Ketamine is one of the most widely used and safest anesthetics in the world according to the World Health Organization who list it as an essential medicine.  Researchers at Yale have been studying low-dose ketamine since 2000 in controlled clinic settings for patients with severe depressions unresponsive to other antidepressants.  The results have been dramatic: In several studies, more than half show a significant decrease in depression symptoms in 24 hours. Overall, around 4 out of 5 went on to find significant improvement. Ketamine is now extensively used for difficult-to-treat depression, anxiety, anxious bipolar depression, PTSD, OCD, and chronic pain. Ketamine is a great, safe and effective drug that helps lots of people when administered by experts under the right conditions.

Clinics are popping up all over the country in what is a largely cash-based model. So just how can you tell if a ketamine clinic has the right qualifications and the right intentions to care for you or someone you love?

We’ve compiled the ultimate, unbiased guide that we hope will help you as you make this important decision.

Take a close look at the website

The website should be comprehensive, educational, and clearly explain that ketamine is not right for everyone or a one-size-fits-all. The site should be transparent that ketamine therapy requires a personalized approach with individualized treatment plans.

Positive patient testimonials, social media reviews, and related media.

The site makes exaggerated claims about how effective ketamine is or that ketamine will “cure” you.

Ketamine therapy is part of a site offering unrelated services or medical treatments and appears to be a “side business”.

Research the qualifications of the staff

The clinic’s physician(s) is board certified in a specialty that relates to mental health or pain. (Ex. anesthesia, emergency medicine, internal medicine, psychiatry). None of the physicians or providers has ever had board actions against them or lost their license (a simple Google search should make this easy to answer).

The care team includes qualified mental health professionals and trained therapists.

Trained medical and mental health experts are on-site or easily available.

Emphasis on a medical-only approach with no mental health experts available. Knowing how to administer an IV does not qualify a clinic as experts in serious, treatment-resistant mood disorders.

Understand the clinic’s screening process

The American Psychiatric Association strongly recommends ketamine clinics carefully assess any patient’s physical and mental status before and after a course of treatment.

Depression, anxiety, PTSD, and other mood disorders are serious mental wellness issues. Your ketamine provider team should include a trained psychologist or therapist and a medical doctor who also conduct detailed pre-treatment screenings.

No qualified mental health professionals are part of the patient assessment team.

Only limited pre-treatment screenings are conducted. Screenings do not cover both medical and psychological patient history.

Same-day appointments are available with no, or limited, pre-screening.

Visit the clinic itself or ask detailed questions

The clinic should be a quiet, calm therapeutic place.  Ketamine infusion therapy is best in a private room. Having friends and loved ones in the room should be your decision (but experienced clinic staff should be able to guide you on whether this is a good idea for you).

A medical professional should be with you during every treatment to monitor you, your vital signs (typically watching for any changes in blood pressure) and provide an extra level of reassurance. One distinct advantage of infusion therapy is that dosage can be controlled during treatment. If you become upset or uncomfortable dosage can be temporarily adjusted immediately.

Relaxing video and/or music is available for you to choose from during treatment.

You should not be in a big room with several other patients behind curtains or experience long waits in a lobby with lots of other people making you anxious before your infusion.

During treatments, some patients can experience feelings of dissociation or disorientation. You should not be left alone in a room during a treatment even if offered a call button.

Consider how much relevant experience the clinic or group has

The longer the clinic has been open, the better. Each patient responds slightly differently to ketamine therapy. A clinic with tried and tested treatment procedures and experience makes a difference.

Some specialists, for example anesthesiologists and emergency medicine physicians may have years of experience with ketamine as an anesthetic However, low dose ketamine in an out-patient setting for mental health is truly a different service.

Cost

$400-$800 for a 40–60-minute infusion is the typical range across the country.

While ketamine infusion therapy for mood disorders is typically not covered by insurance the clinic may be in-network with plans that will help cover the cost of pain therapy. The clinic may also help you file a claim with your insurance company to determine whether they will cover any of the cost of therapy for mood disorders.

The clinic offers competitive third-party financing and payment plans.

Above $800 per treatment is regarded as excessive.

Below $400 per infusion should prompt you to ask if you are receiving an individualized treatment plan and the personalized care you need at each visit.

Other services the clinic should offer

A good ketamine clinic should offer support services, or access to support services – integrative therapy, psychotherapy, counseling, group therapy, and psychiatric medication management are typical.  Ketamine may provide rapid benefits which can be sustained with comprehensive treatment plans including ongoing treatments.  Additionally, ketamine infusion appears to help create new brain pathways that can develop resiliency to depression, the opportunity to learn new coping skills and protect against the return of symptoms.

After each treatment and course of treatments, the clinic actively works with you to track and support your continued wellness and can help with resources for managing any issues or roadblocks that arise after treatment.

The clinic works closely with your existing mental health professional(s).

The clinic does not recognize that ketamine therapy is part of a larger treatment plan for a mood disorder. “If doctors replace your knee but don’t provide for physical therapy you don’t walk again” Dr. Cristina Cusin, professor of psychiatry, Harvard Medical School.

The practice is offering services that seem completely unrelated to ketamine and mental health or chronic pain.