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Mental health services in Cleveland, OH, at Cleveland Medical Institute offer innovative treatments for depression, anxiety, PTSD, and chronic pain. Located in Willoughby, we provide advanced Ketamine Infusion Therapy to address conditions like Major Depressive Disorder, Bipolar Disorder, severe postpartum depression, OCD, and substance abuse. We also offer Stellate Ganglion Block (SGB), a proven treatment for chronic pain and PTSD. Our compassionate team is committed to improving your quality of life with cutting-edge therapies. Visit Cleveland Medical Institute to start your journey to better mental health today.

Mo 08:00-17:00; Tu 08:00-17:00; We 08:00-17:00; Th 08:00-17:00; Fr 08:00-17:00

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6025 Commerce Circle, Willoughby, OH 44094, US

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Ketamine infusion therapy for POTS

When standing up feels like running a marathon

POTS doesn’t get enough recognition — but we recognize it. We evaluate patients with Postural Orthostatic Tachycardia Syndrome for ketamine infusion therapy, a treatment that may offer real relief for the chronic pain and depression that so often follow this condition.

3–6 Million

Americans estimated to live with POTS — most commonly women of childbearing age

7 Years

Average time women wait for a correct POTS diagnosis

64%

Of POTS patients had symptoms attributed to anxiety before a correct diagnosis

Understanding the condition

What is POTS — and why is it so hard to diagnose?

Postural Orthostatic Tachycardia Syndrome is a disorder of the autonomic nervous system — the part of the body that handles heart rate, blood pressure, digestion, and temperature. When this system misfires, the consequences are anything but invisible.

For someone with POTS, simply standing up can trigger a racing heart, dizziness, and a brain fog so thick that forming a sentence takes effort. The fatigue is relentless, the headaches recur, and nausea appears without warning.

Women wait an average of seven years before receiving an accurate diagnosis — years often spent being told their symptoms are anxiety or stress. The reality is far more physical, and far more complex. An estimated 3–6 million Americans live with POTS.

LONG COVID CONNECTION

A Yale study found 28.9% of long COVID patients developed new-onset POTS. What was once rare is now increasingly recognized.

COMMON SYMPTOMS

Racing heart, dizziness, fatigue, brain fog, chronic headaches, chest pain, nausea, exercise intolerance, depression, and anxiety.

THE KETAMINE CONNECTION

Why ketamine may help POTS patients

POTS rarely travels alone. Many patients carry co-occurring conditions — chronic neuropathic pain, CRPS, fibromyalgia, or post-viral nerve sensitivity — that compound their disability. On top of the physical symptoms, the emotional weight is real. Persistent depression and anxiety are near-universal among POTS patients.

“POTS involves excessive sympathetic nervous system activity — the body’s fight-or-flight response stuck in the ‘on’ position. Ketamine has demonstrated its strongest effects in conditions with exactly this profile.”

A longitudinal study tracked 277 ketamine infusions across 63 patients over 15 months. Among all chronic pain subtypes treated, POTS patients showed some of the largest reductions in pain scores — ranking behind only CRPS patients in their response to ketamine. The study concluded that CRPS, POTS, and trauma-related chronic pain patients are the subgroups most likely to benefit. (Sheehy et al., BMC Pediatrics, 2015.)

THE SCIENCE, WITHOUT THE TEXTBOOK

How ketamine works

Most medications that treat depression and pain target the serotonin system. Ketamine doesn’t. It targets a completely different pathway — the glutamate system — which plays a central role in how the nervous system processes and amplifies pain, stress, and emotional distress.

Ketamine blocks a receptor called the NMDA receptor — the biological switch that keeps pain and distress signals firing on repeat. By quieting that signal, it can interrupt the cycle of central sensitization that drives chronic pain, and it does so quickly. Where traditional antidepressants may take six to eight weeks to show any effect, ketamine often works in hours.

Miracle-Gro for the brain

Ketamine stimulates Brain-Derived Neurotrophic Factor (BDNF) — nicknamed “Miracle-Gro for the brain.” In people with chronic depression or pain, the brain begins losing neural connections. Ketamine rebuilds them rapidly.

Confirmed by neuroimaging

A 2023 RCT in Translational Psychiatry measured real gray matter changes in treatment-resistant depression within 24 hours of a single ketamine infusion.

CANDIDACY

Is ketamine therapy right for you?

Ketamine is not a blanket solution for every patient. We start with a thorough evaluation, not an assumption. That said, patients who tend to be good candidates often share common ground:

Chronic pain without relief

Pain that hasn’t responded well to standard treatments, including neuropathic or sympathetic-driven pain.

Treatment-resistant depression

Depression or anxiety that has persisted despite conventional medications or therapy.

Autonomic hyperreactivity

A nervous system that seems stuck in overdrive — sensitive, unpredictable, and slow to settle.

Exhausted other options

Patients who have tried multiple medications and interventions with limited lasting benefit.

IMPORTANT CLINICAL NOTE

Because POTS involves autonomic instability, our protocols are adapted — closer monitoring, modified dosing, and IV fluid support to stabilize blood volume during treatment. Candidacy is determined individually by our physicians after a full medical history review.

WHAT HAPPENS NEXT

What to expect at Cleveland Medical Institute

01 Consultation

Share your history, ask questions, and understand your options — no obligation, no pressure.

02 Physician evaluation

Dr. Demangone reviews your full medical history and designs a protocol for your condition.

03 Infusion series

A typical course runs 2–3 weeks. Many patients notice changes in pain and mood within days.