Feeling trapped in your own mind, endlessly repeating the same habits and behaviors without understanding why, can be a vicious cycle. It can be frustrating and disheartening constantly wondering if change will ever be possible.
Understanding neuroplasticity offers a turning point. Neuroplasticity is the brain’s incredible ability to adapt and change throughout life by forming new neural connections. This adaptability is crucial for learning new skills, recovering from injuries, and adjusting to new situations.
Neuroplasticity can be broadly classified into two types: structural and functional plasticity.
Neuroplasticity is driven by various factors, including learning, experience, injury, and even environmental changes. It is essential for recovery after brain injuries, such as strokes, and plays a significant role in developmental processes, such as language acquisition and skill development.
When you feel stuck, it’s easy to believe that change is impossible. However, neuroplasticity shows us that the brain can adapt and change at any age. This means that no matter how ingrained your habits or thought patterns are, you can rewire your brain to support new, healthier behaviors and ways of thinking.
Two promising techniques that have garnered attention for their ability to enhance neuroplasticity are Ketamine Infusion Therapy (KIT) and Transcranial Magnetic Stimulation (TMS). These therapies are especially beneficial for individuals struggling with emotional regulation, decision-making, learning, memory, trauma resolution, and mood stabilization.
Ketamine Infusion Therapy (KIT)
Ketamine, traditionally known as an anesthetic, has shown proven results in promoting neuroplasticity, particularly in the treatment of depression and other mental health conditions. KIT involves the administration of ketamine in controlled, low doses over a period of time.
Transcranial Magnetic Stimulation (TMS)
TMS is a non-invasive technique that uses magnetic fields to stimulate nerve cells in the brain. It has been widely studied for its potential to enhance neuroplasticity and is commonly used in the treatment of depression.
Taking the First Step Toward Change
Change can feel overwhelming, but understanding that your brain is capable of adapting and forming new connections provides a powerful tool for overcoming this feeling. Embracing techniques like KIT and TMS can support your journey toward better brain health, mental health, and personal growth.
Remember, small steps lead to sustainable, meaningful changes. By leveraging the power of neuroplasticity, you can create a new path for yourself, one that leads to a healthier, more fulfilling quality of life. Embrace the potential for change within you and take action today.
Schedule your no-cost consultation online or call our Care Team at 423-228-0579.
Want to learn more about the incredible power of neuroplasticity? Check out our YouTube video below.
Editor’s Note: This blog was updated on August 16th to include the latest information regarding Matthew Perry’s death.
“It’s difficult to get a man to understand something when his salary depends on not understanding it.†– Upton Sinclair
When this blog was first written, based on the available information, it was reasonable to believe that the medication Matthew Perry took was in line with typical prescribing practices. Initially linked to at-home ketamine use for mental health concerns, it’s important to address the increasing trend of ketamine prescribed for at-home self-administration. While ketamine therapy, when administered in a controlled and supervised environment at appropriate doses, is a safe option for those facing challenging mental health conditions, the move towards at-home use—whether prescribed or not—introduces significant risks. As an advocate for patient well-being and responsible medical practices, I’ve always strongly advised against attempting to use ketamine without proper medical supervision.
Based on the details that emerged on August 15th, it is now understood that Perry’s death resulted from a combination of factors, including provider malpractice, illegal drug use, and the dangerous interplay of multiple treatment elements, such as the unsupervised setting of his hot tub. Confirmation bias, such as assuming that since nothing bad happened last time, nothing bad can happen this time, may have played a role in this tragic event.Â
Numerous companies and providers, both in Chattanooga and nationwide, are prescribing sublingual doses ranging from 150 mg to 1600 mg per administration to address poor absorption. This practice significantly amplifies the associated risks. Sublingual absorption of medications is notably poor (around 10-30%). With ketamine, the effects of a 1200 mg sublingual dose is equivalent to the effects of a much lower IV ketamine dose (150-200 mg), which, while still high, is not typically lethal. Matthew Perry’s untimely death was avoidable and unnecessary, emphasizing the critical need for medical supervision with all ketamine administration.
