The process begins with a referral from your GP or Psychiatrist. Conditions which can be treated with ketamine are treatment resistant depression, and treatment resistant anxiety.
A psychiatric assessment will be conducted to determine suitability for treatment with ketamine. Other treatments may be suggested if they are considered more suitable.
Normally this initial consultation would be billed separately from the ketamine therapy, as some patients will not wish to proceed with treatment or will not be suitable for ketamine therapy.
Once suitability for treatment with ketamine or esketamine (Spravato) is determined, a titration appointment is offered.
At this appointment, the patient's blood pressure, pulse, and oxygen saturation are measured prior to treatment and half an hour after treatment is administerd. Side effects are monitored.
The day following the treatment typically a clinic nurse would be in touch regarding the patients response. It is common for patients to require further increases in dose; in the case of oral ketamine this can be done safely at home by small increments, however some patients may need further on-site titrations.
Spravato has a rapid titration protocol but cannot be administered at home.
Follow up appointments with the psychiatrist will determine appropriate dosing and frequency of dosing, based on response and side effects.
In between follow up appointments, a clinic nurse would be available to advise on management of home dosing (in the case of oral ketamine).
The pre-paid ketamine treatment package includes e-mail and phone contact for advice and is aimed at finding the lowest effective and tolerable dose of oral ketamine or spravato.
It is desirable to find this dose as early as possible in the course of treatment.