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.
Clinical Conditions That We Treat
Depression is very common and can take many forms. It is essential to have a thorough evaluation in order to reach an accurate diagnosis, as this will determine how to choose the best treatment of the many that are available. Treatment-resistant depression (TRD) is a special form of depression where individuals do not experience adequate relief with conventional treatments. We can offer these individuals considerable expertise in the use of TMS, esketamine, and medication combinations to achieve better outcomes.
Many individuals who experience depression also experience clinical states referred to as mania or hypomania. These persons should be carefully distinguished from those who experience depression alone (unipolar depression) because the treatments and other considerations may be very different. We offer a thorough evaluation to establish an accurate diagnosis so that the right treatment can proceed.
Anxiety is quite common, and like depression, there are diverse treatments available. We treat individuals with anxiety syndromes such as post-traumatic stress, panic disorder, generalized anxiety disorder, and obsessive-compulsive disorder.
Conditions such as schizophrenia, schizoaffective disorder, and related conditions require long-term, ongoing care. Medications are a mainstay for these conditions, though psychosocial interventions can offer additional benefit. We have recognized expertise in the use of antipsychotic medications to relieve the more serious symptoms and support well-being.
Get In Touch
895 Moraga Road, Suite 15 Lafayette, CA 94549
Monday 3:30-6:30 PM
Tuesday 2:00-6:30 PM
Wednesday 3:30-6:30 PM
Thursday 1:30-6:30 PM
Friday 1:30-6:30 PM
Saturday 10:00 AM to 2:00 PM