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Esketamine and Ketamine Therapy

When traditional psychotherapies and medications for major depression and mood disorders have not worked, Yale New Haven Psychiatric Hospital (YNHPH) offers treatment options and hope to patients and their families.

In collaboration with the renowned Yale Department of Psychiatry, YNHPH is one of the few sites in Connecticut that offers esketamine treatment and ketamine infusion therapy. Treatments are administered by our highly experienced physicians and staff in a safe, monitored environment.

Esketamine / Spravato®

Esketamine, under the brand name Spravato®, is a prescription nasal spray approved by the U.S. Food and Drug Administration to treat adults with treatment-resistant depression (TRD) or major depressive disorder (MDD) with suicidal thoughts or actions.

A derivative of ketamine, this medicine is thought to target parts of the brain related to mood and behavior. Most patients start to feel improvement of their symptoms rapidly during the course of esketamine treatment. 

Esketamine must be administered in a clinical setting under the supervision of a certified healthcare provider. Patients are monitored for at least two hours for possible side effects, such as dissociations, feeling disconnected from reality, and increased blood pressure. Side effects usually wear off the same day.

Patients should not drive on the day they receive esketamine treatment. Most patients can return to their normal activities the day after treatment.

Esketamine is taken twice a week for the first month, then once a week during the second month for people with a good response to the treatment. After the second month, treatment will vary, based on how the individual patient has responded to initial treatment. Typically, a patient will receive esketamine as part of a treatment plan that also includes an oral antidepressant medication.

Ketamine Infusion Therapy

In the late-1990s, researchers at the Yale Department of Psychiatry were the first to discover that the drug ketamine, which is primarily used to induce and maintain anesthesia, provided rapid relief to some chronically depressed patients who did not respond to traditional medications or treatments. Although research continues to show benefit, ketamine infusion therapy is not approved by the FDA for depression.

However, YNHPH is able to provide ketamine infusion treatment under strict clinical protocols. Prospective patients receive a comprehensive evaluation by a Yale interventional psychiatrist and must be cleared to receive this treatment.

Given through an IV, ketamine works quickly to dramatically improve mood and symptoms of depression. Each infusion treatment lasts about 40 minutes. Patients experience a dream-like state that starts quickly and takes about 15 to 20 minutes to wear off after the drip ends. The most common, temporary side effects can include mild dissociations, floating sensation, blurred vision, and dizziness. One of our interventional psychiatrists is always on site during the entire session to monitor the patient.

Typically, a series of eight ketamine IV treatments are given over four weeks. Some patients experience significant relief from depressive symptoms as early as after the first infusion. Most patients feel relief from depression within eight treatments.

Patients should not drive on the day they receive ketamine treatment. Most patients can return to their normal activities the day after treatment

New patient inquiries and referrals

A referral from a psychiatrist or psychiatric APRN is required, and the patient must undergo an evaluation by one of our interventional psychiatrists. IPS staff work collaboratively with the referring provider.

For more information, please complete the Request for Information form. A patient navigator from Interventional Psychiatry Services will contact you to review the referral and intake process.

Treatments through IPS, including esketamine (Spravato) are usually reimbursed by Medicare, Medicaid, and covered by most commercial insurance. Currently, IV ketamine infusion treatment is only covered by a limited number of insurance providers, and is not covered by Medicare or Medicaid.