Pacific Ketamine Institute


A form of holistic and alternative medicine in which fine needles are inserted into the body at specific points to relieve pain, induce anesthesia, or treat disease. It is based on the concept in traditional Chinese medicine that “meridians,” or pathways, conduct chi, the life force energy, between places on the skin and the body’s organ systems. The technique has been recognized in Western societies and deemed appropriate by the World Health Organization for use in treating more than 40 medical conditions.



An excessive psychological state or physical dependence (or both) on a particular thing. A person could be addicted to drugs, money, work, gambling, eating, nicotine, pornography, computer, video games, etc. The term is often used as an equivalent term for substance dependence and sometimes applied to behavioral disorders, such as sexual, internet, and gambling addictions.


The loss of sensitivity to stimuli, either in a particular area (local) or throughout the body and accompanied by loss of consciousness (general). It may be produced intentionally, for example via the administration of drugs (called anaesthetics).


Any drug administered in the treatment of depression. Most antidepressants work by increasing the availability of monoamine neurotransmitters such as norepinephrine, serotonin, or dopamine, although they do so by different routes.

Anxiety Disorder

It is an umbrella term used to cover the different types of anxieties and fears that were included in psychiatry at the end of the 19th century. Their central theme is the emotional state of fear, worry, or excessive apprehension. This category includes panic disorder, various phobias, and generalized anxiety disorder. Anxiety disorders have a chronic course however waxing and waning in intensity. They may also occur as a result of the physiological effects of a medical condition such as endocrine disorders (e.g., hyperthyroidism), respiratory disorders (e.g., chronic obstructive pulmonary disease), cardiovascular disorders (e.g., arrhythmia), metabolic disorders (e.g., vitamin B12 deficiency), and neurological disorders (e.g., Parkinson’s disease).

Attention deficit hyperactivity disorder (ADHD)

A psychiatric disorder commonly diagnosed in children and is characterized by hyperactivity and attention problems. Behavioural syndromes are characterized by the persistent presence of six or more symptoms involving (a) inattention (e.g., failure to complete tasks or listen carefully, difficulty in concentrating, distractibility) or (b) impulsivity or hyperactivity (e.g., blurting out answers; impatience; restlessness; fidgeting; difficulty in organizing work, taking turns, or staying seated; excessive talking; running about; climbing on things). These symptoms impair social, academic, and/or occupational functioning and appear before the age of 7. Alternatively, ADHD is also still commonly known as attention-deficit disorder (ADD).


A subjective sensation that precedes an epileptic seizure or migraine headache. It may include phenomena of strange tastes or odors, flashes of light (a visual aura), numbness, feelings of unreality, or states of déjà vu.


A family of drugs that depress central nervous system activity (CNS depressants) and also produce sedation and relaxation of skeletal muscles. They are commonly used in the treatment of generalized anxiety, panic disorder, and insomnia and are useful in the management of acute withdrawal from alcohol and seizure disorders. Patients are observed to have considerable variation in abuse potential wherein prolonged use can lead to tolerance and psychological and physical dependence.

Bipolar 1

A subtype of Bipolar disorder, a mood disorder, wherein the individual fluctuates between episodes of mania or hypomania (highs) and major depressive episodes (lows) or experiences a mix of these. Bipolar I disorder requires symptoms to meet the full criteria for a manic episode. You do not have to experience depression to be diagnosed with Bipolar I, but many people with the diagnosis experience both kinds of mood episodes.

Bipolar 2

To qualify for a diagnosis of Bipolar II Disorder, a person has to have experienced a depressive episode and a less severe form of mania known as hypomania. A person experiencing mania will exhibit manic symptoms but is able to continue with day-to-day responsibilities and may even see an increase in job performance or other goal-directed activity. The elevated mood, however, is not so severe that the person requires hospitalization or experiences significant disruption at home or work.


A nonbenzodiazepine anxiolytic of the azapirone class that acts as a partial serotonin agonist at 5-HT1A receptors. Both it and its primary metabolic product, 6-hydroxybuspirone, produce some relief of subjective symptoms of anxiety without the sedation, behavioral disinhibition, and risk of dependence associated with the benzodiazepines. However, due to its relative lack of efficacy compared with benzodiazepines

Central nervous system (CNS)

This the entire complex of neurons, axons, and supporting tissue that constitute the brain and spinal cord. The CNS is primarily involved in mental activities and in coordinating and integrating incoming sensory messages and outgoing motor messages.


