FAQs

No. Our Ketamine treatments are not appropriate for patients struggling with active use of substances including but not limited to: alcohol, cocaine, heroin, methamphetamines, benzodiazepines, and other stimulants. We require that patients struggling with substance disorders/addictions first seek help from a licensed addiction/rehabilitation specialist prior to seeking treatment at CIT Clinics. We limit the use of Ketamine in this manner for your safety.

It is normal for patients to feel anxious or worried about infusion treatments at first. Our approach is very meticulous and deliberate and we will slowly (but steadily) work towards finding "your optimal dose". Every patient is different and requires different amounts of medicine depending on their biology and psychology. When you receive Ketamine at our clinic you are doing so in the safest way possible - administered and monitored by a team of medical professionals who are prepared for any possible (and very unlikely) emergencies. This allows you to relax and focus on getting the most from your treatment.

We offer personalized Combination Infusion Therapy protocols including the following:

• IV Ketamine
• IV NAD+
• IV Glutathione
• IV vitamins/minerals (Myer's Cocktail)
• Ketamine Assisted Psychotherapy
• Mindfulness Coaching
• Intranasal Ketamine/Spravato
• Intranasal Ketamine/NAD+/Lidocaine

Combination Infusion Therapy is a cutting-edge approach to treatment resistant physical and emotional pain including:

• Depression
• Anxiety
• PTSD
• Migraines & Headaches
• CRPS & Chronic Pain

It is also used by healthy people wishing to improve their healthspan:

• Immunity & Resilience
• Athletic Performance
• Anti-aging
• Recovery from surgery

Please note, Combination Infusion Therapy is NOT used to treat:

• Substance use disorders
• Active withdrawals
• Psychosis
• Schizophrenia

NAD+ stands for nicotinamide adenine dinucleotide, which is an active form of a coenzyme that plays a significant role in the chemical reactions within your cells. NAD+: 

• Turns carbohydrates, fats, and proteins into usable energy (Krebs Cycle)
• Regulates your body’s stress response
• Repairs and synthesizes DNA
• Regulates your circadian rhythms
• Promotes stem cell production
• As you age, natural levels of NAD+ begin to decrease. If you add sickness, disease, or chronic stress to the mix, your NAD+ levels deplete more rapidly.

We work with providers that fall broadly into 3 categories:

Emotional Pain

• Primary Care Physicians
• Neurologists
• Psychiatrists
• Psychologists
• Therapists/Counselors
• Life Coaches
• Social Workers

Physical Pain

• Pain Specialists
• Primary Care Physicians
• Surgeons
• Orthopedic Specialists
• Neurologists
• Physical Therapists

Healthspan

• Primary Care Physicians
• Functional Medicine Providers
• Dieticians
• Athletic Coaches
• Life Coaches

We pride ourselves in being very administratively efficient because it means we can intake new patients quickly and easily. Assuming there are no medical contraindications we can usually offer an appointment for new patients within 1 week of processing their intake form and speaking with you as their referring provider. Please begin your referral by submitting a New Patient Referral. If you have any questions about our process please call 415.475.9660. We're happy to help.

As soon as we receive your patient referral we will reach out to your patient via phone call. The purpose of this call is to confirm their interest in Combination Infusion Therapy and answer any questions they may have. If at the end of the call they would like to proceed they will be asked to submit a New Patient Intake Form. This provides us with the necessary contact information and medical history so we can begin onboarding them. After reviewing their intake information we will reach out to you to discuss your patient's medical condition and better understand your reason for making the referral to CIT Clinics. If we still agree that these treatments may benefit your patient our team will begin scheduling their first treatment.

Yes we offer a full range of patient services including Ketamine Assisted Psychotherapy.

Yes. Our Combination Infusion Therapy protocols include ketamine along with IV vitamins and minerals for the treatment of depression, anxiety, PTSD, OCD and more.

Most of our patients come to our clinic after many years of frustration and struggles with treatment resistant emotional and/or physical pain. If you’re struggling with anxiety, depression or PTSD you’re probably also feeling physically exhausted, fatigued and run down. Similarly, if you are suffering from chronic physical pain, you are most likely also feeling emotionally depleted, anxious and depressed. The connection between our body and our mind is real and complex. Combination Infusion Therapy is a cutting-edge approach to healing physical and emotional pain by integrating treatments that address the health and balance of your brain, your body and your mind. You can discuss your health needs with our Wellness Coordinator by scheduling a free phone consultation here.

