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Jun 7, 2017

Megan Oxley, MD 

Michigan Progressive Health- A Ketamine Infusion Clinic

Megan Oxley, MD is a Board Certified Emergency Medicine physician. She graduated from Wayne State University in 2009.  Her career started in inner city Detroit, then took her to rural Maryland and she now works at Henry Ford Wyandotte Hospital.  Dr. Oxley enjoys the fast pace of the emergency room, getting to know new people, putting patients at ease during a stressful time in their life and enjoys having the ability to make people feel better immediately.  She is honored daily to be a part of helping people heal.

Megan founded Michigan Progressive Health in May 2016. Listen to this podcast as we follow the steps that one needs to take to open a small infusion clinic- with no business experience! We also learn why Megan opened the clinic and who benefits from ketamine infusions.

What you will learn:

  • What is Ketamine?
  • What are the indications for its use?
  • Who administers Ketamine therapeutically?
  • How does an ER doctor without outpatient experience start a clinic?
  • The process that Megan went through to build her business
  • Strategies Megan used to promote her business

Resources mentioned in the show:

Wix.com- Website building app

Learn more about Ketamine:

  1. Murrough, Perez, et al.  “Rapid and longer-term antidepressant effects of repeated ketamine infusions in treatment-resistant major depression”  Biological Psychiatry 2013 Aug 15; 74(4): 250–256.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725185/

SUMMARY:  In this article, there were 24 patients treated with six IV infusions of ketamine (.5mg/kg) over 12 days.  The overall response rate was 71% as defined as a reduction in the MADRS scale by  greater than 50%.  The median time to relapse after the last ketamine infusion was 18 days.  25% were symptom free at 90 days, 75% of patients had symptoms free days between 11-27 days.  Side effects were reported to be a mild significant increase in dissociative symptoms.  One patient had to discontinue therapy due to an increase in blood pressure that did not respond to medications (highest BP 180/115).

  1. Shiroma, Johns et al.  “Augmentation of response and remission to serial intravenous subanesthetic ketamine in treatment resistant depression” Journal of Affective Disorders. 2014 Feb;155:123-9.

http://www.jad-journal.com/article/S0165-0327%2813%2900778-7/abstract

SUMMARY:  In this article, there were 14 patients treated with six IV infusions during a 12 day period.  12 subjects finished all six infusions with 92% response rate and 66% went into remission.  5 out of 11 responders remained in “response status” during the next 28 days.  For the 6 out of 11 responders that relapsed, the mean time was 16 days.  Response was defined as ≥50% improvement in baseline MADRS score and remission was defined as MADRS score ≤9.  No subject experienced severe dissociative symptoms or hemodynamic changes that required stopping the infusions.

  1. Correll, Maleki et al.  “Subanesthetic ketamine infusion therapy: a retrospective analysis of a novel therapeutic approach to complex regional pain syndrome.”  Pain Medicine. 2004 Sep;5(3):263-75.

http://painmedicine.oxfordjournals.org/content/painmedicine/5/3/263.full.pdf

SUMMARY:  This article reviewed 33 cases of patients with CRPS that were treated with ketamine infusion.  The patients received a prolonged low dose infusion of ketamine, on average 10-20mg/hr over 2-4 days.  76% of patients experienced complete pain relief after the first course of treatment.  Pain relief lasted at least three months for most patients.  Adding a second course of treatment allowed over 50% to be pain free for over a year.  One patient had to discontinue additional treatments after the first infusion after developing elevated liver enzymes.  These did normalize after treatment was stopped.

  1. Feder, Parides et al.  “Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial.”  JAMA Psychiatry. 2014 Jun;71(6):681-8.

http://archpsyc.jamanetwork.com/article.aspx?articleid=1860851

SUMMARY:  In this double blind, placebo-controlled cross over study, a single dose of ketamine (.5mg/kg over 40 minutes) was compared to midazolam.  Authors note a significant immediate reduction in the CAPS score and frequently this reduction was maintained for over 2 weeks.  The only side effects noted were transient dissociative symptoms, none of which required stopping the infusion.