Chronic Migraine

A type of migraine characterized by 15 or more headache days per month.

Chronic Pain

Variations of pain that continues to occur despite all medical and pharmacological efforts at treatment. In many cases, the pain is initially caused by tissue damage or disease. The continuation of the pain is often the result of pathological changes in the central nervous system.

Cognitive behavioral therapy (CBT)

A type of psychotherapy that integrates theories of cognition and learning with treatment techniques from cognitive therapy and behavior therapy. It assumes that cognitive, emotional, and behavioral variables are functionally interrelated. CBT is aimed at identifying and modifying a person’s maladaptive thought processes and problematic behaviors through cognitive restructuring and behavioral techniques to achieve change.

Cognitive processing therapy (CPT)

A subtype of cognitive-behavioural therapy originally used with victims of rape or sexual trauma and later applied to those with posttraumatic stress disorder. It emphasize cognitive strategies to help people alter erroneous thinking caused by the traumatic event.


The simultaneous presence in an individual of more than one illness, disease, or disorder.

Complex regional pain syndrome (CRPS)

A chronic pain condition that most often affects one limb (arm, leg, hand, or foot) usually after an injury consistently for six months or greater. CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems.


The outer or superficial layer/s of a structure, as distinguished from the central core. In mammals, the cortex of a structure is identified with the name of the gland or organ, for example, the cerebellar cortex, or cerebral cortex. (Plural, cortices).


Any variety of small proteins or peptides that are released by cells as signals to those or other cells. Each type stimulates a target cell that has a specific receptor for that cytokine. Cytokines mediate many immune responses, including proliferation and differentiation of lymphocytes, inflammation, allergies, and fever.


A negative affective state characterized by low self-esteem, low mood, and lack of interest in the activities to be performed in daily life. These may range from unhappiness and discontent to an extreme feeling of sadness, pessimism, and despondency, that interferes with daily life. It is symptomatic of a number of mental health disorders.


A defense mechanism in which conflicting impulses are kept apart or threatening ideas and feelings are separated from the rest of the psyche.

Dissociative Anaesthetic

An agent capable of producing amnesia, analgesia, and sedation without the loss of consciousness. PCP and ketamine were formerly used as dissociative anesthetics.

Electroconvulsive therapy (ECT)

A controversial treatment wherein a seizure is induced by passing a controlled, low-dose electric current through one or both temples. The patient is prepared with an anesthetic and injection of a muscle relaxant. An electric current is then applied for a fraction of a second which immediately produces a two-stage seizure (tonic and clonic). ECT may be bilateral or unilateral (usually of the right hemisphere). It is most often used to treat patients with severe endogenous depression who fail to respond to antidepressant drugs.

Emotional dysregulation

Any excessive or otherwise poorly managed mechanism or response. For emotional dysregulation, an extreme or inappropriate emotional response to a situation (e.g., temper outbursts, deliberate self-harm). This may be associated with mood disorders, autism spectrum disorder, psychological trauma, or brain injury.

Episodic migraine (EM)

Characterized by having a migraine 0 to 14 headache days per month.


A medication sold under the brand names Ketanest and Spravato, among others, that is used as a general anesthetic and for treatment-resistant depression. Esketamine is used as a nasal spray or by injection into a vein.

Familial hemiplegic migraine (FHM)

An inherited form of hemiplegic migraine which is a type of migraine with aura that causes motor impairment (such as weakness) in addition to at least one visual, sensory, or speech disturbance (aura) that occurs before the migraine headache begins. FHM commonly begins during childhood or adolescence and has four subtypes based on where the gene mutation occurs.


A syndrome of uncertain origin that is characterized by widespread musculoskeletal pain and chronic fatigue. Pain may be triggered by pressure on numerous points on the body. Common symptoms are muscle stiffness, headaches, sleep disturbance, and depression. Symptoms also overlap with those of chronic fatigue syndrome, and fibromyalgia is often comorbid with other disorders, such as irritable bowel syndrome and migraine.

