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  • John M. Thurston, MD

Understanding Relapse: Mental Health and Maintenance Therapy


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Mental health recovery is a journey, not a destination. For many individuals, treatments such as Ketamine infusions and Transcranial Magnetic Stimulation (TMS) offer a path towards stabilization and improvement. However, the journey doesn’t end with the initial treatment phase—maintenance therapy plays a crucial role in preventing relapse and supporting long-term recovery. Here’s how maintenance sessions work for both Ketamine and TMS.


 Ketamine Maintenance Therapy


Ketamine, originally used as an anesthetic, has been found to provide rapid relief from depression and other mental health conditions due to its unique action on the brain’s NMDA receptors. After completing an initial series of treatments, which typically involves multiple sessions over a few weeks, the question of how to maintain the benefits arises.


 How It Works:

Maintenance or “booster” therapy with Ketamine usually follows the initial intensive phase. The frequency of maintenance sessions varies based on individual response but commonly ranges from once a week to once every few months. These sessions are crucial because they help to sustain the neurochemical changes initiated by the initial treatments.


 Benefits:

Regular maintenance sessions help to:

- Extend the relief from symptoms experienced after the initial series of treatments.

- Prevent the return of depressive symptoms and other conditions.

- Stabilize mood over longer periods.


 TMS Maintenance Therapy


TMS uses magnetic fields to stimulate specific areas of the brain involved in mood regulation. Like Ketamine, there is an initial treatment phase followed by maintenance.  However, TMS generally doesn't require maintenance sessions as frequently to prolong the benefits.


 How It Works:

The approach to maintenance with TMS can vary. Some patients may transition to a tapering phase, where the frequency of sessions gradually decreases over time. Others might require periodic maintenance sessions after completing the initial phase. Generally insurance companies will approve subsequent treatments based on 50% reduction in standardized scores such as BDI-II and/or HAM-D.  


 Benefits:

Maintenance sessions for TMS are designed to:

- Maintain the improvements in mood and cognitive function.

- Help the brain stabilize the new patterns of activity encouraged during the initial treatment phase.

- Reduce the risk of relapse into depression or other mental health issues.


 The Importance of Personalization in Maintenance Therapy


Both Ketamine and TMS require a tailored approach when it comes to maintenance therapy. The right schedule and frequency of maintenance sessions depend on individual factors such as:

- Severity of symptoms

- Response to initial treatment

- Lifestyle and changes in life circumstances

- Overall mental and physical health


 Final Thoughts


Understanding the importance of maintenance therapy is crucial for anyone considering or currently undergoing Ketamine or TMS treatments. Regular follow-ups with healthcare providers ensure that the treatment remains effective and responsive to the patient’s evolving needs. By adhering to a personalized maintenance schedule, individuals can significantly enhance their long-term recovery prospects and maintain the gains they have worked so hard to achieve.


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