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Author: Admin | 2025-04-28
Increase in Ketamine dosing to establish a therapeutic Ketamine level, which is very easy to provide.Lithium, a mood stabilizer for bipolar disorder, can enhance the effects of Ketamine as both stimulate similar signaling pathways in the brain. Lithium may bolster the anti-depressant effects of Ketamine. Stimulants (ADHD medications, Adderall, Ritalin, Vyvanse, Concerta ) should be held the day of Ketamine treatments. Both stimulants and Ketamine can raise heart rate and blood pressure slightly but can be more profound when used together so should be avoided when possible.Opiates, new data suggests that taking opiates on infusion day may play into Ketamine effectiveness. We will generally advise patients to hold or reduce pain medications prior to and shortly after infusions. Which is often not an issue given Ketamines effects on treating pain. Medications that interact with Ketamine in the Liver-CYP2B6 Enzyme-The CYP450 enzymes in the liver, particularly the CYP2B6 group, are crucial for metabolizing Ketamine to norketamine, its main metabolite. Some medications, also metabolized by CYP2B6, can influence Ketamine levels:Dexamethasone, a common steroid, induces CYP2B6, accelerating ketamine breakdown and decreasing its available levelsOrphenadrine (Norflex), a muscle relaxant, inhibits CYP2B6 and thereby slows ketamine breakdown, increasing its presence in the bodyGenetic variations, such as having polymorphisms of the CYP2B6*6 allele, may slow ketamine clearance from the body, potentially increasing unwanted side effects.CYP3A4 EnzymeThe CYP3A4 enzyme, another group within the CYP450 family, metabolizes approximately half of all drugs on the market. This enzyme's extensive involvement in drug metabolism leads to many potential interactions. -
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