Fight-or-flight Response

A pattern of physiological changes elicited by the activity of the sympathetic nervous system in response to threatening or stressful situations that leads to mobilization of energy for physical activity (e.g., attacking or avoiding the offending stimulus), either directly or by inhibiting physiological activity that does not contribute to energy mobilization.

Generalized anxiety disorder (GAD)

A disorder which is characterized by uncontrollable, irrational, and excessive worry with respect to daily life activities. The magnitude of worry experienced by an individual with this disorder is excessive if compared with the actual cause or problem. Common symptoms are restlessness, fatigue, impaired concentration, irritability, muscle tension, and disturbed sleep. For a formal diagnosis of GAD, the worry is often experienced as difficult to control, and the various symptoms that accompany the anxiety occur on more days than not for a period of 6 months or more.


An ester of the amino acid glutamic acid that serves as the predominant excitatory neurotransmitter in the brain. Glutamate has a critical role in cognitive, motor, and sensory functions. Its effects are observed by binding to glutamate receptors on neurons. Excessive activity of glutamate at these receptors is associated with damage to nerve tissue (neurotoxicity) and cell death.

Holistic treatments

A form of therapy based on the premise that body, mind, and spirit function as a harmonious unit and that an adverse effect on one also adversely affects the others, requiring treatment of the whole to restore the harmonious balance. For example, yoga classes, gym workout, and journaling.


The term is derived from the Greek word husteros, “uterus,” based on the early and erroneous belief that such disorders were unique to women and originated in uterine disorders. This condition is now largely classified as conversion disorder but with symptoms dispersed across other formal diagnoses as well. While technically outdated, it is often used as a lay term for any psychogenic disorder characterized by symptoms such as paralysis, blindness, loss of sensation, and hallucinations and often accompanied by suggestibility, emotional outbursts, and histrionic behavior.


Difficulty in initiating or maintaining a restorative sleep, which results in fatigue, the severity or persistence causing clinically significant distress or impairment in functioning. Such sleeplessness may be caused by transient or chronic physical condition or psychological disturbance. Other terms include agrypnia, ahypnia, ahypnosia, anhypnia.

Interpersonal psychotherapy (IPT)

A time-limited form of psychotherapy imposing that relations with others constitute the primary force motivating human behavior. Its central feature is the clarification of the person’s interpersonal interactions with others, including the therapist. The therapist helps them to explore current and past experiences in detail, relating not only to interpersonal reaction but also to general environmental influences on personal adaptive and maladaptive thinking and behavior.

Irritable bowel syndrome (IBS)

A common functional disorder of the intestines characterized by abdominal pain or discomfort (e.g., bloating) and changes in bowel habits, with some experiencing increased diarrhea, constipation, or alternating between the two. There is yet no known cause (psychological or physiological), though stress and emotional variable are recognized as key factors. Also called mucous coliti or spastic colitis.

IV Infusion/Injection

IV stands for intravenous and constitutes the injection of a substance into a vein with a hypodermic syringe. This technique is used when rapid absorption of a drug is needed, when the substance would be irritating to the skin or to muscle tissue, or when it cannot be administered through the digestive tract. Slow intravenous injection, called intravenous (IV) infusion, is used for blood transfusions, parenteral administration of nutrients (i.e., directly into the bloodstream, bypassing the digestive tract), or continuous administration of drugs.


A drug that is closely related to PCP (phencyclidine) that acts as an antagonist at NMDA receptors and formerly used as a dissociative anesthetic. It is ingested in the form of tablets, capsules, or powder by drug users for its hallucinogenic effects. Low-dose intravenous infusions have been reported to improve symptoms in patients with treatment-resistant unipolar and bipolar depression.

Ketamine Infusion Therapy

A form of treatment where the ketamine is administered intravenously to patients and typically last for 45-60 minutes. Usually recommended for mood disorders like depression, PTSD, bipolar disorder and other mood disorders but also chronic pain management although it will require a larger dose and are provided over a longer interval often lasting between 3-4 hours.

The experience is reported mostly to be a pleasurable one. Most patients feel a sense of warmth and comfort and the treatment does not induce loss of consciousness. The effects are felt immediately, unlike many of the SSRI drugs that take weeks or months to see an effect. During the treatment, pulse, oxygen levels, and blood pressure will be constantly monitored.

