How to implement a ketamine clinic

Abstract Recent research on ketamine’s rapid antidepressant effect has been generating a growing interest on the best way to provide ketamine as a treatment option for resistant depression. However, the individual experiences of a mental health worker that aims to initiate a ketamine clinic can vary widely depending on the clinical setting. This chapter describes the process of developing a subanesthetic intravenous ketamine infusion service, combining the experiences of both academic and community public hospitals. We outline practical issues of setting up the service, funding, staffing, physical environment, protocols for patient assessment, responding to adverse events, and monitoring of outcomes. Establishing successful collaborative links between different healthcare departments such as nursing, anesthesiology, psychiatry, and hospital administration is discussed as being integral to the straightforward launching of a ketamine clinic. In addition, prompt dissemination of results and protocols, as well as sharing of data from each clinic would allow for similar services at other institutions to open. This would allow for the overall increased delivery of support for patients with depression. The protocols and processes included in this chapter should be continually adjusted and optimized depending on future research of ketamine, to practice the safest methods possible.