The most recent issue of Psychiatric News PsychoPharm features an article exploring the off-label use of this medication in special clinics. The piece describes what patients can expect at ketamine centers, including the physicians running them and the course and cost of standard treatment regimens.
The majority of the ketamine clinics in the United States are run by anesthesiologists, who tend to have firsthand experience with using ketamine and managing side effects. Psychiatric News spoke with anesthesiologists at ketamine clinics in New York and Arizona, where patients are initially given four infusions of ketamine within about two weeks.
Such procedures can be expensive, with most clinics charging $400 to $800 for a single infusion of ketamine, Dennis Hartman of the Ketamine Advocacy Network told Psychiatric News. (The Ketamine Advocacy Network is a website whose mission is to spread awareness about ketamine therapy for treatment-resistant depression.)
Although ketamine works for many patients, an estimated one-third of all patients in clinical trials do not respond to the medication.
“We need to find particular characteristics that can predict response,” APA President Maria A. Oquendo, M.D., Ph.D., told Psychiatric News. Oquendo is involved with a clinical trial evaluating the safety and effectiveness of ketamine in patients with refractory depression.
Anesthesiologists Glen Brooks, M.D., medical director of the New York Ketamine Infusions LLC, and Mark Murphy, M.D., the medical director of the Ketamine Wellness Centers in Mesa, Ariz., noted that patients at their clinics undergo mental health screening before receiving ketamine infusion, and they recommend that patients receive ongoing psychiatric or psychological care during treatment. Additionally, staff at the clinics routinely communicate with referring psychiatrists.
For related information, see “APA Task Force to Address ‘What’s Next?’ for Ketamine.”