A common but self-limited side effect of Ketamine is nausea which is usually treated upfront and controlled by adding Zofran to the treatment.  Zofran is an anti-nausea medicine that is used in hospitals and ERs throughout the world. Patients usually regain full faculties within minutes. Some patients feel tired after their infusion while others may feel fine and ready to walk.

Major depressive disorder (MDD)

A mood disorder characterized by persistent sadness and other symptoms of a major depressive episode but without accompanying episodes of mania or hypomania or mixed episodes of depressive and manic or hypomanic symptoms.


A state of excitement, overactivity, and psychomotor agitation, often accompanied by over-optimism, grandiosity, or impaired judgment.


A state of enhanced mood and increased energy and activity that resembles mania but milder.


A recurrent headache that is severe and usually limited to one side of the head, and likely to be accompanied by nausea, vomiting, and photophobia. These may be preceded by an aura of flickering or flashing light, blacking out of part of the visual field, or illusions of colors or patterns. They are much more common in women than in men.

Monoamine Oxidase Inhibitors

A group of antidepressant drugs that function by inhibiting the activity of the enzyme monoamine oxidase in presynaptic neurons, thereby increasing the amounts of monoamine neurotransmitters (serotonin, norepinephrine, and dopamine) available for release at the presynaptic terminal.

Mood Disorder

A psychiatric condition in which the principal feature is a prolonged, pervasive emotional disturbance, such as a depressive disorder, bipolar disorder, or substance-induced mood disorder. In DSM–5, mood disorders are divided into two categories: bipolar and related disorders, which include its subtypes (e.g., bipolar I, bipolar II, cyclothymic disorder); and depressive disorders (e.g., major depressive disorder, persistent depressive disorder or dysthymic disorder, premenstrual dysphoric disorder). Also known as affective disorder.


A secure, reliable, easy-to-use reporting and monitoring tool that helps ensure the best possible outcomes for IV ketamine treatment patients.


The production of new neurons during early nervous system development and throughout the lifespan.

Neuropathic Pain

Pain caused by damage to peripheral nerves.


A large number of chemicals that can be released by neurons to mediate transmission of nerve signals across the junctions (synapses) between neurons. When triggered by a nerve impulse, the neurotransmitter is released from the terminal button (axon), travels across the synaptic cleft, and binds to and reacts with receptor molecules in the postsynaptic membrane. Neurotransmitters include amines (e.g., norepinephrine, serotonin) and amino acids (e.g., glutamate, glycine). Some neurotransmitters can be categorized as generally excitatory (e.g., glutamate, glysine) or generally inhibitory (e.g. gamma-aminobutyric acid).

N-Methyl-D-Aspartate (NMDA) Receptor

A type of glutamate receptor that binds NMDA as well as glutamate. They participate in a variety of information-processing operations at synapses where glutamate is the neurotransmitter. The drugs of abuse ketamine and PCP are antagonists at NMDA receptors, preventing the influx of calcium ions at calcium channels, which may cause the hallucinogenic effects of these drugs.

Obsessive-Compulsive Disorder (OCD)

A disorder characterized by recurrent intrusive thoughts (obsessions) that prompt the performance of neutralizing rituals (compulsions). Typical obsessions involve themes of contamination, dirt, or illness and doubts about the performance of certain actions (e.g., an excessive preoccupation that one has neglected to turn off a home appliance). Common compulsive behaviors include repetitive cleaning or washing, checking, and hoarding. The obsessions and compulsions—which are recognized by affected individuals as excessive or unreasonable, cause significant distress, and interfere with daily functioning.


A group of compounds that include naturally occurring opiates (e.g., morphine) and their semisynthetic derivatives (e.g., heroin). Their effects include analgesia, drowsiness, euphoria or other mood changes, respiratory depression, and reduced gastrointestinal motility. Opioids are clinically used as pain relievers, anesthetics, cough suppressants, and antidiarrheal drugs, however, many are subject to abuse and dependence.

Pain Management

The prevention, reduction, or elimination of physical or mental suffering or discomfort, which may be achieved by pharmacotherapy (e.g., administration of opioids or other analgesics), psychological interventions, neurological and anesthesiologic methods (e.g., nerve blocks, self-administered pumps), complementary or alternative methods (e.g., acupuncture, acupressure), or a combination of these.