Matthew Perry’s case highlights a significant concern – certain companies insist that using ketamine at home is as safe as supervised administration in a clinic. However, closer scrutiny reveals that such assertions lack any scientific support. Despite these companies boasting the ease and cost-effectiveness of at-home ketamine use, it is imperative to consider the increased risks and the lack of efficacy with sublingual administration of ketamine. It is not only significantly more dangerous but it also has the lowest chance of success when compared to any other administration modality.
The escalating instances of injuries and fatalities linked to DIY ketamine use underscore serious ethical concerns. It is disconcerting to witness some providers downplaying these risks, leaving patients insufficiently informed. Convenience should not take precedence over patient safety and treatment effectiveness. Providers utilizing this modality do so either out of greed or ignorance. While the sublingual ketamine model does offer a financial incentive and is far less labor intensive for the provider, we find that most of those prescribing at-home ketamine are well meaning. They simply are ignorant of the many risks associated with rapid acting anesthetics like ketamine. Also, the legality of at-home ketamine use gives a false sense of security, but technical legality does not equate safety or appropriateness.
In conclusion, Matthew Perry’s tragic story serves as a poignant reminder of the severe consequences associated with DIY ketamine use. It is imperative for the scientific and medical community to vehemently discourage any form of at-home ketamine use and advocate for responsible, medically supervised administration. Our commitment to those seeking help must prioritize treatments that are not only effective but, above all, safe.
About Scenic City Neurotherapy
Founded in 2019, Scenic City Neurotherapy is at the forefront of advanced and comprehensive treatments for those facing treatment-resistant conditions. Our goal is to excel in opioid free pain management and mental health treatment, setting a standard of care that results in better outcomes and improved brain health. We specialize in Ketamine Infusion Therapy and Transcranial Magnetic Stimulation (TMS) Therapy.
If you’re seeking innovative solutions for mental health, chronic pain, or neurodegenerative conditions, Scenic City Neurotherapy offers transformative treatment options. Join us in advancing brain optimization and empowering individuals to reclaim their lives.
Contact Charles Miller, Founder and Chief Medical Officer, to learn more about our Minimally Stimulated Ketamine Infusion Therapy (MSKIT®) and Transcranial Magnetic Stimulation (TMS) protocols. Call 423-228-0579 or visit www.ScenicCityNeuro.com.
Transcranial Magnetic Stimulation (TMS) therapy has been researched for over thirty years. In 2008, the FDA approved it in the United States for the treatment of Major Depressive Disorder in adult patients who tried medications with no satisfactory results.
TMS therapy utilizes a series of brief magnetic pulses that stimulate targeted neurons in the prefrontal cortex of the brain. Neuronal lesions found in this area of the brain are responsible for symptoms of depression and anxiety. These lesions can be described as poorly communicating brain cells often due to periods of heightened stress or trauma. Using Stim-Guide mapping, our targeted approach will determine each patient’s ideal treatment target and ensure perfect stimulation for the entirety of each treatment. The goal is optimization of neuronal communication and restoration of brain activity to normal levels with little to no side effects.
Many mental health professionals are including TMS therapy as part of their treatment plan to address the root cause of their client’s depression. The treatment is simple, non-invasive, and medication free. While the treatment does not require any downtime, the two protocols offered at Scenic City Neurotherapy require different time commitments.
Choosing a TMS treatment path that fits the patient’s schedule is imperative for success.
Scenic City Neurotherapy is the region’s only provider of iTBS (SNT Protocol). This aggressive 5-day protocol was developed by the Stanford Department of Psychiatry. It allows the patient to undergo 10 sessions per day for five consecutive days, totaling 50 sessions. In addition to the treatment room, the patient is provided access to a kitchen area and their own private room to relax, read, study, or work (if necessary) between sessions. This option is good for individuals who have the ability to take time off from work.
The rTMS (Classic TMS) protocol is one treatment per day, Monday-Friday, for 6 weeks with a 3-week wean, totaling 36 sessions. This option is good for those who cannot take off time from work or daily responsibilities. Individuals can drive themselves to and from each session and carry on normally for the remainder of the day.
It is important that treatment protocols are tailored to fit the needs of the individual. While counseling and/or medication alone can effectively treat depression, there are many advantages to including TMS therapy in your treatment plan to address the root cause of your client’s depression.
