Ketamine

Update on our Ketamine Test Dose Treatment Program

Tuesday, October 31, 2023

Dear Prospective Patients and Referrers,

We are writing to inform you that we will be discontinuing our ketamine test dose treatment program, effective November 1, 2023.

When we established the program several years ago, outpatient etamine treatment was just starting to become widely available. We established our one-time test dose ketamine program as a service to the community, in order to help identify those patients in whom ketamine could be administered safely on an outpatient basis.

Based on feedback from patients and referrers, this service is no longer in line with the needs of the community. Both referrers and patients are seeking programs that provide ongoing administration and supervision of ketamine treatment. We regret that we are unable to provide this level of care for patients receiving ketamine as we focus on growth and expansion of our Transcranial Magnetic Stimulation (TMS) Service.

As an alternative to our program, we recommend consideration of clinics that provide Spravato intranasal esketamine. Alternatively, many private-practice psychiatrists offer in-office treatments with a variety of compounded ketamine formulations.

While we no longer offer ketamine treatment, we have increased availability of TMS treatment through our clinics in Westwood, Pasadena, and Calabasas. We provide the most comprehensive TMS treatment options available in Southern California — including accelerated (one-week) treatment and MRI-guided TMS — in one of the nation’s leading clinical and research programs. Please follow this link to refer your patients with depression, OCD, chronic pain, or tinnitus for a consultation with one of our faculty experts.

We appreciate your understanding of our commitment to delivering only the highest quality psychiatric care to our patients. Please let us know if we can be of service to you.

Regards,

What is Ketamine?

Ketamine is one of the most promising new treatment options for depression. Ketamine has been used for decades as an anesthetic. In recent years, research has demonstrated that the use of ketamine in lower doses can improve depression.

When used for the treatment of depression, ketamine is usually administered in an outpatient (clinic) setting and can be given intravenously (through an IV), intranasally (as a nasal spray), or orally (by mouth). Ketamine is usually administered two to three times per week for several weeks, with the potential for additional doses at a less frequent interval. The long-term benefits of ketamine treatment for depression are not fully established, but some patients require regular maintenance treatments to maintain their response.

At UCLA, we offer oral ketamine treatment. While Spravato nasal spray is FDA approved for depression, any other use of ketamine for a mental health condition is considered an off-label use of ketamine and is not approved by the FDA. For this reason, in our clinic, we reserve the use of ketamine for patients who have not responded to TMS.

Does it really work?

Two decades of researches support the use of ketamine for relief of depressive symptoms. A recent clinical trial (Domany et al, 2019) established that oral ketamine is safe and significantly more effective than a placebo for the treatment of depression. In this study, with just three weeks of treatment, depressive symptoms were reduced by 40% on average, and 1 in 4 patients saw their depression resolve by the end of the study. Noticeable benefit began as early as 40 minutes after the first dose.

What are the downsides?

In the doses used for treatment of depression, ketamine should not cause an intense psychological experience, but it may cause temporary dissociation, sedation, impaired coordination and balance, and dizziness or vertigo. It may also lead to nausea or vomiting, headache, and increased heart rate and blood pressure for a short time after each dose. Ketamine is a potentially addictive substance and can rarely lead to craving, dependence, or abuse.