Panic disorder (PD)

A type of anxiety disorder characterized by recurrent, unexpected panic attacks that are associated with (a) persistent concern about having another attack, (b) worry about the possible consequences of the attacks, (c) significant change in behavior related to the attacks (e.g., avoiding situations, engaging in safety behavior, not going out alone), or (d) a combination of any or all of these.

Phencyclidine (PCP)

A hallucinogenic drug sometimes referred to as a “psychedelic anesthetic” because it was originally developed as an amnestic analgesic for use in surgical situations and was later discovered to produce psychedelic or dissociative reactions. Its medical use was discontinued due to adverse reactions, including agitation, delirium, disorientation, and hallucinations. High doses may induce stupor or coma.


A persistent and irrational fear of a specific situation, object, or activity which is consequently either strenuously avoided or endured with marked distress.


A pharmacologically inert substance (e.g., sugar pill) that is often administered as a control in testing new drugs. Formerly, placebos were occasionally used as diagnostic or psychotherapeutic agents, for instance, in relieving pain or inducing sleep by suggestion, but the ethical implications of deceiving patients make this practice debatable.

Positron emission tomography (PET) scans

An imaging technique using radiolabeled tracers that emit positively charged particles (positrons) as they are metabolized. It is used to evaluate cerebral metabolism and blood flow as well as the binding and transport of neurotransmitter systems in the brain. It also enables documentation of functional changes that occur during the performance of mental activities and detect damage or disease (e.g., cancer) in other organs of the body.

Postpartum depression

A controversial disorder involving the manifestation of major depressive episodes or, less commonly, minor depressive disorder that affects some women within 4 weeks to 6 months after childbirth.

Posttraumatic Stress Disorder (PTSD)

A disorder resulting from when someonelives through or witnesses an event in which they believed is a threat to life, physical integrity, and safety and experiences fear, terror, or helplessness. Symptoms are characterized by (a) reexperiencing the trauma in painful recollections, flashbacks, or recurrent dreams or nightmares; (b) avoidance of activities or places that recall the traumatic event, disinterest in significant activities and with feelings of detachment and estrangement from others; and (c) chronic physiological arousal, leading to exaggerated startle response, disturbed sleep, difficulty in concentrating or remembering, and survivor guilt. A separate criteria have been developed for children age 6 years or younger.

Problem-Solving Therapy

An evidence-based cognitive behavior intervention to improve one’s ability to cope with stressful experiences by enhancing his or her problem-solving skills. The therapy aims to augment the following skills: (a) problem orientation (how one approaches and recognizes problems); (b) problem definition in concrete terms; (c) generation of possible solutions; (d) decision making (evaluating the consequences of alternative solutions and selecting the most optimal); and (e) solution implementation and evaluation of the outcome. PST has been reportedly effective in the treatment of various psychological and behavioral problems such as depression, anxiety, and conduct disorder, and of distress associated with chronic medical conditions, such as coronary heart disease, cancer, and HIV/AIDs.


A popular brand of fluoxetine which is an antidepressant prototype of the SSRIs (selective serotonin reuptake inhibitors). It inhibits the serotonin transporter, preventing reuptake of serotonin into the terminal button (axon) of the presynaptic neuron. This presumably results in higher levels of available neurotransmitter to interact with postsynaptic receptors. Fluoxetine differs from other SSRIs in that it and its biologically active metabolic product, norfluoxetine, have a prolonged half-life of 5 to 7 days after a single dose; thus, it takes 20 to 35 days for the drug to reach steady-state concentrations. Like other SSRIs, it should not be used with monoamine oxidase inhibitors.


Any psychological treatment by a trained professional that primarily uses forms of communication and interaction to assess, diagnose, and treat dysfunctional emotional reactions, ways of thinking, and behavior patterns. This may be provided to individuals, couples, families, or members of a group. There are many types of psychotherapy but generally fall into four major categories: psychodynamic psychotherapy, cognitive therapy or behavior therapy, humanistic therapy, and integrative psychotherapy. Also called talk therapy.