There are many advantages to TMS therapy as a treatment option for depression. At Scenic City Neurotherapy, we utilize Magstim, the most advanced FDA-approved rTMS therapy system offering Stim-Guide mapping. This type of neuronavigation helps to ensure precise coil positioning with every patient treatment – thus enhancing optimal outcomes for a much-improved quality of life.
The TMS therapy protocols with StimGuide boast the following success rates:
The patient can achieve long term relief in as little as five days without the long-term need for a daily medication. TMS Therapy bypasses common side effects of antidepressants such as:
The patient can achieve long term relief in as little as five days without the shock or induction of a seizure like with ECT. TMS avoids the unpleasant side effects of ECT therapy such as:
During the consultation process at Scenic City Neurotherapy, medications are thoroughly discussed and taken into careful consideration when formulating the patient’s treatment plan. We prioritize the safety and well-being of our patients, which is why we require any adjustments to their medication regimen to be done under the guidance of their prescriber.
Throughout the stabilization phase of treatment, we encourage patients not to make any medication or lifestyle changes. Our focus during this period is to ensure a stable foundation for their treatment journey.
Once stabilization treatment is complete, our collaborative approach comes into play. Patients will work closely with their prescriber to optimize medication plans and, in many cases, reduce the need for daily medications. Our goal is to support patients in accessing a wide range of therapeutic options, and ketamine-assisted TMS is one such resource we offer to enhance their treatment experience.
By combining our expertise in ketamine-assisted TMS with the guidance of the patient’s prescriber, we aim to create a comprehensive treatment approach that complements and augments the therapeutic tools available to your clients. Our shared goal is to empower patients on their path to improved mental health and well-being.
Research shows the combination of psychotherapy and TMS therapy can positively affect the patient’s response and remission rates. It may also decrease the number of sessions required to respond.
Neurotherapy treatments such as TMS therapy cause the brain to undergo an optimization process. The goal with these treatments is to enhance cognition and emotional regulation while improving emotional and physical reactivity. Simply put, TMS therapy restores the conscious, logical areas of the brain’s control like what we feel and how much we feel. It is a purely physiological change which allows the patient to maximize success while working with his or her psychotherapist to reach goals and establish daily self-management of mental health.
We have developed our approach with the specific goal of collaborating with our patient’s entire health care team. Our focus is on refining the brain’s unconscious response to various stimuli, leading to more appropriate reactions. By doing so, we facilitate improved outcomes in conjunction with the care plan other medical providers are conducting with our patients.
One of the key benefits we offer is the enhancement of neuroplasticity, or the brain’s ability to adapt and reorganize itself in response to new experiences and information. An increase in neuroplasticity enables patients to integrate and retain new information more effectively, promoting overall growth and progress.
Our commitment is to work alongside all health care providers in our community, utilizing our expertise to enhance the patient’s neuroplasticity and overall treatment experience. Our medical team is readily available for discussions with supporting health care providers regarding their patient’s treatment plan. Together, through a collaborative effort, we can empower patients to achieve their goals and make meaningful improvements in their journey towards better mental well-being.
We believe that maintaining better mental health is an ongoing and lifelong journey. Our boosters serve as a tool to be utilized in sustaining and supporting this continuous improvement.
Typically, the patient will receive their first booster approximately 4-6 weeks after the initial stabilization period. However, the frequency and timing of these boosters are tailored to each individual’s specific needs and response to treatment. As practices and coping skills improve, there is a diminishing need for regular treatment. The patient becomes empowered to navigate their mental health journey more independently.
Whether the patient chooses to proceed with TMS boosters or ketamine infusion boosters, one of the significant advantages of our approach is there is no risk of dependency, eliminating the need for a wean-off process.
Our goal is to equip patients with the tools and necessary support for long-term well-being and resilience. By customizing maintenance plans and providing booster infusions when needed, we strive to assist our patients in achieving sustained progress and a fulfilling quality of life.
Insurance coverage for TMS therapy varies by location, insurance plan, and protocol.
Our Classic TMS Protocol is covered by the vast majority of insurance providers with the exception of Medicaid. Patients are usually responsible for their portion of deductibles and copays until they meet their maximums. Our TMS Director will file the insurance application and find out the specific details on the patient’s financial responsibilities.
