At Madrona Clinics, we specialize in safe and effective ketamine treatments as part of our comprehensive, multi-modal care plans. We offer the full spectrum of modalities, including IV/IM Ketamine, Intranasal Ketamine, Ketamine-Assisted Psychotherapy (KAP), and Esketamine (Spravato). These rapid-acting treatments are breakthrough options for treatment-resistant depression. Our compassionate, evidence-based protocols are tailored to your unique needs, offering renewed hope and a chance for lasting, transformative healing.

IV/IM Ketamine

IV and IM Ketamine are safe and effective off-label treatments for severe or treatment-resistant depression, offering a powerful option for patients who haven’t responded to traditional care.

Both Intravenous (IV) infusion and Intramuscular (IM) injection provide a rapid-acting delivery of the medication. The effects of the treatment begin quickly, and the total time in the clinic is generally 90 to 120 minutes.

Beyond depression, these treatments are also supported by evidence for managing anxiety disorders, PTSD symptoms, and CRPS (Complex Regional Pain Syndrome).

Intranasal Ketamine

Intranasal Ketamine (Compounded) is an off-label treatment proven to be a safe and effective option for severe or treatment-resistant depressive symptoms. This compounded formulation offers a convenient, non-invasive treatment route. It has a slightly slower onset and a longer duration of acute effects compared to IV/IM administration.

There is also supportive evidence for its use in treating anxiety disorders and PTSD symptoms. The total time spent in the clinic for treatment and monitoring is typically 120 minutes.

Esketamine

Esketamine (Spravato), the S-enantiomer of ketamine, is an FDA-approved nasal spray utilized for two specific adult indications: treatment-resistant depression and the acute management of depressive symptoms associated with major depressive disorder with suicidal ideation or behavior.

Insurance coverage is frequently available provided there has been documentation of inadequate response to prior antidepressant medication trials. Patients should plan for a total treatment time in the clinic of approximately 120 minutes for administration and required monitoring.

Q & A

How does ketamine work?

Ketamine targets the brain’s glutamate system, promoting synaptic connections and enhancing neuroplasticity. This mechanism differs from traditional antidepressants, which typically take weeks to show effects by targeting serotonin, norepinephrine, or dopamine systems.

How many treatments will I need?

For IV & IM Ketamine, treatments will occur twice per week for a total of six treatments, followed by maintenance treatments which vary in frequency based on your unique needs. For other routes of administration, of both ketamine or esketamine (Spravato), treatments will occur twice per week for a total of eight treatments, followed by a weekly treatment for a total of 4 treatments, then maintenance treatments which vary in frequency based on your unique needs.

What are ketamine’s benefits?

Rapid Relief: Potential for rapid symptom alleviation, sometimes within hours, but often after the first few sessions.

Effective for Treatment-Resistant Conditions: Helps those who haven’t responded to other treatments or only had mild improvement.

Enhances Neuroplasticity: A multiplicity of evidence support neuroplasticity induction by ketamine- which can be leveraged with adjunctive therapies, such as psychotherapy or TMS.

Improves Quality of Life: Facilitates a return to meaningful daily activities and overall well-being.

Will I also need therapy & medications?

At Madrona Clinics, we recommend most treatments be integrated into a comprehensive, multi-modal treatment plan. Holistic care can offer synergistic benefits. Historically, for Esketamine to be covered by insurance, it had to be delivered in conjunction with an antidepressant medication, but this is no longer the case for most insurance companies. IV and Intranasal Ketamine are not covered by insurance and do not require the concurrent use of antidepressant medication.

Does Madrona Clinics offer ketamine-assisted psychotherapy (KAP)?

We offer evidence-based KAP, informed by our expertise in psychedelic-assisted therapies, work with non-ordinary states of consciousness (NOSC), and the most up to date neurobiology. Please visit Psychotherapy Services page to learn more.

What are the safety considerations & adverse effects?

Ketamine is a safe and effective treatment when administered in a controlled environment, under medical supervision and with appropriate screening and monitoring.

Potential side effects may include:

Dizziness
Nausea
Transient changes in blood pressure
Increased heart rate
Temporary dissociation or altered perception

Our team ensures a thorough screening for medical contraindications has taken place before initiation of treatment. Sometimes this involves discussion with your primary care provider or specialist, such as a cardiologist. We also ensure all treatments are conducted safely, with protocols in place to manage any side effects.