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Ormond Beach Observer Monday, Apr. 22, 2019 1 year ago

Ormond Beach resident leading ketamine infusion treatment in Port Orange

Founders Bill Self and Dr. Carlos Montalvo are hoping to treat depression with a new form of medicine.
by: Jarleene Almenas Associate Editor

Ormond Beach resident Bill Self has dealt ketamine virtually all of his professional life. 

As a nurse anesthetist who worked in local hospitals, the drug was commonly used in the anesthesia he administered to patients. However, it wasn't until he started teaching at the University of North Florida that he started studying all of its potentials. 

Then, when his son came home from college during the 2016 Christmas break suffering from depression, Self was further pushed into his research on ketamine. 

“That’s when the drive really started, for me, for what else is out there that we could do to look out for treatment for our kid," Self said.

A year later, Self, a Mainland High School alumnus, and Dr. Carlos Montalvo jointly founded a ketamine infusion center, and started seeing patients in 2018. Self holds a doctorate in nursing, and his Port Orange based clinic, "Life is Ketaful," is one of less than 10 in the state. Self reports a 70% success rate in his patients, which include his own son who now owns his own business in Ormond Beach, Self's Vapor and Taproom.

Recently, Self met a woman who initially suffered from post-partum depression. Self met her after she had been taking antidepressants for a decade. He said that after her infusion treatment, she told him she was back to feeling well, even attending her children's sporting events. 

Another woman he treated suffered from depression and an average of 15 migraines a month. Following her infusion treatment, Self said she told him her migraines have lessened to one or two a month and are easily treated with Ibuprofen or caffeine.

“When we get those kinds of successes, it makes this really kind of worthwhile,” Self said.

What is ketamine?

Ketamine is classified as a dissociative hypnotic, Self said. That means it works on NMDA receptors and antagonizes glutamate, a neurotransmitter in the brain. Ketamine interrupts the connection between glutamate and the NMDA receptors, which is meant to allow neurons to stop the current "loop" of communication in the brain of someone suffering from depression.

It's typically used in people with treatment resistant depression, Self said, or when someone has taken two or more classes of antidepressants without a successful response. 

If someone is interested in ketamine infusions, first he or she would have to see a primary care physician or mental health provider to obtain a medical history. Self needs to see this to evaluate patients.

Should patients want to go forward with the infusions, they would receive a sequence of six over two weeks. The dosage is controlled, and is calculated based on weight. Each infusion takes 45 minutes to complete. 

“It can definitely make you feel strange or funny, but not scared," Self said. "It’s not a scary thing. A lot of people like being in that place. It’s comfortable.”

How much?

There are a few misconceptions regarding Ketamine, Self said. Some people are concerned about the fact it is also used in veterinary care, and has been used as an illicit drug. 

While this is true, Self explained, ketamine infusion is different. It's being administered in a controlled environment, and isn't meant to sedate you. 

Currently, it is considered off-label by the Food and Drug Administration, which doesn't allow for insurance companies to cover the cost. A two-week treatment of ketamine infusions at Life is Ketaful costs $2,500. 

One day, Self hopes insurance companies will re-evaluate their coverage, as depression affects many people. He's seen it firsthand with his son, and seeing the success rate in his other patients has also been rewarding.

“We are trying to move the needle on the thought and the discussion on mental health," Self said.

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