TY - JOUR
T1 - Developing an IV Ketamine Clinic for Treatment-Resistant Depression
T2 - a Primer
AU - Parikh, Sagar V.
AU - Lopez, Daniela
AU - Vande Voort, Jennifer L.
AU - Rico, Jose
AU - Achtyes, Eric
AU - Coryell, William
AU - Goddard, Andrew
AU - Goes, Fernando
AU - Greden, John F.
AU - Singh, Balwinder
AU - Kaplin, Adam
AU - Frye, Mark A.
AU - Maixner, Daniel
AU - Watson, Brendon
AU - Drake, Karina
AU - Tarnal, Vijay
AU - Riva-Posse, Patricio
AU - Bobo, William V.
AU - Bio-K Study Team, Study Team
N1 - Publisher Copyright:
Copyright © 1964–2021 by MedWorks Media Inc, Los Angeles, CA All rights reserved. Printed in the United States.
PY - 2021/6/1
Y1 - 2021/6/1
N2 - The efficacy of subanesthetic intravenous ketamine for treatment resistant depression (TRD) has spurred a growth of clinics nationwide that provide this service. Ketamine is an FDA-approved drug as an anesthetic but remains unapproved for psychiatric indications, and this status raises a number of short- and long-term safety and efficacy concerns that need to be addressed when implementing and developing this type of clinic. Using a framework of systems, provider, and patient domains, we provide a review of the key challenges in providing ketamine infusions and suggest potential approaches. Under systems issues, we highlight broad stakeholder engagement involving cross-departmental and multidisciplinary considerations, business case development, and delineation of administrative standard operating procedures. In the provider domain, we highlight specific roles for different treatment team members as well as suggested training requirements. In the patient domain, we identify a variety of standard operating procedures involving initial patient assessment parameters, ketamine dosing and administration guidelines, and safety monitoring procedures. Together, this review provides key considerations for developing a ketamine clinic for depression, in an effort to meet the pressing demand for this novel treatment option while helping to ensure its safe implementation.
AB - The efficacy of subanesthetic intravenous ketamine for treatment resistant depression (TRD) has spurred a growth of clinics nationwide that provide this service. Ketamine is an FDA-approved drug as an anesthetic but remains unapproved for psychiatric indications, and this status raises a number of short- and long-term safety and efficacy concerns that need to be addressed when implementing and developing this type of clinic. Using a framework of systems, provider, and patient domains, we provide a review of the key challenges in providing ketamine infusions and suggest potential approaches. Under systems issues, we highlight broad stakeholder engagement involving cross-departmental and multidisciplinary considerations, business case development, and delineation of administrative standard operating procedures. In the provider domain, we highlight specific roles for different treatment team members as well as suggested training requirements. In the patient domain, we identify a variety of standard operating procedures involving initial patient assessment parameters, ketamine dosing and administration guidelines, and safety monitoring procedures. Together, this review provides key considerations for developing a ketamine clinic for depression, in an effort to meet the pressing demand for this novel treatment option while helping to ensure its safe implementation.
KW - antidepressant agents
KW - depressive disorder
KW - drug therapy
KW - intravenous
KW - ketamine
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M3 - Review article
C2 - 34421148
AN - SCOPUS:85114850277
SN - 0048-5764
VL - 51
SP - 109
EP - 124
JO - Psychopharmacology bulletin
JF - Psychopharmacology bulletin
IS - 3
ER -