About Ketamine Treatment

Discovered in 1962, ketamine has been around for a long time. In 1970 the FDA approved intravenous ketamine for the induction and maintenance of anesthesia. Today, ketamine remains only approved for applications in anesthesia.

Increasing information is being produced supporting ketamine’s efficacy in treating treatment resistant depression (TRD). As recently as 2021 the American Journal of Psychiatry published an article titled, “Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation” by R.S. McIntyre, et al. Within this article it was stated that, “Replicated short-term randomized controlled studies have unequivocally established the rapid and significant efficacy of both formulations and routes of delivery (of ketamine) in adults with TRD.”

How does it accomplish this feat? The predominant theory is that ketamine promotes synaptogenesis and synaptic potentiation. This means that researchers believe ketamine treatment helps create more connections between nerves in the brain and strengthens those connections.

IV vs SPRAVATO

IV

Using ketamine for TRD is considered off-label. “It is estimated that between 40 and 60 percent of all prescriptions written in the United States are for off-label uses.” - James B Riley, Jr & Aaron Basilius, Hematology & Oncology News & Issues, Vol6, No.5. Because its use in TRD is off-label, IV ketamine treatments are a cash pay treatment. If you choose to seek reimbursement from your insurance carrier, we are happy to provide a superbill which will be required by the carrier.

SPRAVATO

Spravato is an FDA approved intranasal treatment of esketamine (a specific form of ketamine) for TRD. The great news about it being FDA approved is that it is insurance reimbursable. Please visit the product website for additional information at spravato.com/trd/about-spravato.

Additional Resources

Ketamine & Depression: How it Works - Yale Medicine Explains

Ketamine for Treatment Resistant Depression - University of Maryland School of Medicine

The New Science of Ketamine For Depression (with James Murrough, MD, PhD) - Mount Sinai

Is Ketamine Living Up to the Promise for Depression? - Medscape

Ketamine Resources

Office of the Commissioner: FDA approves new nasal spray medication for treatment-resistant depression; available only at a
certified doctor’s office or clinic. US Food and Drug Administration, 2019
https://www.fda.gov/news-events/press-announcements/fda-approves-new-nasal-spray-medication-treatment-resistant-depression-available-only-certified

McIntyre RS, Carvalho IP, Lui LMW, et al: The effect of intravenous, intranasal, and oral ketamine/esketamine in mood disorders: a meta-analysis. J Affect Disord 2020; 276:576–584

Papakostas GI, Salloum NC, Hock RS, et al: Efficacy of esketamine augmentation in major depressive disorder: a meta-analysis. J Clin Psychiatry 2020; 81:19r12889

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