The Neurogenesis Project
Ketamine Therapy for
Neurological Conditions
Sub-anesthetic ketamine, administered as part of a precision neurological protocol, to restore synaptic plasticity and treat conditions that have not responded to standard care.
Dr. Sean Orr uses ketamine not as a standalone therapy but as one component in a sequenced neuroregenerative program designed around your specific brain physiology.
What Ketamine Does in the Brain
NMDA receptor antagonism, BDNF release, and rapid synaptogenesis
Ketamine works through a mechanism entirely different from conventional antidepressants. At sub-anesthetic doses (typically 0.5 mg/kg infused over 40 minutes), it blocks NMDA receptors on GABAergic interneurons, which disinhibits glutamate signaling in the prefrontal cortex and hippocampus. The resulting glutamate surge activates AMPA receptors and triggers a downstream cascade that includes release of brain-derived neurotrophic factor (BDNF) and activation of the mTOR pathway.
The practical result: new dendritic spines begin forming within hours. A 2010 study by Li et al. in Science showed that a single sub-anesthetic ketamine dose reversed the synaptic deficits caused by chronic stress in rats within 24 hours. In humans, Zarate et al. (2006) published in the American Journal of Psychiatry that 71% of treatment-resistant depression patients showed response within 24 hours of a single IV ketamine infusion, compared to 0% on placebo.
This speed matters clinically. SSRIs require four to eight weeks to produce effect because they work through slow serotonergic adaptation. Ketamine produces measurable changes in neural connectivity within two hours because it acts directly on glutamate, the brain's primary excitatory neurotransmitter, and triggers structural synaptic remodeling rather than just shifting neurotransmitter levels.
Conditions Treated with Ketamine
Neurological and neuropsychiatric applications supported by clinical evidence
Treatment-Resistant Depression
Defined as failure to respond to two or more adequate antidepressant trials. The STAR*D trial showed that after two failed medication attempts, the remission rate for each subsequent drug drops below 15%. Ketamine offers a mechanistically distinct alternative with response rates between 60% and 70% in published trials.
Post-Traumatic Stress Disorder
Feder et al. (2014) in JAMA Psychiatry demonstrated that a single ketamine infusion produced rapid and measurable reduction in PTSD symptoms compared to midazolam control. Ketamine may accelerate fear extinction by promoting neuroplasticity in the amygdala-prefrontal circuit during a window when traumatic memory consolidation can be disrupted.
Chronic Neuropathic Pain
NMDA receptor activation is central to wind-up and central sensitization in chronic pain states. Sub-anesthetic ketamine interrupts this cycle. The American Society of Regional Anesthesia published consensus guidelines in 2018 supporting ketamine infusions for CRPS, fibromyalgia, and neuropathic pain refractory to conventional analgesics.
Acute Suicidal Ideation
Wilkinson et al. (2018) meta-analysis in the American Journal of Psychiatry found that ketamine reduced suicidal ideation within 4 hours of infusion, an effect that persisted for up to 72 hours. No other pharmacological intervention produces anti-suicidal effects at that speed.
Obsessive-Compulsive Disorder
Rodriguez et al. (2013) published in Neuropsychopharmacology that a single ketamine infusion produced rapid and sustained anti-obsessional effects in patients with OCD who had not responded to serotonin reuptake inhibitors. The glutamatergic mechanism offers a pathway outside the serotonin system entirely.
Cognitive Decline and Brain Fog
By restoring synaptic density and BDNF expression, ketamine may improve processing speed and executive function in patients experiencing early cognitive decline. Dr. Orr evaluates candidacy through neurocognitive testing and neuroimaging before and after treatment to measure structural and functional change.
How We Use Ketamine Differently
A sequenced protocol, not a standalone infusion
Most ketamine clinics administer six infusions over two to three weeks and send you home. That model treats ketamine as the entire intervention. Dr. Orr treats it as one mechanism within a broader neurological program.
The logic is straightforward. Ketamine opens a window of heightened synaptic plasticity that lasts roughly 24 to 72 hours after each infusion. During that window, the brain is unusually receptive to other interventions that support, protect, and consolidate the new synaptic connections being formed. If you close that window without additional support, many of those connections degrade.
Neurological Workup
Before the first infusion
Neurocognitive testing, metabolic panels, inflammatory markers, and neuroimaging establish your baseline brain function. Dr. Orr identifies which neural circuits are compromised and whether ketamine is the right tool for your specific pathology.
Sequenced Treatment
During the plasticity window
Ketamine infusions are timed alongside NAD+ IV therapy, targeted amino acid supplementation, and when indicated, neurostimulation. Each intervention is sequenced to capitalize on the plasticity window that ketamine creates rather than administered on an arbitrary schedule.
Measured Outcomes
Post-treatment and follow-up
Repeat neurocognitive testing and imaging quantify what changed. We do not rely on subjective self-report alone. If maintenance infusions are warranted, the frequency is determined by objective data, not a fixed calendar.
