How To Find The Best Ketamine Therapy Clinics
There are now more than 1800 ketamine clinics in the United States alone. Many people utilize these as ways to rapidly alleviate the symptoms of treatment-resistant depression, as well as help with chronic pain.
So where can you find the best ketamine therapy clinics? That’s not as complicated as you might think.
While clinics attached to hospitals and other medical centers are generally safe, stand-alone clinics vary wildly in the quality of care provided. Some clinics have rigorous patient assessments, stringent safety protocols, or run by a combination of psychiatric and anesthetic care providers. Some make inflated claims about the benefits of the treatment, are staffed only by nurse practitioners, and offer pricey custom ketamine formulations that have not shown to increase efficacy.
To help find the right ketamine treatment center for you, we’re providing the resources below. These recommendations are based on guidelines issued by the American Psychiatric Association and the American Association of Nurse Anesthetists. We also include commentary from medical professionals and patients who have undergone ketamine therapy.
Claims Of Efficacy And High-Pressure Sales
While ketamine has shown great promise in treating resistant forms of depression and chronic pain, it is not a miracle drug. Unfortunately, there is no such thing.
If you run across a clinic that frames ketamine therapy as a miracle drug, proceed with caution and be sure to check that the clinic meets other standards we describe here. The clinic website and the professionals running the clinic should be moderate in their claims about how ketamine may benefit an individual.
Since most ketamine treatments usually are not covered by insurance, out-of-pocket costs may be steep. This has resulted in the proliferation of manipulative sales tactics that coerce patients into trying the treatments. While some otherwise reliable clinics may engage in such practices, if there’s pressure when you contact the clinic for a price quote, it may be best to investigate other options.
Cost Of The Best Ketamine Therapy Clinics
Clinics may charge anywhere from $350 to $1,000 for a single infusion. Treatment plans usually involve the administration of six or more infusions, followed by monthly “maintenance” infusions.
Infusions for chronic pain require higher doses and are often more expensive. Infusions for depression, the most common condition for treatment, costs an average of $500. Significantly higher costs are a major red flag, and a lack of transparency regarding costs should eliminate a clinic from consideration. The increased cost may be due to arbitrary price inflation or to the offering of supposed “custom formulations,” which have not been shown to provide additional benefits.
Expensive testing procedures, such as genetic analyses that supposedly help to tailor ketamine dosages, are usually unnecessary. If a clinic offers these types of services, be suspicious.
Collaboration With Other Providers
Reliable, professional ketamine clinics make an effort to coordinate care with the patient’s psychiatrist and/or primary care physician.
By obtaining the patient’s medical history, particularly a list of medications that they have used in the past, ketamine clinics can ensure that the patient is an appropriate candidate for treatment. And it has been shown to help with a wide array of mental health disorders. Patients with a history of drug abuse or who have suffered previous psychotic episodes are typically not candidates for ketamine therapy.
Be wary of any clinic that does not require coordination of care with a primary care physician and/or a psychiatrist. Some clinics rely on Patient Health Questionnaire (PHQ)-9 to diagnose major depressive disorder, but results of this questionnaire should not be considered adequate justification for ketamine treatment. Insight from a patient’s other care providers is essential in determining whether or not ketamine is appropriate.
Having a psychiatrist onsite conducting patient intake interviews indicates that a clinic takes the administration of this powerful medication seriously. A psychiatrist can also more accurately determine whether any side effects from the medication put the patient at risk.
Since anesthesiologists often administer drugs such as ketamine, their presence suggests that best practices will be observed during treatment.
Clinics should also have nurses or nurse practitioners on staff to monitor infusions and address patient needs as they arise.
Additionally, virtual ketamine assisted therapy is becoming more popular and accepted.
Safety Protocols At The Best Ketamine Therapy Clinics
Be on the lookout for ketamine clinics that do not have appropriate safety protocols in place. Clinics should:
- Establish whether or not ketamine therapy will be safe for the patient. Coordinate care with primary care physicians and psychiatrists, review medical records, and conduct any necessary blood work.
- Be double-checking that the patient’s identity is accurate, and that they’re administering the correct dosage.
- Always be communicating the risks of ketamine treatment.
- Following up with patients about any experienced side effects.
- Have cardiovascular (heart rate, blood pressure) and respiratory (oxygen saturation) monitoring equipment for each patient.
- Employ nurses monitoring patients for any sign of ketamine toxicity.
- Already have a plan in place for patients that respond poorly to ketamine. This should include means of administering oxygen in case of respiratory difficulty and a crash cart in case of cardiac arrest. Staff who are certified in the use of this equipment should be on site. Restraints should also be available in the rare case that a patient reacts violently to the medication.
- Be in close proximity to a hospital in case of a medical emergency caused by the administration of ketamine.
It’s important to understand the industry standards while searching for the best ketamine therapy clinics. For instance, the standard therapeutic dose by IV is 0.5 mg/kg per 40 minutes. Dosage for pain is much higher, though dosages should not exceed 1 mg/kg per hour. Dosage for ketamine sprays and lozenges will vary. Always ask the provider how the staff are determining dosage.
If they are using much higher or much lower doses, ask them why they are deviating from the standard.
Some clinics add benzodiazepines to the dose in order to mitigate the side effects. However, these chemicals may actually reduce the efficacy of the treatment. In fact, some analysis suggests that side effects such as sensory distortions are in fact key to the efficacy of the treatment.