The SNT protocol currently is able to report the highest rate of remission when compared to all other neuro-regenerative interventions for intractable depression. While this protocol is not yet covered by insurance, it is the most effective treatment available for depression. We work with the patient to maximize affordability and help facilitate coverage through financing options and health spending accounts.
Check out our TMS pricing.
We have seen TMS therapy help patients transition a chronic condition into complete remission, minimizing the need for a daily medication. Their ability to feel present in the moment is enhanced so that they can feel good when good things happen, feel bad when bad things happen, and feel reasonably neutral when nothing is happening.
TMS therapy functions as the missing piece of today’s mental health care plan. Improvement will continue as the patient works to improve their environment and coping skills. Progress made during psychotherapy in the days after treatment works to build them up as they advance toward a long term goal of self-maintenance.
Minimally Stimulated Ketamine Infusion Therapy (MSKIT®) protocols were established to ensure the treatment provides the greatest success for the patient in the safest possible way. MSKIT® protocols include adjuncts such as NAD+ to enhance the benefits of what we can do with ketamine-only treatment. When a patient receives treatment at Scenic City Neurotherapy, they are receiving a process, not a single drug.
What is NAD+?
Nicotinamide adenine dinucleotide (NAD+) is a coenzyme that is naturally produced in your body to repair DNA and facilitate energy production. Coenzymes, often referred to as “helper moleculesâ€, are less effective alone and a crucial catalyst for enzymes that also cannot function solo. Consider the enzymes in your mitochondria – NAD+ is responsible for activating these enzymes, turning nutrients into energy, and assisting in the production of over 90% of your body’s energy.
Scientists began studying NAD+ in the early 1900s for its role in fermentation. Little did they know that years later it would play a role in mitigating pellagra, a debilitating disease caused by a deficiency in niacin (Vitamin B3), a precursor to NAD+. These findings and more pointed to what we now know about NAD+ playing a critical role in facilitating the body’s creation of proteins, enzymes, and other biologic compounds necessary for our body’s natural processes to occur.
How does NAD+ affect withdrawal?
Since the 1960s, NAD+ has been used to minimize symptoms and shorten the duration of alcohol, opioid, benzodiazepine, and antidepressant withdrawal. The excessive use of these substances depletes NAD+ stores, inhibiting the production of energy needed for on-going metabolic processes. You can think of NAD+ as a powerful detoxifier. Your body begins to clear out the unnatural substances in your system, resulting in removal of cravings and reduction of withdrawal symptoms, which we understand to be extremely difficult, uncomfortable, and the reason many people end up in and out of treatment facilities.
When your body is capable of optimal energy production for its natural processes, you are able to recover better both physically and mentally. Thus, the benefits associated with adequate NAD+ levels extend far beyond withdrawal.
Can NAD+ reduce fatigue?
The straightforward answer is yes, NAD+ can reduce fatigue. There are a variety of factors that can drain your energy and leave you feeling more exhausted than usual such as irregular sleep patterns, persistent stress, mental illness, or brain fog.
NAD+ plays an essential role in the production of ATP, an organic compound that transfers energy from one cell to another for many processes in our body. It is an immediate source of energy (in small quantities) that cells can access faster than other larger energy sources such as glucose. Its functions include assisting metabolic processes, muscle contraction, synaptic signaling, helping enzyme-catalyzed reactions take place more quickly, and more. When NAD+ levels are in-balance, our body is better equipped to maintain homeostasis.
Why does NAD+ decline with age?
It is often said that our bodies and brains begin to decline as we age, but it’s rarely explained why. Over time our cells can become damaged from environmental factors, including extremes of temperature, exposure to toxins, and mechanical damage. Such damages trigger your internal cellular stress response, promoting cell survival or evoking programmed cell death.
NAD+ functions at the center of your cellular stress response. It binds with protein molecules to support cell vitality and survival. Low levels of NAD+ could result in an inability to stimulate the cellular stress response. The current body of research shows supplementing NAD+ can slow or prevent your body and brain’s decline with age.
Why Scenic City Neurotherapy?