Since Ketamine works on pain receptors in the brain, you will experience an immediate reduction of pain once the Ketamine infusion starts. After the infusion, you will likely feel less (if any) pain for a 24 hour period. After several consecutive treatments, many patients report a reduction/cessation of pain for days and sometimes weeks. The biggest challenge with treating CRPS is to maintain a regular infusion schedule in order to keep CRPS at bay.

In our experience 3-4 consecutive days of low-dose Ketamine infusions lasting approximately 3-4 hours each, offers CRPS patients the most relief. Some patients then take a day or two off treatments, and then repeat the treatment cycle again.

With CRPS, we believe there are changes in the central nervous system at work. These changes wind up the pain signals from your body. Normally, bumping your leg or touching a cold item would cause a small amount of pain. In someone with CRPS, those stimuli cause intense, severe pain. This type of amplification of pain is believed to be due to activation of one of the nerve cell receptors, namely NMDA receptor. Ketamine Is a potent anesthetic that works on these receptors, blocking them from firing, which decreases the pain.

Dose increase - Imagine yourself nearing the end of a therapy session with a client who appears to be on the edge of a breakthrough. They just need a subtle nudge of dissociation to really dig into what has been holding them back for years. You simply press the call button and a CIT Anesthesiologist visits the treatment room with a small 5mg IV bolus of ketamine. Your patient is able to explore the issues further, the session extends 15-20 minutes, and they are able to conclude a successful session that would have otherwise been unachievable had the Ketamine been administered orally or via intramuscular injection. Dose decrease - Conversely, consider a PTSD patient that you have been working with for years: They are in the midst of a session when their experience begins to darken as past memories are re-visited. You press the call button and a CIT Anesthesiologist arrives to turn down the Ketamine infusion rate and explores the option to administer a small amount of benzodiazepine medication (Versed). A small dose is given, the experience softens for the patient, just enough so that they can continue exploring the thoughts and emotions that just surfaced. Compare this to a dark experience with oral or IM Ketamine whose administration cannot be rescinded. 

Yes. We require all providers to have an active professional liability insurance policy per their licensure requirements.

Treatment cost depends on the duration of the session and whether or not your patient wants other Combination Infusion Therapy medicines such as NAD+ and/or Glutathione in addition to Ketamine. For our standard Ketamine plus IV nutrients infusions you will be charged the following:

• 45 minute session - $690
• 60 minute session - $725
• 90 minute session - $825
• 120 minute session - $995

If you suffer from chronic pain, you probably know all too well how difficult it can be to treat. The long road of evaluations, diagnoses, and attempts to relieve the pain can leave you mentally and physically exhausted, and no better off than when you started. Pain management is a field of medicine that helps you manage your pain better through a number of different treatments, often used in combination, such as:

• Physical therapy
• Medication management
• Interventional therapies and surgeries
• Behavioral therapies
• Alternative therapies, such as acupuncture and chiropractic care
• While pain management can be effective, if your chronic pain resists these treatments, it might be time to give ketamine and/or NAD+ therapy a try.

First and foremost, Ketamine is an analgesic, which means it stops pain in its tracks like most painkillers. By altering your neurotransmitters with Ketamine, you can find long-lasting relief from chronic pain. Furthermore, to boost the effects of ketamine infusion therapy, we also offer nicotinamide adenine dinucleotide (NAD+) infusions, which restore your body’s energy, promote healing by activating the DNA repair process, reduce oxidative stress, reduce inflammation and better regulate body’s systems at a cellular level. The combination of both Ketamine and NAD+ offers a powerful solution to chronic pain.

A common misconception about trauma is that only victims of violence (war, violence, rape, accidents, etc.) experience PTSD. Other non-acute causees of PTSD include repeated and prolonged experiences such as domestic violence, emotional abuse/manipulation and illnesses. It is impossible to predict who will exeriencr PTSD and quite common that people experiencing similar events react very differently and are therefore more or less likely to suffer from PTSD.

Following the initial series of six treatments, we expect to see significant improvement that lasts from a few weeks to several months. Typically a “booster” ketamine infusion treatment is required after that time period to maintain relief of symptoms.

