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.