At Scenic City Neurotherapy, we understand our patients’ outcomes depend on the protocols we follow. We follow best-practice methods developed by the foremost experts in the field of psychiatry and anesthesia at Yale, Stanford, and Johns Hopkins.
Our MSKIT® protocol, including NAD+, is designed for efficacy. Ketamine stimulates neurogenesis, or the regrowth of brain cells known as neurons, returning the brain to an optimal state in which you can work to alleviate depressive or chronic pain symptoms. NAD+ provides you with the boost in energy and cognition that is often needed to get back on track with daily practices that support your desired quality of life.
If you have questions about our process, call 423-228-0579 to schedule a no-cost consultation.
At Scenic City Neurotherapy, we refer to our evidence based IV ketamine therapy protocol as Minimally-Stimulated Ketamine Infusion Therapy (MSKIT®). It produces the highest rates of patient reported remission of symptoms, maximal comfort while undergoing treatment, and a team approach which includes counselors, general physicians, psychiatrists, physical therapists (for pain) and our anesthesia team.
MSKIT® requires significant patient preparation and education. We passionately believe it is important for each patient to have a fair understanding of how Ketamine Infusion Therapy works and accurate expectations with physiologic improvement.
What can you expect at your No-cost Consultation?
The process will begin with a no-cost consultation. One of our qualified medical providers will sit down with you to determine if you are a good fit for therapy, or if you have any contraindications that would put you at risk. In addition to discussing your mental and physical health history, your provider will explain the ketamine infusion therapy process. You will have as much time as you need to ask questions and address concerns you have with the treatment process.
You are welcome to bring a friend or family member to your consultation, but it is not required. During the treatment process, you might feel the need to talk things through. It can be helpful for your support system to be educated on neurotherapies, how they work, and why they work as well. If they have questions about how to support you, have them check out our Supporting a Loved One Through Neurotherapy blog.
If you are a candidate for ketamine infusion therapy, our Care Team will collaborate with you to establish a personalized treatment plan. It is crucial we promote the best environment, including before, during, and after the treatment process, for you to achieve your goals. Here are a few things to consider when creating your treatment plan:
When you feel prepared to start treatment, our Patient Care Coordinator will work with you to manage logistics. You will want to make sure that paperwork, payment, drivers, and schedules are sorted out before beginning the Stabilization.
What do you need to know about the Stabilization Phase?
Stabilization refers to your initial series of infusions. The mood and mood/pain hybrid protocols consist of six infusions over three weeks. You should plan about an hour and a half for a standard mood infusion appointment door to door. The acute pain protocol typically calls for four infusions over a two week period. These infusions will be longer so it is best to ask your provider about the length of your pain focused infusions. While your experience in the chair does not affect the outcome of the treatment, our goal is to make your time in the chair as comfortable as possible.
There are a few things you can do in preparation for your infusion.
There are a few things we want you to know about during your infusion.
Watch Key Steps to Navigating Stabilization on our YouTube Channel.
It is important you understand Stabilization is only the beginning. The work you do outside of our treatment room, during and after the Stabilization Phase, will help you achieve the long term goal of self-maintenance.
What is Maintenance Phase?
The rapid improvements seen with Ketamine Infusion Therapy are only the halfway mark. By establishing custom maintenance plans and providing booster infusions as needed, we are able to assist you in achieving sustained progress and a fulfilling quality of life.
Ketamine infusion therapy enhances the way your brain communicates and allows you to maximize the gains you make outside of the treatment room. Psychotherapy – establishing positive coping skills, working through past traumas, and optimizing your daily habits are oftentimes – is extremely effective after completing our process. Patients who are being treated for chronic pain might also require physical therapy to increase muscle mass and improve flexibility. Everyone’s process is different and should be tailored to each person’s individual needs. If you feel things start to slip, it might be time to schedule a booster appointment.
Ketamine boosters are similar to a safety net which help maintain plasticity while you optimize coping skills, environment, and medications. Typically, our patients will receive their first booster approximately 4-6 weeks after stabilization. However, the frequency and timing of these boosters are tailored to each individual’s specific needs and response to treatment. There is a diminishing need for regular treatment as practices and coping skills improve.
