Ketamine & Esketamine Treatment for Treatment-Resistant Depression
For some adults with depression, standard treatments such as antidepressant medication and psychotherapy may not provide adequate relief. Ketamine and esketamine are treatment approaches that may be considered for certain patients with treatment-resistant depression. Dr. Patrick evaluates each patient individually to determine whether one of these options may be appropriate.
What Is Ketamine Treatment?
Ketamine is a medication that has been used in medical care for decades. Ketamine is not FDA-approved for the treatment of depression or any other psychiatric disorder. When used for depression, ketamine is prescribed off-label. At lower doses, ketamine may provide rapid improvement in depressive symptoms for some patients who have not responded adequately to conventional antidepressant treatments. Treatment is provided only after an individualized psychiatric evaluation to determine whether ketamine may be appropriate.
What Is Esketamine Treatment?
Esketamine (SPRAVATO®) is an FDA-approved prescription nasal spray for adults with treatment-resistant depression. It is administered in a certified healthcare setting under medical supervision. Patients are monitored after each treatment, and an individualized evaluation is required to determine whether esketamine is appropriate.
What to Expect During Treatment
Before beginning treatment, Dr. Patrick conducts an individualized psychiatric evaluation to review your symptoms, treatment history, medications, and overall health. If ketamine or esketamine is appropriate, a treatment plan will be developed based on your individual needs.
Treatment is provided in a comfortable clinical setting with appropriate medical supervision. Patients receiving esketamine are monitored after administration in accordance with required safety procedures. Monitoring for ketamine treatment is determined according to the treatment provided and the individual patient's clinical needs.
Because these treatments can temporarily affect alertness, perception, blood pressure, and coordination, patients should follow all instructions regarding transportation and activities after treatment.
Who May Be a Candidate?
Ketamine or esketamine treatment may be considered for adults with depression who have not experienced adequate improvement with conventional treatments, including antidepressant medications and psychotherapy.
These treatments are not appropriate for everyone. Dr. Patrick conducts an individualized psychiatric evaluation that considers treatment history, current medications, medical history, and other factors before determining whether ketamine or esketamine may be an appropriate treatment option.
Possible Side Effects and Safety
Ketamine and esketamine can cause temporary side effects during or after treatment. These may include dizziness, nausea, changes in blood pressure, sedation, or changes in perception. Patients are monitored as appropriate during treatment and before leaving the office.
Because these treatments can temporarily impair alertness and coordination, patients should not drive themselves home after treatment. Specific safety instructions and transportation requirements will be discussed before treatment begins.
After Treatment
After treatment, patients remain in the office for the appropriate period of observation before leaving. Because ketamine and esketamine may temporarily affect alertness, coordination, judgment, or perception, patients must arrange appropriate transportation home. Patients receiving SPRAVATO® should not drive, operate machinery, or perform activities requiring complete alertness until the next day after a restful sleep. Specific post-treatment instructions for ketamine will be provided based on the treatment received.
Dr. Patrick will provide individualized instructions regarding activities, medications, and follow-up care based on the treatment received.
Frequently Asked Questions
How are ketamine and esketamine different?
Ketamine has been used in medical care for decades. When used to treat depression, ketamine is prescribed off-label. Esketamine (SPRAVATO®) is a nasal spray that is FDA-approved for certain adults with treatment-resistant depression and for depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior.
How often are treatments given?
Treatment schedules vary depending on the medication, individual response, and clinical needs. Dr. Patrick will develop an individualized treatment plan after evaluation.
Can I drive after treatment?
No. Patients receiving ketamine or esketamine must arrange transportation home after treatment. Patients receiving SPRAVATO® should not drive, operate machinery, or perform activities requiring complete alertness until the next day after a restful sleep.
Does insurance cover treatment?
Coverage varies depending on the treatment and insurance plan. The office can discuss treatment costs and available payment options before treatment begins.