Sometimes the positive effects of treatment can be seen within minutes of completion. Typically after the third infusion for patients being treated for depression, we will know if ketamine is producing the desired results. Patients and their friends or family members may notice significant changes in mood and behavior almost immediately.

About 60% of people with depression aren't helped by the first antidepressant they try, and about 30% don't respond to several attempts at treatment. Researchers still don't know why so many don't people respond well to "anti-depressants" such as SSRIs, SNRIs, etc. Treatment Reistant Depression can be defined as Depression that doesn't respond to two (or more) different antidepressants from different classes.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems.

Within a few minutes of receiving Ketamine via infusion you will feel a sense of euphoria, calm and even a bit dissociated. Most patients report feeling a sense of relief and a cessation of anxiety within minutes. Depending on the dose you are receiving this may fluctuate in intensity. Our anesthesiologists can monitor how you're feeling and adjust the dose to ensure your experience is pleasant.

Everybody is different, so depending on your current health you could experience noticeable effects for up to 3-4 days after your treatment. Even if you don't “feel” effects you are likely still reaping the benefits. Patients experience the most long-lasting benefits when they receive Myer's Cocktails on a regular basis or clustered around physically challenging events (jet lag, after a really hard work out/race, post surgery, recovery from flu/illness, etc.)

Most patients report an almost immediate sense of wellbeing, perkiness and energy within minutes of the the infusion starting. Especially if you have been athletically active, the combination of fluids and nutrients can be felt almost immediately.

Depending on the amount of hydration fluid you are receiving the infusion can take anywhere from 20 - 60 minutes.

This depends on your underlying health status and the condition you are hoping to treat. After a consultation with our medical team, we will determine the most appropriate dose ane frequency of treatments for you.

Depending on how much hydrating fluid you woul like to combine with your Glutathione, the infusions can take anywhere from 20 - 45 minutes.

Any condition associated with excessive oxidative stress, inflammation and free radical damage (which includes most major conditions) could theoretically be helped by intravenous glutathione. The best-studied uses are for Parkinson’s Disease and side effect reduction associated with conventional cancer treatments. Other potential uses include conditions such as multiple sclerosis, progressive neuropathy, chronic fatigue syndrome, fibromyalgia, metabolic syndrome, diabetes and hypertension.

While there is an abundance of over the counter Glutathione oral tabs available at health stores and the Internet, eating Glutathione is much less effective than intravenous therapy for treating chronic illness. Glutathione is not typically effective when ingested orally because the enzymes in your stomach dissolve the bonds between the amino acids before it can be effectively absorbed.

Receiving your first treatment is contingent on us receiving the necessary documentation about your current health status, medications your are currently taking and past treatments your have received. This can take anywhere from a few days to 1-2 weeks. In order to provide you with safe and effective treatments our medical care team needs the necessary information prior to giving you any infusion thereapies.

Ideally we are able to consult with any medical professionals who have provided you with mental health services (such as your therapist, psychiatrist, social worker, primary care physician, etc.). If you don't currently have a mental health care professional who is treating you we can help. Our Wellness Coordinator will discuss your options during your initial phone consultation.

If, together with our Wellness Coordinator, you decide to proceed with infusion therapy treatments we will collect the following information via online communication:

• Your Contact Information
• Health Questionnaire
• Medical Records Release Authorization (your consent to have your mental health provider release pertinent medical records to CIT Clinics.

Consultations take place over the phone. When you book your free consultation be sure to enter the phone number that you want to use at the appointment time.

Consultations typically take 15 - 20 minutes.

In order to determine whether or not our infusion therapies are an appropriate treatment for the condition you are wanting to treat, our Wellness Coordinator will ask you questions about your current medical history and treatments you have had. Together we will then be able to determine what course of treatment to pursue.

No. The consultation is free of charge.

CIT Clinics are pleased to offer BR+NAD-Brain Restoration Plus, the highest quality NAD+ formulation available from the only manufacturer in the world certified by the U.S. Food and Drug Administration.  We are endorsed providers of this pure product that produces the best and most consistent results.  Our board-certified physicians have been trained and certified by the founders of the first clinic to offer NAD+ therapy in the country, Richard Mestayer, M.D. and Paula Norris, M.Ed. of the Springfield Wellness Center. ****Please be careful of other products marketing themselves as NAD**** NAD+, NADH and NR (Nicotinamide Riboside) are not the same. Although NAD+ plays a role in the same pathway as NADH and NR, there are certain NAD+ consuming reactions where only NAD+ can be utilized. In these reactions, NADH and NR are not effective. While NADH and NR are less expensive than NAD+, the positive effects are not nearly as potent as NAD+. BR+NAD and our REAL NAD+ tablets are the purest forms of NAD+ available.

