IV Ketamine Infusion

Intravenous (IV) ketamine infusion therapy has emerged as a treatment option for a variety of chronic pain conditions including fibromyalgia, small fiber neuropathy, complex regional pain syndrome (CRPS), reflex sympathetic dystrophy (RSD) and psychiatric conditions including depression, post-traumatic stress disorder (PTSD), suicidal ideation, and obsessive-compulsive disorder (OCD). Dr. Hanna is America’s top doctor offering IV Ketamine Infusion treatment, with over 7,000 treatments performed for pain and depression. Patients are reporting amazing, miraculous results with only a few treatments.

Great News! Dr. Hanna now is now accepting most insurance for his IV Ketamine Infusion Treatments!










History of Ketamine


Ketamine is not a new drug. It has been used for five decades in human and veterinarian medicine. Ketamine is an anesthetic drug that was introduced into clinical practice in 1970.1  At anesthetic doses it results in a complete loss of consciousness while preserving certain protective reflexes. That has made it attractive to anesthesiologists in selective patients. While it does stimulate opiate receptors, much like morphine, its NMDA receptor antagonism at subanesthetic doses is thought to be much more important in the treatment of chronic pain and psychiatric disorders. Blocking the NMDA receptor and preventing the passage of ions through the channel interrupts pain signal transduction, giving central pain centers a chance to “reboot”. This often requires that a patient undergo a series of low dose ketamine infusions for dramatic or complete elimination of their chronic pain. Ketamine infusions have been most often used when other treatment modalities have failed. Certain types of pain considered to be “neuropathic” in origin have been most studied and are considered to be most responsive to ketamine therapy.




The primary and most well known pharmacological action of ketamine is NMDA antagonism.  This is the main rationale for the use of ketamine infusions to treat chronic pain and psychiatric conditions that are not responsive to conventional therapeutic options.  Many studies have shown increased NMDA expression and activity in animal models of chronic pain.2-4  Further, subsequent studies have shown that NMDA antagonism is useful in these same models of chronic pain.5-8  The most studied of these NMDA antagonists is ketamine and is the subject of many current CRPS research endeavors.9-12 Ketamine exhibits extensive polypharmacology that has yet to be fully understood in the context of CRPS.13  This has led some to regard the drug as “a pharmacologist’s nightmare” because there is not one clear defining mechanism of action.13  However, we believe that the multiple pharmacological actions of ketamine may produce an “entourage effect” that is uniquely beneficial for the management of many treatment-resistant psychiatric conditions, CRPS and other pain conditions that are refractory to opiate therapy or in patients where opiate narcotics are contraindicated.


IV Ketamine Procedure


At the Florida Spine Institute, treatment protocols are individually planned depending on the nature of your pain and your responsiveness to initial sessions. Infusion cocktails are prepared in house so that they can be tailored to each patient’s therapeutic needs.  A variety of medications are often used:


  • Lidocaine
  • Ketamine
  • Magenesium


These medications are typically mixed with saline in an IV bag and infused slowly over several hours, depending on the medication and/or protocol being used.  Usually, a series of treatments will be recommended daily for a period of a week or more. The duration of pain relief following one or more ketamine infusions cannot be predicted. The goal is to achieve lasting relief as measured in weeks or months following the last treatment. Most patients who enjoy prolonged pain relief will need to return on occasion for a booster infusion, or continue to take low dose intranasal ketamine at home.


Ketamine infusion therapy is generally well tolerated and, as such, very few patients need to terminate treatment due of side effects. Still, ketamine is a derivative of phencyclidine (PCP) a known psychedelic and if not combined with sedation can cause hallucinations in many patients. You will be given a benzodiazepine to control this dysphoria. Other possible side effects include nausea and rarely a headache. These side effects can also be managed and often eliminated during the infusion therapy. Following the completion of a daily infusion regimen, patients are usually tired for several hours and need to be accompanied home by a responsible adult. We have yet to observe any long-term side effects that can be attributed to low dose intravenous ketamine therapy. Furthermore, ketamine is not highly addictive like more common FDA approved analgesics like opioids.


Published Clinical Evidence




Analgesic Response to Intravenous Ketamine Is Linked to a Circulating microRNA Signature in Female Patients With Complex Regional Pain Syndrome.


Complex regional pain syndrome: An optimistic perspective.


Rational pain management in complex regional pain syndrome 1 (CRPS 1)–a network meta-analysis.


Pain relief is associated with improvement in motor function in complex regional pain syndrome type 1: secondary analysis of a placebo-controlled study on the effects of ketamine.


Outpatient intravenous ketamine for the treatment of complex regional pain syndrome: a double-blind placebo controlled study.


For Depression


Single i.v. ketamine augmentation of newly initiated escitalopram for major depression: results from a randomized, placebo-controlled 4-week study.


Pharmacologic approaches to treatment resistant depression: Evidences and personal experience.


Ketamine and Other NMDA Antagonists: Early Clinical Trials and Possible Mechanisms in Depression.


R-ketamine: a rapid-onset and sustained antidepressant without psychotomimetic side effects.

Patient Testimonials

 Lizzy, Dr. Hanna’s patient had been diagnosed with CRPS / RSD in 2013 after a tetanus injection. Her symptoms were so severe, she couldn’t walk and could not perform everyday functions. Dr. Hanna began IV Ketamine treatments for Lizzy and within a few sessions, she was able to walk and is on her way to full remission..

After a car accident left Nancy Cotterman with a badly broken foot, she was diagnosed in 1998 with CRPS / RSD. Nancy was a pioneer in the IV Ketamine Infusion Treatment for CRPS / RSD pain. Nancy is now a patient of Dr. Ashraf Hanna and has had tremendous success with her treatments at the Florida Spine Institute in Clearwater, Florida.

An on-the-job injury in 2012 resulted in Laura Tramo’s right arm becoming unusable due to severe pain and muscle atrophy. She was diagnosed with CRPS / RSD and first tried heavy doses of pain medication. When the pain level did not decrease and the pain meds made her nauseous, she looked for a better treatment option. After meeting with Dr. Ashraf Hanna, she began IV Ketamine treatment with incredible results!

Gabriel was found in a coma after having an adverse reaction to his medication. The coma left him with severe complications, resulting in a stroke. He was then diagnosed with CRPS / RSD and depression. He is now being treated by Dr. Ashraf Hanna with IV Ketamine Infusions and has had incredible results at Florida Spine Institute in Clearwater, Florida.


Karen Schoenberg discusses her CRPS / RSD pain management treatment and overall experience with Dr. Hanna of Florida Spine Institute. Karen was diagnosed with CRPS / RSD and had serious, chronic pain for 4.5 years and could not get any relief. Dr. Hanna suggested IV Ketamine Infusion therapy, and after treatment, Karen’s pain took a dramatic turn and is now on the way to full remission.

Sherry Johnson, Dr. Ashraf Hanna’s patient, suffered from severe CRPS/RSD for years. The pain was so intense, she was bedridden. After beginning IV Ketamine Infusion Therapy at the Florida Spine Institute with Dr. Hanna, her pain is reduced and she now has her quality of life back.

Natalia, Dr. Hanna’s patient, had been diagnosed with CRPS / RSD after an injury to her wrist. Her symptoms included chronic pain and multiple flare-ups in other parts of her body. Natalia began IV Ketamine treatments with Dr. Hanna and after a few sessions, the pain was completely removed.

Jacinta, Dr. Ashraf Hanna’s patient, suffered from severe CRPS / RSD pain for years. After trying multiple treatments involving high dose medications and a spinal cord stimulator she has found pain relief with IV Ketamine treatment at the Florida Spine Institute.