Understanding Ketamine
What is Ketamine?
Ketamine is a medication classified as an NMDA receptor antagonist, which blocks the brain’s N-methyl-D-aspartate neurotransmitter. First developed in the 1960s, ketamine was initially used as an anesthetic and has since been employed in clinical settings for anesthesia and acute pain management. However, the way ketamine is being used in 2024 has expanded beyond these traditional settings.
Is Ketamine Approved for Mental Health Treatment?
It’s important to distinguish between ketamine and esketamine (SPRAVATO), as they are chemically similar but distinct drugs. While ketamine is FDA-approved as an anesthetic and widely used in surgical, operative, and emergency settings, it has also shown significant promise as an off-label treatment for mental health conditions, particularly depression and PTSD. Esketamine (SPRAVATO), a derivative of ketamine, was FDA-approved in 2019 specifically for treatment-resistant depression, further validating the therapeutic potential of this class of medication. The growing body of research and positive patient outcomes have made ketamine-assisted therapy an exciting and transformative option for individuals struggling with mental health challenges who have not responded to traditional treatments.
Ketamine infusion therapy is not a first-line therapy for psychiatric disorders and may be considered by the patient’s interdisciplinary team after the failure of standard treatment.
Esketamine (SPRAVATO)
IV Ketamine
FDA Approval | FDA-approved for treatment-resistant depression and suicidal ideation in 2019. | Off-label use for mental health conditions like depression, PTSD, anxiety, and chronic pain. FDA-approved as an anesthetic. |
Insurance Coverage | Often covered by insurance (depending on plan and prior authorization). | Rarely covered by insurance for mental health; typically self-pay. |
Treatment Frequency | Administered twice per week for the first 4 weeks, then weekly for 4 weeks, then every 1-2 weeks for 4 weeks, then maintenance therapy based on response. | Induction involves 6 infusions over 2–3 weeks; we may need maintenance doses depending on your response. |
Route of Administration | Nasal spray administered in a clinical setting under supervision. | Intravenous (IV) administration in a medical clinic under direct monitoring such as heart rhythm, vital signs, neurological assessments by an RN. |
Monitoring Requirements | Requires 2-hour observation post-treatment. Patients cannot drive after treatment. | Requires 1.5 hours of appointment time which includes the infusion and post-infusion observation. Patients cannot drive after treatment. |
Supplemental Therapy | Requires concurrent psychotherapy as part of the treatment plan. | Requires concurrent psychotherapy as part of the treatment plan. |
Mechanism of Action | Selectively targets NMDA receptors as esketamine (a single isomer of ketamine). | Targets NMDA receptors, promoting neuroplasticity with both isomers of ketamine (racemic mixture). |
Onset of Action | Fast-acting, with noticeable improvements within hours to days for many patients. | Fast-acting, with noticeable improvements within hours to days for many patients. |
Accessibility | Available at approved healthcare facilities; requires a Risk Evaluation and Mitigation Strategy (REMS) program. | Offered at specialized clinics. |
Overall Cost (Long-term) | Potentially higher due to recurring co-pays, frequent visits, and higher drug pricing. | Can be more affordable long-term for uninsured patients or those requiring fewer maintenance sessions. |
Indication | Treatment-resistant depression and Depression with suicidal ideation. | Broader use, including depression, anxiety, PTSD, OCD, bipolar disorder, etc. |
Administered under the supervision of our experienced infusion team, ketamine works by modulating glutamate pathways in the brain, promoting neuroplasticity, and alleviating symptoms in ways conventional medications often cannot. Our goal is to provide a safe, supportive, and personalized experience, helping patients regain hope and reclaim their lives.