Good mental and physical health is a process to achieve and a lifetime of practice. Improvement is incremental, not always linear, and a result of continuous effort and self-prioritization by the patient.
If you have questions about treatment, boosters, or a referral, call 423-228-0579.
Mark Twain once said, “It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.†This insightful quote resonates strongly with the events surrounding the tragic loss of lives during a deep water dive conducted by OceanGate Expeditions on June 18, 2023. The ill-preparedness of the submarine they were aboard, despite the presence of the CEO among the passengers, suggests that the problem was not deliberate carelessness but rather a lack of fact-based decision making. This exemplifies the crucial role of incorporating scientific evidence to ensure safety and success in any endeavor. In the context of ketamine and psychedelic therapies, it is essential to recognize the risks associated with an incomplete understanding and the need for accurate information and effective dissemination among practitioners.
Ketamine and psychedelic therapies have gained significant attention in recent years for their ability to positively influence the brain’s baseline function without inducing unconsciousness. These therapies stimulate a neuroregenerative response, leading to enhanced connectivity, cognition, and mood regulation. There are even some who find benefit in the “experience†due to the loss of inhibition and suggestibility which occurs during psychedelic inebriation. The foremost experts have established best-practice protocols which outline the best administration route, modality, and environment for optimal results among all patient populations and demographics who suffer with a particular disease or diagnosis. However, due to the abundance of inaccurate knowledge available among the public and professional communities, there is a growing number of practitioners who are administering these substances without a comprehensive understanding of their side effects and health risks. This knowledge gap poses potential harm to the individuals they aim to treat and hampers the field’s progress.
Ketamine is a well-known and safe anesthetic adjunct used across various medical settings, including anesthesia for children aged six months and older. While ketamine itself is generally safe, it is not without its risks. During the COVID-19 pandemic, authorized providers became able to prescribe controlled substances via telehealth, which opened the door for companies to offer sublingual compounded forms of ketamine for at-home use. Thus, venture capitalists invested billions of dollars in advertising for web-based companies and providers who were prescribing opioid agonists, adderall, and other substances that had once required an in-person appointment. While venture capitalists saw a profitable opportunity, ethical ketamine therapy providers refrained from using this sublingual route due to its poor absorption and potential health risks, including the life-threatening complication of laryngospasm. Unfortunately, some patients have diverted from best-practice models and opted for self-administration of sublingual ketamine. I have seen this poor, ignorant decision result in fatal incidents such as laryngospasm-induced deaths associated with companies pushing take-home ketamine.
My outrage sparked by large investment firms endangering patients’ lives for profit turned into shock when it became evident that these providers had no knowledge of laryngospasm or the potential risks associated with sublingual ketamine. These practitioners adopted non-scientific ideas about the therapeutic benefits of ketamine and psychedelics in treating mood disorders, abandoning the scientific and reproducible approach in favor of a human experimentation model that often lacks factual basis. While their intent was to increase access to care and help struggling individuals, the result became increased risk for patients due to a lack of familiarity with established research and data on safe and effective ketamine administration.
When I openly confronted these providers and companies about their unethical practices, I learned their intent was to increase access to treatments for those who are struggling. While this softened my approach significantly, good intentions alone cannot protect those seeking help from unnecessary risks. Neglecting to invest a mere ten minutes in understanding potential risks can have severe consequences for patients. Continuing to prescribe at-home ketamine administration prioritizes profits over patient safety, sacrificing optimal outcomes for the sake of convenience. The belief that nothing bad can happen due to the absence of prior incidents perpetuates confirmation bias and stifles critical thinking regarding safer and more affordable administration methods. The tragedy involving the CEO of OceanGate Expeditions serves as a poignant reminder that ignorance, rather than greed, can lead to devastating outcomes.
In the end, the events surrounding the loss of lives during the ill-fated dive expedition and the misuse of ketamine in therapeutic settings underscore the importance of knowledge and understanding in ensuring safety and success. It is crucial for practitioners to continually educate themselves on the potential risks and best practices associated with ketamine and psychedelic therapies. By prioritizing accurate information, adhering to scientific approaches, and maintaining a deep sense of responsibility towards patients, we can foster a safer and more effective treatment environment, thus avoiding the perils of ignorance.
