Ketamine has been used for decades as an anesthetic drug. Studies over the past 20 years have shown that ketamine has uses beyond anesthesia, including as a treatment for difficult-to-treat depression.
If you have not found relief from depression with traditional treatment methods, ketamine may help. At the Center for Interventional Psychiatry at UPMC Western Psychiatric Hospital, we are committed to offering our patients the latest advancements in mental health treatments — including ketamine treatment — all while ensuring the highest level of quality and safety.
Contact Us
For more information about ketamine treatment or to schedule an appointment with the Center for Interventional Psychiatry, please call 412-246-5063.
What Is Ketamine Treatment for Depression?
The action mechanism of ketamine in depression is thought to be through neuroplasticity, or creating new connections in the brain.
Ketamine treatment is only recommended for patients who are 18 years of age or older and have tried other traditional treatments for depression without success or have difficult-to-treat depression. It can be given as a nasal spray or through an IV, but it must be administered in a clinic or hospital setting to ensure patient safety.
Types of ketamine treatment
At the Center for Interventional Psychiatry at UPMC Western Psychiatric Hospital, we offer two forms of ketamine-based treatment for depression:
- Esketamine intranasal therapy (Spravato) — This FDA-approved nasal spray contains ketamine and must be taken in a clinic or hospital under medical supervision. After receiving the nasal spray, your provider will observe you for two hours before you are discharged. The nasal spray is given twice a week to start for four weeks. For patients whose depression improves, they will receive treatment once a week for four weeks and then every other week and tapered over time.
- Intravenous (IV) ketamine infusion — This treatment delivers ketamine directly into the bloodstream. While ketamine infusion does not have FDA approval as a treatment for depression, research shows it is effective and is used off-label with success to treat depression. Infusions, which last about an hour and must be administered in a clinic or hospital, are given twice a week to start for four weeks. For patients whose depression improves, they will receive treatment once a week for four weeks and then every other week and tapered over time.
Why Would I Need Ketamine Treatment?
If you are receiving treatment for depression and have not found relief using traditional medications and therapy, your provider may recommend ketamine treatment.
Who is a candidate for ketamine treatment?
To receive ketamine treatment, you must be over 18 years of age and have been diagnosed with depression. Ketamine is only used to address treatment-resistant or difficult-to-treat depression.
Ketamine therapy is not recommended for everyone.
You may not be a candidate if you:
What Are the Risks and Side Effects of Ketamine Treatment?
As with any drug, ketamine comes with possible side effects. People may experience these effects during treatment, and they usually resolve during the required observation period after treatment.
They include:
- Dissociation — Feeling disconnected from yourself or your surroundings.
- Elevated blood pressure.
- Nausea.
- Sedation or drowsiness.
If you are referred for treatment, you will complete a psychiatric consultation with one of our providers to determine if this treatment will be appropriate for you.
What Should I Expect from Ketamine Treatment?
It's important to talk to your provider about any questions or concerns you have related to your ketamine treatment. In general, though, you can expect to be treated at a clinic or hospital and be released the same day. Side effects are typically mild and resolve after a few hours.
Before: How to prepare for ketamine treatment
For esketamine, you should not have anything to eat for two hours before your scheduled treatment time and nothing to drink for 30 minutes before your treatment.
For IV ketamine, you should have nothing to eat for four hours before your scheduled treatment time and nothing to drink for two hours before your treatment. The consulting provider will also review your current medications and let you know whether you need to hold any on your treatment days.
You can bring headphones or earbuds to listen to music during your treatment. You should dress in comfortable clothes.
How long does ketamine treatment take?
If you are receiving esketamine intranasal therapy, you will need to stay at the clinic or hospital for two hours for observation after you receive the medication.
If you are receiving IV ketamine, the infusion takes about an hour. You then need to stay an additional hour for observation.
For both treatments, it’s important that you have someone who can drive you home afterward. You are not permitted to drive for the rest of the day after you receive treatment. You should not drive, operate heavy machinery, or make important decisions on the day of your treatment.
What’s the success rate of ketamine treatment?
The current literature suggests that ketamine treatment is 50% effective at improving depression symptoms.
