KETAMINE

Ketamine is an old medication with a new use for treatment-resistant depression. Ketamine works in the brain in a manner quite different from conventional antidepressants, and there is some evidence that it can alleviate depression for some patients who do not respond to conventional antidepressants alone. It is approved as an add-on (“adjunct”) treatment, not to be used alone. It requires administration twice-weekly in the first week, always in the physician’s office, with a 2-hour period of monitoring in the office after dosing, to watch for sedation or other changes in mental state. It may also be associated with an increase in suicidal ideation, and it is not safe in pregnancy. It is also a controlled substance. Therefore, doctors and patients alike must be cautious in deciding to use it, and managing the course of treatment. Nonetheless, it may often work when other drug combinations do not, and often quite rapidly. We will engage you in a discussion about whether and how this medication may fit in the range of appropriate treatment options for you.