Developing an IV Ketamine Clinic for Treatment-Resistant Depression: a Primer

Sagar V. Parikh, Daniela Lopez, Jennifer L. Vande Voort, Jose Rico, Eric Achtyes, William Coryell, Andrew Goddard, Fernando Goes, John F. Greden, Balwinder Singh, Adam Kaplin, Mark A. Frye, Daniel Maixner, Brendon Watson, Karina Drake, Vijay Tarnal, Patricio Riva-Posse, William V. Bobo, Study Team Bio-K Study Team

Research output: Contribution to journalReview articlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)109-124
Number of pages16
JournalPsychopharmacology bulletin
Issue number3
StatePublished - Jun 1 2021


  • antidepressant agents
  • depressive disorder
  • drug therapy
  • intravenous
  • ketamine

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)


Dive into the research topics of 'Developing an IV Ketamine Clinic for Treatment-Resistant Depression: a Primer'. Together they form a unique fingerprint.

Cite this