CTK, or Combined TMS and Ketamine treatment, may increase the benefit you can see from either treatment alone.
Studies show promising results
Ketamine treatments and TMS can each rapidly and effectively relieve symptoms of mental health conditions such as depression, anxiety and PTSD.
Recent studies have shown that combining treatments may be more effective than either treatment alone, especially for treatment-resistant symptoms or conditions such as treatment-resistant depression (TRD):
“..the combination of TMS and ketamine presents a promising treatment modality for patients with TRD, offering significant improvements in depressive symptoms and better outcomes..” and “The combination therapy showed a higher efficacy compared to monotherapies of either TMS or ketamine alone.”
From: Combination of Transcranial Magnetic Stimulation and Ketamine in Treatment-Resistant Depression: A Systematic Review. Arubuolawe OO et al. Cureus. 2024;16(7):e64712. Published July 17, 2024. doi:10.7759/cureus.64712 Full text (PDF)
The combination of TMS and ketamine treatment, also known as CTK, can be administered in multiple ways. Treatments may be given one at a time within the same treatment window; for example, ketamine treatment can be given a few times per week during a period of daily TMS. Alternatively, accelerated TMS may be given during the period of time a patient is receiving their initial series of 6 ketamine treatments. CTK may also be done by receiving TMS and ketamine simultaneously.
Some considerations for combined Treatment
TMS and Ketamine may be combined in any number of ways, although it is important to address the requirements of each.
When combining treatments sequentially, it often makes sense to provide ketamine after TMS, as ketamine can change the electrical thresholds or dosing for the TMS.
Treatments may also be combined concurrently, or at the same time.
Although TMS on its own does not require fasting and permits patients to drive themselves home, patients must still adhere to the fasting and driving restrictions of ketamine treatment.
Patients can expect to experience the common side effects associated with either treatment — for example, possible headaches with TMS and transient nausea with ketamine treatments.
Best-in-class Treatments toward Better Results
At Wells Medicine, we provide accelerated TMS, which typically involves 50 total sessions of TMS over the course of five days, or alternatively, 20 sessions of TMS over a single day. In addition to allowing patients to see results much more rapidly than the standard protocol of TMS, accelerated TMS shows promise to be more effective than the standard protocol of TMS.
We focus on providing intravenous (IV) ketamine infusions of racemic ketamine, which is the most effective form of ketamine treatment — allowing for total bioavailability of the drug, precise and controlled dosing, and extended administration over the infusion duration.
These are best-in-class treatments, combining already-excellent treatment modalities that have significant positive results in many cases — even for treatment-resistant and acute symptoms — with protocols designed to deliver some of the best practical results in the clinical setting. With studies suggesting that combining TMS and ketamine treatment may yield better results than either alone, the combined treatment may truly be an exceptional option for many people.
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.
