Goldilocks ketamine dose

Goldilock’s Ketamine Dose

We work from the standard weight-based ketamine dose to find the optimal dose for each individual patient — not too much and not too little, but just right — toward the best possible results.

With ketamine treatment for depression, anxiety, PTSD and other conditions, more is not always better. We aim to find the right dose for each individual patient that is most likely to yield good results for the patient.

The “standard” dose

The “standard” dose for a ketamine infusion treatments is 0.5 milligrams of ketamine per kilogram of the patient’s body weight per hour (0.5 mg/kg/hr). This is the dose that has been used in the majority of foundational studies and as the basis for clinical practice for many years.

This dose was selected, in large part, because it is well-tolerated by most people while yielding significant results in symptom reduction. Patients generally feel floaty, without much nausea or feeling like the experience is frightening or too strong. This is a dose that most people will feel comfortable with.

Within the context of a clinical trial, consistency is key in order to produce results with statistical significance. 0.5mg/kg/hr is an excellent dose for research and it is a very good starting point for clinical practice, but it may not be the optimal dose for each individual patient. More than likely, that dose is going to be a little too low for some people and a little too high for other people.

Finding your right dose

Our goal when finding the optimal dose for a patient is to find a Goldilocks zone where the ketamine is very floaty and vivid without causing significant nausea or a “bad trip” or a negative experience, and without causing ketamine to act as a sedative.

There are many individual factors may require an adjustment in dosing.

  • Sometimes patients have body weight outside of an average or ideal range and may require dose adjustment for this reason.
  • Sometimes patients are taking medications that can increase, or decrease, their tolerance to other medications, including ketamine, and may benefit by adjustments to their ketamine dose.
  • Sometimes patients appear to have innate or genetic factors that impact their response to ketamine, such that they benefit by an adjusted dose.
  • Sometimes patients at the extremes of age may need dose adjustments 

For many reasons, the starting or “standard” dose for ketamine treatment may need to be adjusted to be higher or lower for each individual patient. We work with each individual patient to find what the best dose is for them to ensure they are experiencing the most benefit from treatment with the least side effects.

IV Infusions Allow for Adjusted Dosing

IV infusions allow for continuous sustained administration of carefully-controlled amounts of ketamine toward the best possible result for the patient.

  • With precision controlled pumps, the dose and rate of administration may be carefully controlled, started, stopped, increased or decreased throughout an infusion and from one infusion to the next.
  • Because the medication is provided over time (40 minutes in many cases), there is more opportunity for adjustment, and a larger total dose can be administered.
  • Because the medication is provided by IV directly into the bloodstream, more of the medication is bioavailable, which is more efficient, and more precise, and allows for greater control.

IV infusion is the best possible way to administer therapeutic, sub-anesthetic doses of ketamine for the treatment of mood disorders and some pain conditions – including depression, anxiety and PTSD. It is the gold standard. It allows us to work toward this ‘just right’ or ‘Goldilocks’ dose for each patient.

Toward the Best Possible Results

There are multiple factors that contribute to successful treatment with ketamine. Finding a good dose is one of the key factors. It contributes to patient comfort, tolerability, and safety. We believe it likely contributes to the best possible results for our patients.

In this way we work with the best available treatment method toward the best possible outcomes.

About Us

Wells Medicine is a Houston-based practice designed to provide meaningful care for mental health. Providing targeted interventional treatments for Depression, Anxiety, OCD, PTSD and other conditions, with Ketamine Treatments, Stellate Ganglion Blocks, TMS, and Nitrous-Oxide Treatments. Focused on comprehensive care and integration with Psychiatry, Psychology, and Support Services. We are evidence-based, patient-focused and mission-driven.

The content here is for informational purposes and should not be relied upon for medical decisions. For the details of your specific medical conditions and treatments consult your doctors or other qualified healthcare professionals.