Intravenous Ketamine for Depression
Intravenous, or IV Ketamine is the hottest topic in the field of Psychiatry for use in "Treatment Resistant Depression". That is, depression that does not improve after multiple trials of antidepressants and/or psychotherapy have failed to provide relief.
Ketamine has been approved by the U.S. FDA as an anesthetic since 1970. There are over a dozen studies in the Psychiatric journals showing a more rapid improvement in depressive symptoms compared to medications and psychotherapy.
Ketamine has been approved by the U.S. FDA as an anesthetic since 1970. There are over a dozen studies in the Psychiatric journals showing a more rapid improvement in depressive symptoms compared to medications and psychotherapy.
Current status of Ketamine
According to the current Psychiatric Literature, the experts in Treatment Resistant Depression (TRD) recommend a careful risk/benefit analysis before offering Ketamine as a possible treatment.
This includes being evaluated by a Psychiatric Physician experienced in treating patients that have not responded to standard therapies such as "SSRI" antidepressants and Psychotherapy ("talk therapy"). And, the determination if other treatment options are available. Treatment Resistant Depression designation is determined by an MD Psychiatrist experienced in evaluating and treating TRD. Diagnosing and treating TRD involves experience in the use of more aggressive treatment options, such as MAOI antidepressants (Monoamine Oxidase Inhibitors), and multiple mood stabilizer combinations and Clozapine, in the case of Treatment Resistant Bipolar Depression/Mixed states. Additional understanding of TRD patients involves experience in the use of ECT (Electroconvulsive Therapy), and/or VNS (Vagus Nerve Stimulation). Current status of Ketamine in The ValleyAs IV Ketamine is not covered by Health Insurance, and, is only available on a Private Pay basis, over the past few years, there has been a mushroom effect of IV Ketamine Centers sprouting up and basically offering IV Ketamine to anyone that has the money to pay for it. I have seen IV Ketamine given to misdiagnosed patients, and the overselling in the number of treatments, with patients incurring the loss of thousands of dollars. There are IV Ketamine Centers that are not staffed by Psychiatrists. There is one center where a Psychiatrist reviews your records, but never sees you, and, of course, always gives his approval for treatment. Another Ketamine proprietor offers you a "free" IV Ketamine Treatment, if you do not improve after undergoing 30 Transcranial Magnetic Stimulation treatments under your Health Insurance in his office. One center is currently under investigation by the State Attorney General.
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