For patients interested in the nutritional and supplementation side of brain health between visits, Dr. Orr developed Action Potential Supplements to provide physician-grade formulations that support mitochondrial function, neurotransmitter precursor availability, and neuroinflammation management during and after treatment.
Safety, Monitoring, and What to Expect
Physician-administered with continuous oversight
Every ketamine infusion at The Neurogenesis Project is administered by Dr. Orr or under his direct supervision in a private clinical suite. Continuous pulse oximetry, blood pressure monitoring, and cardiac telemetry are standard. Infusions typically last 40 minutes, followed by a 30- to 60-minute observation period.
During the infusion, patients commonly experience mild perceptual changes, a floating sensation, and temporary dissociation. These effects are expected at sub-anesthetic doses and resolve completely within one to two hours. Nausea, when it occurs, is managed with ondansetron. Blood pressure elevations are typically modest (10 to 20 mmHg systolic) and transient.
Contraindications include uncontrolled hypertension, active psychosis, untreated hyperthyroidism, and pregnancy. Dr. Orr screens for these and other exclusion criteria during the initial neurological evaluation. Patients cannot drive for 24 hours after an infusion and must arrange transportation in advance.
Ketamine vs. Spravato (Esketamine)
Spravato is the FDA-approved nasal spray form of esketamine (the S-enantiomer of ketamine), indicated specifically for treatment-resistant depression. IV racemic ketamine contains both the S- and R-enantiomers and is used off-label. Published comparisons suggest that IV racemic ketamine may produce stronger antidepressant effects, though Spravato has the advantage of FDA approval and potential insurance coverage. Dr. Orr discusses both options during consultation and recommends based on your clinical profile, not administrative convenience.
Related Treatments and Programs
Ketamine works best as part of a broader protocol
Program
Intensive Brain Health Program
A five- to ten-day concentrated protocol combining ketamine, NAD+ IV therapy, neurostimulation, and advanced diagnostics under Dr. Orr's direct supervision.
Learn about the Intensive Program →Treatment
NAD+ IV Therapy
Nicotinamide adenine dinucleotide delivered intravenously to restore mitochondrial function, support DNA repair, and extend the neuroplastic effects of ketamine.
Explore NAD+ therapy →Condition
Cognitive Decline
Early-stage memory loss, brain fog, and processing speed deficits evaluated and treated through precision neurological protocols.
Read about cognitive decline treatment →Frequently Asked Questions
Common questions about ketamine therapy at The Neurogenesis Project
How is ketamine therapy at The Neurogenesis Project different from a standalone ketamine clinic?
We do not administer ketamine in isolation. Every infusion is embedded within a broader precision neurological protocol that may include NAD+ IV therapy, neurocognitive testing, advanced neuroimaging, and targeted supplementation. Dr. Orr designs the protocol around your specific neurology, not around a single molecule. The goal is durable neuroplastic change, not symptom suppression.
What conditions does sub-anesthetic ketamine treat?
The strongest evidence supports ketamine for treatment-resistant depression (patients who have not responded to two or more antidepressant trials), PTSD, and certain chronic pain syndromes including complex regional pain syndrome (CRPS) and neuropathic pain. Emerging research also supports its role in anxiety disorders, obsessive-compulsive disorder, and suicidal ideation. Dr. Orr evaluates candidacy during the initial neurological workup.
Is ketamine therapy safe?
At sub-anesthetic doses administered by a board-certified physician with continuous monitoring, ketamine has a well-established safety profile. The most common side effects are transient dissociation, mild nausea, and temporary increases in blood pressure, all of which resolve within one to two hours. Serious adverse events are rare when the drug is given in a medically supervised setting with proper screening.
How many sessions are needed to see results?
Most patients in the published literature show measurable improvement within the first one to three infusions. Our Intensive Brain Health Program typically delivers a concentrated series over five to ten days, which allows us to stack ketamine alongside other neuroregenerative interventions. Some patients benefit from periodic maintenance infusions afterward, determined by clinical response and follow-up neurocognitive testing.
Does insurance cover ketamine therapy?
Most commercial insurance plans do not cover off-label IV ketamine infusions at this time. Spravato (esketamine nasal spray) has FDA approval for treatment-resistant depression and may be covered under certain plans. Our patient coordinator can discuss pricing and help you evaluate whether Spravato or IV ketamine is the better fit for your clinical situation. A full cost breakdown is provided before any treatment begins.
Can ketamine therapy be combined with other treatments?
Yes. That is the core of our approach. Ketamine opens a window of heightened neuroplasticity, and we use that window strategically. NAD+ infusions support mitochondrial repair in neurons. Targeted supplementation protects newly formed synaptic connections. Neurostimulation can reinforce circuit-level changes. Dr. Orr sequences these interventions based on timing and mechanism, not as a buffet of add-ons.
Find Out Whether Ketamine
Is Right for Your Brain
Dr. Orr evaluates every patient individually. A consultation determines whether ketamine fits your neurology and, if so, how it should be sequenced alongside other interventions for the best outcome.
Request a ConsultationOr call (912) 268-3097 to speak with our patient coordinator.