Yes, you would almost certainly need to be in a hospital. There are different ways to treat with ketamine, but the infusion treatments that I was going to get for the study were such that the patients often would hallucinate during for hours after the infusion. Obviously, that would not be safe outside of a controlled setting. Not everyone has that as a side effect, but it happens often enough & is quite severe when it does happen (though I'm told they are almost always very pleasant hallucinations) so that the person is not in touch with reality enough to be left unsupervised. There are also some medical reasons why they may need to discontinue the treatment, so you would need to be in the hospital for that.
There are 3 and 5 day treatments. For the study, it was a 5 day treatment & I needed to commit to an in-patient hospital stay of 14 days. I was told part of that was for the study, but it was also for safety reasons. Some people do get short term memory loss. From what I've heard & the few people I've talked with who went through it, the memory loss usually resolves after a couple weeks, with the exception that some people do not remember the time they were in the hospital (not the worst side effect, right? i mean, who really wants to remember a hospital stay. :)
The good news about it is that you would know within a week whether or not it is working. None of these crazy 6-8 week waiting periods like what you get on the a/d meds. That's why a lot of psych's like it for depression -- in theory, they could give it to people who are committed & by the time they're released they could be feeling happier -- and I do mean happier, it's not like a/d's where you just feel like a numb zombie if it works.
Anyways, I didn't get the ketamine for depression, just for pain & I assumed that treating my pain was helping with the depression, but maybe that was the ketamine. I'm on Actiq now since the ketamine wasn't covered by my new insurance, and the Actiq doesn't seem to have the same effect on depression as the ketamine did so perhaps it really was the med -- not that I'm complaining about the Actiq, it's 100% better than anything else.
I do so hope they can find something that can work for you. I know it's pretty scary to make the decision to go ahead with the ketamine infusion. I was terrified when they explained all the side effects to me & I had actually gotten some ketamine treatments in the past. But just take it all in & try to approach it logically. Is it worth losing a couple weeks of your life in order to have a long term remedy for your pain & depression? It's not a permanent cure, but it could last for many months at a minimum & it does have the possibility of lasting for years b/c sometimes it can kick the pain entirely out of your system, kinda like a re-start button & it can take quite some time for that pain to build back up.
The best part, from my experience & what I've been told, is pain usually generates from one place, but once it has spread there's no way to tell the origination point. By getting rid of all the pain, they might be able to tell where exactly your pain is coming from (e.g., which nerve, tissue or organ & an exact point on that body part).
idk. It's an unenviable decision you have to make, but I just wanted to offer you a bit of hope that there may be some real good that could come of it. It is an non-traditional treatment, so of course, check everything with your doc, but if it works even half as well as the NIH doctors told me their initial studies showed it would then perhaps this will finally be the magic cure to break the depression and pain cycles & to get you on a better path.