How much NAD+ your body needs is determined your current health status, your history and the condition your are trying to treat. Chronic depression, anxiety, PTSD and physical pain are very taxing on the body and result in varying degrees of NAD+ depletion. Together, with the CIT Clinics medical team you will determine the appropriate dose and course of treatment.

When NAD+ is administered via IV it is mixed with saline solution and slowly drips into your blood stream. Some patients experience discomfort from the NAD+ infusion (eg. GI discomfort, sensations of pressure in the belly and chest) and therefore want to slow the drip rate down. This means the rate of administering NAD+ goes down and the treatment takes longer (sometimes as much as several hours longer). Since CIT Clinics physicians are board certified anesthesiologists, we are able to add Ketamine to the NAD+ infusion making the process much more comfortable and faster.

The side effects of treatment are minimal and appear related to the rate at which the NAD+ is administered. At a faster rate, patients may experience slight upper torso pressure, abdominal cramping and lower leg soreness. Flushing, mild nausea and a slight headache may also occur. These side effects typically disappear within just a few minutes of slowing the rate of infusion. Patients are able to pass the time in our relaxing clinic environment by watching TV, reading, and listening to music. You will also have access to high-speed internet and can bring your laptop or tablet.

A small IV is inserted into your arm while you sit in a comfortable recliner. The NAD+ is added to a saline hydration bag allowing the NAD+ to slowly drip directly into your blood stream. Depending on the amount of NAD+ being infused as well as your tolerance for the drug, this process can take anywhere between 1 - 4 hours. Adding a small amount of Ketamine to the infusion will greatly reduce the length of time needed for the NAD+ infusion.

While NAD supplements are available in some health stores, they are not nearly as effective as receiving NAD intravenously because the compounds are not fully absorbed. The body's digestive tract and liver break most of the desired compounds down thereby drastically reducing the bioavailability of the NAD (the amount of a drug or supplement that your body can actually use). As a result, oral NAD+ supplements as well as subcutanneous (under the skin) injections of NAD+are much less effective than IV infusions.

The occasional side effects that we see from low dose ketamine treatments usually resolve shortly after treatment. We may use supplemental medications to treat nausea, anxiety, hallucinations, and/or blood pressure changes.

Patients usually recover from the effects of the infusion within 20-30 minutes. There may be residual cloudiness and mild difficulty walking for a few hours. You may also feel fatigued for the remainder of the day. We recommend the patient have a low impact and relaxing remainder of their day following the infusion.

During the infusion, some patients report changes in their vision, speech, and thought processes. They often describe feelings of dissociation from their body. It can feel like a sedated or dreamlike state. If unpleasant hallucinations or other sensations occur, we may decrease the infusion rate and/or administer medications to minimize these experiences.

Chronic use of benzodiazepines (e.g. Ativan and Xanax) and Lamictal (Lamotrigine) may render ketamine therapy less effective, and we may recommend those medications be stopped or dosages significantly reduced at least 5-14 days before treatment. Patients on MAOi’s should not take ketamine. Consult with your prescribing doctor prior to stopping any medication.

This varies from patient to patient and cannot be predicted. Many of our patients experience relief from their symptoms within the first few treatments. Our rate of success is 85% after the 6 treatments and most patients notice a "shift" after their first infusion.

If you meet the guidelines for Ketamine infusion therapy, you will begin with an Evaluation Treatment. This consists of a guided, 60-minute infusion during which we weill gently and carefully introduce your brain and body to Ketamine. The goal is to determine how well you tolerate the medicine both physically as well as emotionally. During the followup meeting (within 48 of your in-clinic session), we will recommend a care plan that is personalized to your needs. This plan typically includes several more ketamine infusions alongside a series of coaching sessions to help you integrate insights from the sessions. This journey typically takes 3 to 8 weeks and may involve 3 or more ketamine infusions. Every patient has different requirements and we tailor every care plan based on our patients' symptoms, tolerance of Ketamine, level of engagement with coaching, etc.