1090 Glendon Avenue
Los Angeles, CA 90024
This location is in the heart of Westwood, adjacent to UCLA and minutes from Beverly Hills and Century City. Therefore there are numerous hotels within walking distance or just a short drive from our center. Use your computer to map our address and find locations of hotels nearby.
Parking for this location:
If you are driving to our center, we are located in The Westwood Building, which also has an on-site parking ramp which independently charges daily fees. There is also metered parking in front of the center, which is free before 8 am, and then the meter can be paid at intervals.
Secondary treatment center:
For those patients who live in or who wish to fly into the San Francisco Bay area there is a second treatment location available currently in Watsonville California. This location is accessible from all major airports in San Francisco, Oakland and San Jose. This location has a limited number of available scheduled treatments, so be sure to request details when contacting Dr. Leverone before scheduling any travel.
All treatments are administered by Thomas Leverone, MD, a Board Certified Anesthesiologist with years of experience in ketamine infusion therapy, in conjunction with a select staff of ICU trained RN's with years of experience in all kinds of infusion therapy and patient recovery.
Cost, Payment and SchedulingWhile many insurance companies say that they will cover ketamine infusion treatment, they do not actually pay enough to even cover costs. Therefore, at this time and until further notice, we do not accept any insurance for ketamine infusion therapy treatment. We provide the treatment on a cash basis, payment to be collected in advance of service. Payment is accepted as cash, check, or credit card (VISA, MC, and AMEX only). Payment made by cash or credit card can be made on the morning of ketamine infusion treatment. Personal checks may be required to clear your bank before ketamine infusion treatment is rendered so this type of payment must be made in advance. If you wish to attempt to be reimbursed by your insurance company, you may do so for yourself after the treatment. You may request a copy of the operative report of ketamine infusion therapy and a statement of payment made to the center. This will be provided 5 to 7 business days after the procedure, and should be sufficient for your insurance company. If you wish to request this, call Lisa Sandoval at 310-209-6500 ext. 103.
As ketamine infusion therapy becomes more mainstream treatment, insurance companies will likely reimburse sufficiently to allow Dr. Leverone to accept insurance. However at the current time and because of the requirements of the facility, it is not possible.
Our current charge is $2000.00 per day of infusion, regardless of the number of days. The additional total cost of the oral ketamine and any adjuvant medications you will need with the ketamine may vary slightly, but typically costs less than $200.00.In order to schedule ketamine infusion therapy treatment with Dr. Leverone you will need to click on the questionnaire, fill in answers to the questions, and then click "submit". Please note that there are a few exclusionary criteria for ketamine infusion therapy, not everyone can receive the treatment even with a correct diagnosis, and these will be revealed in the questionnaire. You will also need to fax in the completed physician referral form (click on that page and print) and a recent (within 30 days) complete history and physical from your general practitioner. It is very helpful to also fax a copy of a recent workup by your pain specialist. Additionally Dr. Leverone will need lab work done within 30 days of treatment, to include CBC, Electrolytes, and Screening Liver Function Tests (ALT, AST, Alkaline Phosphatase), and a 12-lead EKG. Chest X-ray is sometimes required, but may be waived in certain patients. This can be determined at the time of scheduling. All of the above pre-procedure information must be received by Dr. Leverone prior to rendering ketamine infusion treatment.While Dr. Leverone will do all he can to accommodate the patient’s schedules, there may be some delay between the desired date of ketamine infusion treatment and the available date. Availability of appointments for ketamine treatment schedules should be confirmed before getting any lab work performed. Treatment will be tentatively scheduled based on Dr. Leverone's availability when the referral form is received. Once the remaining required information is received, the scheduling will be finalized. To schedule a treatment in Los Angeles, or for questions regarding scheduling, please call Sharona Javaheri at 310-209-6500 ext.133. To schedule a treatment in Watsonville, please contact Dr. Leverone using the form by clicking on "Contact" and then "submit".