Going Rogue: The Ethics of Running a Ketamine Clinic

The discovery of ketamine for depression is absolutely the biggest breakthrough we’ve seen in depression treatment in over 50 years. Since the early part of the century, study after study has demonstrated ketamine’s substantial rapid-acting effect in reducing depressive symptoms. Not surprisingly, the media have taken notice:Time Magazine, Scientific American, Business Insider, Forbes, Psychology Today, and National Public Radio are only a few of the media outlets that have reported on the use of ketamine for depression and the advancements that have been made as a result of ongoing research. It seems that, every day, there is a new discovery about how ketamine works to treat depression…

Along with the discovery of ketamine for depression came the consequent development of an entirely new medical industry: ketamine clinics. Ketamine clinics have sprung up in every corner of the country, providing off-label ketamine treatments to those suffering from severe cases of treatment-resistant depression, anxiety, PTSD and other psychiatric conditions. Making ketamine available off-label has undoubtedly saved many lives—we’ve seen hundreds of patients go from the darkest depths of depression to living rich and fulfilling lives. However, the question arises: has ketamine for depression gotten out of control?

We came across a thought-provoking article by Megan Thielking in Scientific American, ‘Is the Ketamine Boom Getting Out of Hand?’ that highlights some major concerns about the integrity of some ketamine clinics. High-pressure sales tactics, astronomical prices, questionable or unqualified leadership, failure to properly screen patients, far-fetched or exaggerated claims about what patients can expect from ketamine treatments…

…and the list goes on.

Back in 2016, we opened Vitalitas Denver to fill a gap in mental healthcare. Our mission was simply to bring hope to those suffering from depression. Considering the overhead costs associated with hiring highly experienced anesthesiologists and purchasing state-of-the-art monitoring equipment, we kept our prices as low as possible—the lowest in the country, actually—with the hope that ketamine infusions would be more accessible to more people. Since we opened our doors, we have performed thousands of infusions and helped hundreds of patients reclaim their lives.

However, we advocate for selectivity in deciding who is and who is not a good candidate for this therapy. Ketamine is not a panacea, and it is not without risks.  Ketamine clinics should collaborate closely with the patient’s entire extended care team, from primary care physicians to mental healthcare providers. We offer a therapist-led support group for our patients, as a multi-modal approach to depression treatment is almost always more effective that just ketamine infusions alone.  We hope other clinics will consider offering similar support groups.  Furthermore, we fiercely advocate for complete transparency in informing our patients about what we do, why we do it, and every molecule of every drug we give them.

We believe that ketamine can save lives. How can we not offer ketamine infusions when they have the ability to prevent suicide, give a wife her husband back, a daughter her mother back? There are many ethical ketamine clinics practicing high quality medicine, wanting to bring hope to those who have none. The optimist in us believes that most ketamine clinics have rightly-ordered priorities. As the Scientific American piece illustrates, however, several clinics are operating in a gray area of business ethics and a troubling area of medical ethics. Ketamine is highly effective, but we should resist the temptation to let our practices run ahead of the science or at odds with our ethical obligations as physicians.

Contact Vitalitas Denver

Vitalitas Denver is one of the country’s most highly-rated ketamine clinics. We are happy to answer your questions about ketamine for depression, and help you determine if you or a loved one is a candidate. Depression is a complex and nuanced condition, and there is no one-sized-fits-all solution. Ask us your questions today, and we’ll help point you in the right direction…whatever that direction may be.

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