Following a protocol of twice weekly for the first four weeks, once weekly for the next four weeks, followed by either once weekly or every other week for at least 30 months.
About 46-52% of tr-MDD patients achieve remission of symptoms after ten doses.(1,2) Esketamine treatment also decreases the risk of relapse by about 51%.(3)
Patients are typically supervised for 2 hours after self-administering the medication to monitor for sedation, dizziness, dissociation reactions, and increased blood pressure. Patients will need to be driven home from the clinic after each treatment.(4)
Insurance authorization takes 2 to 7 days. For approval, patients must have failed four meds with a trial of 8 weeks or intolerable side effects in two or more medication classes and at least six weeks of psychotherapy.
IV Ketamine is not FDA-cleared. It's an out-of-pocket treatment and will not be covered by insurance. For this reason, we recommend an Esketamine trial before an IV Ketamine Trial. IV Ketamine may be more likely to produce a response within 24-hrs in comparison to Esketamine, but long-term remission rates seem to favor Esketamine.
Following a protocol of 2 times a week for four weeks, then once weekly for the next 2 weeks.(5) You will be in the clinic for about 1 hour per treatment.
Depending on the protocol used, about 72% of tr-MDD patients show a rapid response, and 38% achieve remission of symptoms after 10 doses.(6) About 40% of patients relapse without continued maintenance dosing. If given once weekly maintenance dosing, then about 90% of patients continue their remission.(7)
If Ketamine is effective, then we can talk about potentially transitioning to Ketamin Lozenges dosed once a week at home for maintenance.
Phone: (206) 467-6300
Email: [email protected]