Rheumatoid Arthritis (RA)

The inflammation of a joint or joints, causing pain, swelling, and stiffness. The potentially severe and disabling form is rheumatoid arthritis, an autoimmune disorder that can be chronic, painful, recurrent, and debilitating. Psychosocial effects can include lifestyle changes, stress on personal relationships, and depression.

Reflex sympathetic dystrophy (RSD)

Overactivity of the sympathetic nervous system, which may occur following local injury, usually to a limb, that is associated with damage to nerves and blood vessels. Associated results are pain, limb disuse, shiny and thin skin, loss of hair, and bone demineralization.


The recurrence of a disorder or disease after a period of improvement or apparent cure. The term is also applicable to the recurrence of substance abuse after a period of abstinence.


A reduction or significant abatement in symptoms of a disease or disorder, or the period during which this occurs. Remission of symptoms does not necessarily indicate that a disease or disorder is cured.

Seasonal Affective Disorder (SAD)

A type of mood disorder where there is a predictable occurrence of major depressive episodes, manic episodes, or both at particular times of the year. The usual pattern is the occurrence of major depressive episodes during the fall or winter months. Also called seasonal mood disorder.

Selective serotonin reuptake inhibitors (SSRI)

Any of a class of antidepressants that are thought to act by blocking the reuptake of serotonin into serotonin-containing presynaptic neurons in the central nervous system. SSRIs have demonstrated efficacy in the treatment of not only depression but also panic disorder, obsessive-compulsive disorder, eating disorders, and premenstrual dysphoric disorder. Common side effects include nausea, headache, anxiety, tremor, and some may experience sexual dysfunction. SSRIs include fluoxetine, paroxetine, sertraline, citalopram, and fluvoxamine. Also known as SRI (serotonin reuptake inhibitor).

Separation Anxiety Disorder

A form of anxiety disorder occurring typically in childhood or adolescence that is characterized by inappropriate, persistent, and excessive anxiety about separation from home or major attachment figures. This may include marked anticipatory anxiety over upcoming separation and persistent and excessive worry about harm coming to attachment figures or about major events that might lead to separation from them (e.g., getting lost). There may be school refusal, fear of being alone or going to sleep without major attachment figures present, separation-related nightmares, and repeated complaints of physical symptoms (e.g., vomiting, nausea, headaches, stomachaches) associated with anticipated separation. These symptoms cause clinically significant distress or impairment in functioning and the disorder having also been recognized existing in adults in which symptoms must be present for at least 6 months.

Serotonin and Norepinephrine Reuptake Inhibitor (SNRI)

Any of a class of antidepressants that exert their therapeutic effects by interfering with the reabsorption of both serotonin and norepinephrine by the neurons that released them. They include venlafaxine and duloxetine.

Social Anxiety Disorder

A type of anxiety disorder characterized by extreme and persistent social anxiety or performance anxiety which causes significant distress or prevents participation in social activities. The feared situation is most often avoided altogether or else it is endured with marked discomfort or dread. Also called social phobia.

Suicidal ideation

Thoughts about or preoccupation with killing oneself, often as a symptom of a major depressive episode. Most instances of suicidal ideation do not progress to an actual attempted suicide.


The specialized junction through which neural signals are transmitted from one neuron (the presynaptic neuron) to another (the postsynaptic neuron).

Transcranial Magnetic Stimulation (TMS)

Localized electrical stimulation of the brain caused by changes in the magnetic field in coils of wire placed around the head. Depending on the parameters, TMS may elicit a response or disrupt functioning in the region for a brief time. The technique was originally devised and is primarily used as an investigatory tool to assess the effects of electrical stimulation of the motor cortex. It is approved for the treatment of depression and is being investigated as a possible therapy for other psychological conditions (e.g., OCD) and some types of movement disorders (e.g., Tourette’s Syndrome)


Any experience that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings intense enough to have a long-lasting negative effect on a person’s attitudes, behavior, and other aspects of functioning. These include those caused by human behavior (e.g., rape, war, industrial accidents) as well as by nature (e.g., earthquakes) and often challenge one’s view of the world as a just, safe, and predictable place.


A popular trade name for a serotonin antagonist at the 5-HT3 serotonin receptor that is used for the prevention and treatment of nausea resulting from chemotherapy or anaesthesia.

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