I was inspired to write this blog post by the third patient in three days to contact me about Ketamine infusions.
She wanted to know if I could provide her with Ketamine infusions for her treatment resistant depression.
Ketamine infusions are one of the treatments for depression that we provide access to for our patients. Among the other treatments are access to transcranial magnetic stimulation, evidence-based psychotherapy, mindfulness meditation, nutritional assessment and support, genetic testing to predict medication response, etc.
The focus of our clinic is trying to provide access to all of the evidence-based treatments for depression and bipolar and to try to integrate the treatment of these conditions across the broad spectrum of options available to help our patients navigate an increasingly complicated and confusing array of choices.
But as with pharmacotherapy for depression, we’re not the least expensive way to access any given treatment modality. Our initial consultation is comprehensive and tries to identify the best treatment option for each individual patient based on thorough review of their history.
Many of our patients are really pleased with this assessment, but of course if you know exactly what it is that you need it will seem excessive.
If you know what you need for the treatment of your depression then we’re probably not the right place for you to go to get help.
Over the years people have wondered why it is that we continue to this initial assessment.
The reason is that, we have never been able to identify who it is who will benefit from this kind of in-depth assessment and who will not.
About eight years ago we decided to provide some of our patients who really were feeling that this was overkill with an abbreviated initial assessment in order to get them into treatment more rapidly.
What we found out was that about half of all of these patients who said they didn’t need a more comprehensive assessment ended up needing one and the result was that, in those fifty percent, effective treatment was delayed by weeks or months. This didn’t seem like a good way to save money given the cost of futile care.
Back to my initial point. If you know that you need Ketamine infusion, or you know you need TMS, or you know you need a Prozac refill, we’re probably not the right place for you. But if you have a treatment resistant depression and you’d like to consult with experts on what would likely be the most effective treatment for you given your past history and given our experience working with our patients using all of these different modalities, get in touch with us for an initial consultation.
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