Ketamine

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1. Anesthesia: Inducing sedation or general anesthesia for surgical procedures.

2. Pain management: Treating acute or chronic pain, especially for conditions like complex regional pain syndrome.

3. Depression treatment: IV ketamine infusions have shown rapid antidepressant effects in treatment-resistant patients.where to buy ketamine online for sale uk

4. Emergency medicine: Sedating patients with severe agitation, aggression, or suicidal ideation.

5. Research: Studying ketamine’s potential therapeutic applications, such as treating post-traumatic stress disorder (PTSD), anxiety disorders, or substance use disorders.

What do we know about the benefits of ketamine?

A prescription version of ketamine called esketamine (Spravato), given through a nasal spray, was approved in 2019 by the FDA for hard-to-treat depression. However, guidelines required its use “under the supervision of a health care provider in a certified doctor’s office or clinic.” That means medical professionals need to watch you use it, and then follow you after you’ve taken your dose, checking your vital signs and how you are doing clinically.

The effectiveness of ketamine nasal spray for TRD was first demonstrated for short-term treatment in research that showed meaningful decreases in depression scores for the group given ketamine over the group that received a placebo. (It’s worth noting that participants in both groups continued taking their regular antidepressants due to concerns around not treating TRD in the placebo group.)

A longer-term study found that nasal ketamine (plus their regular antidepressant) helped people stay in stable remission 16 weeks into treatment.

Relief from TRD with ketamine happens rapidly: instead of waiting for an antidepressant medicine to hopefully provide some relief over the course of weeks, people who are suffering under the crushing weight of depression can start to feel the benefits of ketamine within about 40 minutes.

Is ketamine the right treatment for you?

First, it’s important to remember that ketamine isn’t a first-option treatment for depression. It’s generally used only when other, more longstanding treatments haven’t been effective. Ketamine doesn’t offer a cure; rather, it improves symptoms of depression for a certain amount of time.

Talk to your primary care doctor, your mental health provider, and any other health care professionals who care for you to help make a decision. Based on your goals, your experiences with depression, and the possible side effects of the drug, it’s often easier to say who isn’t appropriate for ketamine treatment.

Should you go to a ketamine clinic for treatment?

Independent, outpatient ketamine clinics are popping up all over the place. It is estimated that there are currently hundreds to thousands of these clinics — almost all of which were established in 2019 when ketamine was approved for treatment-resistant depression.

Typically, these clinics are for-profit enterprises. They are staffed by some combination of either a psychiatrist or an anesthesiologist (who can administer the infusion), a nurse, a social worker, and (of course) the businesspeople who make it all work.

In writing this piece I called several ketamine clinics, posing as a patient, to investigate what would be involved in receiving ketamine therapy. Most of them seemed as if they would provide ketamine for me without any major hurdles, after an introductory medical interview by a nurse or a social worker. A few clinics required communication or a diagnosis from my psychiatrist — and this seemed quite sensible.

The clinics operate on a fee-for-service arrangement, so you would pay out of pocket, as insurance rarely covers this treatment. In the Boston area where I live, the ketamine infusions cost about $600 each, and a course of six infusions and a clinical re-evaluation are typically recommended. (I should note that the ketamine clinics affiliated with medical academic institutions seem to have more safeguards in place, and they may also be enrolling people in clinical trials.)