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Ketamine Infusion Therapy Is Finding New Applications

Rae, a 30-something Colorado Springs woman, had suffered from depression most of her adult life. Antidepressants didn’t help, she says.

“I found that running kind of kept it at bay,” she adds. But several months into a pregnancy, she had to stop running for medical reasons, and she was overwhelmed by the depression. By the time her child was born, “I was suicidal,” she says.

So she turned to a new tool: ketamine infusion therapy. Somewhere around the fourth or fifth treatment in the six-session series, she says, “the suicidal thoughts were completely gone. It was like a switch. It’s not a magic bullet, but it gave me hope again.”

Ketamine has been used for decades as an anesthetic; more recently, it gained infamy as a club drug. Now, it is gaining attention as a treatment for major depression and other issues. Its use via IV to treat depression is an off-label one; the Food and Drug Administration, however, has approved one form, esketamine, as a nasal spray for treatment-resistant depression.

Dr. Christian Hodach offers both infusion therapy and the nasal spray at his Resurgence Ketamine Clinic, which he opened this year in Colorado Springs. But he favors the IV form, saying it can be better controlled, and its effect is much more pronounced than the nasal form (also known as Spravato™). In addition to treating depression and other mood disorders, he uses ketamine to address chronic pain and substance use disorders.

Hodach reports an 80% success rate in treating mood disorders; those patients, he says, typically have suffered for years, have gotten no relief from standard antidepressants and “are at the end of their rope.” A consensus statement published in 2017 by the American Psychiatric Association pointed to research noting that ketamine can produce “rapid and robust antidepressant effects” but cautioned that the data on safety and long-term efficacy remains limited.

Hodach, however, has long used ketamine as an anesthesiologist; initially, it was used as a sedative during battlefield surgery. But its mechanism in easing depression isn’t clear.

“Nobody really knows how it works for depression,” Hodach says. But it has been hypothesized, he adds, that it increases certain neurotransmitters and helps restore connections in the brain “that have withered away.” The medicine itself is out of one’s system by the end of the day, he says, but the effects remain. Exactly how long those effects last, though, is not clear; patients at Resurgence are told they may need future “maintenance” infusions.

Infusion therapy is not cheap. Resurgence spells out the costs on its website; they vary depending on the treatment. Each infusion in the initial series for a mood disorder, for example, is $450. (Resurgence offers discounts to military, first responders. and law enforcement.) Some insurance carriers are beginning to cover some of the costs, Hodach says, although Rae—who has returned for one “booster” infusion since her initial series—says “zero” of her costs were covered.

“But it was totally worth it,” she adds. “There’s really no words to describe how much better I feel.”