IV and IM Ketamine

In addition to FDA Approved Spravato, or intranasal esketamine treatment, MBS also offers intravenous (IV) and intramuscular (IM) racemic ketamine treatments. There are a few differences worth understanding.  Racemic IV/IM ketamine treatments for depression have been around longer.  Although similar doses of ketamine are administered during a Spravato Treatment, IV/IM ketamine has a higher bioavailability and thus generally produces more profound effects including dissociation.  Unfortunately, due to IV/IM ketamine treatments NOT being FDA approved they are also not covered by insurance companies as mental health procedures.

Similar to Spravato Esketmaine treatments IV/IM ketamine interventions have published data for efficacy treatment resistant depression.  Data for anxiety treatment with IV/IM ketamine is not as positive but does show promise for some patients. There is also data suggesting benefit for depression in bipolar patients, however there is a real associated increased risk of inducing manic symptoms during treatment.

An important thing to consider is that many patients will need maintenance treatments for sustained efficacy with all ketamene treatments.  Due to expense, need for observation in clinic during treatments, and the need for rides to appointments, alternative treatments should be considered first. These include FDA approved medication, psychotherapy and exercise programs.  Also, most patients will require more than 4 treatments for substantial benefit.

If IV/IM ketamine is something you are considering the first step would be an evaluation to review history and discuss treatment options in an appointment. Additional questions can also be answered by staff prior to scheduling an evaluation for treatment.

Having helped start the Spravato Clinic at Loyola University Medical center during residency, Dr. Brown has been gaining experience with ketamine treatments since 2019.  Dr. Brown also completed advanced certification post residency with the Integrative Psychiatry Institute for competency in IV/IM ketamine treatments.