IV Ketamine Therapy for Depression
IV Therapy for Depression
IV therapy is a physician-directed medical treatment that may be considered for adults living with certain depressive disorders, particularly when standard treatments have not provided sufficient benefit.
Ketamine has been authorized in Canada for use as an anesthetic for many years. Its use in depression involves lower, sub-anesthetic doses administered under medical supervision. While research is ongoing, clinical studies suggest that ketamine may reduce depressive symptoms in some individuals.
Who May Be Considered for Treatment
IV therapy may be considered for adults with:
- Major Depressive Disorder (MDD)
- Treatment-Resistant Depression (TRD) (inadequate response to at least two antidepressant trials)
- Bipolar depression (depressive phase only, with appropriate psychiatric oversight)
Treatment suitability is determined only after a comprehensive medical and psychiatric assessment.
IV therapy is not considered a first-line treatment for depression.
Regulatory Information
In Canada, ketamine is approved as an anesthetic medication. The use of IV therapy for depression is considered an off-label medical use, meaning it is prescribed based on clinical judgment and available scientific evidence but is not specifically authorized by Health Canada for this indication.
Patients will be informed of this status during the consent process.
How It Works
Ketamine acts on the brain’s glutamate system, which plays a role in mood regulation and neural connectivity. Research suggests it may promote changes in neural signaling associated with depressive symptoms.
Some patients report improvement within hours to days; however:
- Not all patients respond
- Response duration varies
- Ongoing evaluation is required
What to Expect
Initial Assessment
A physician will review:
- Mental health history
- Medical history
- Current medications
- Previous treatment trials
- Potential risks and contraindications
If appropriate, an individualized treatment plan will be developed.
Infusion Appointment
- IV therapy is administered intravenously over approximately 40 minutes
- Vital signs (blood pressure, heart rate, oxygen saturation) are monitored
- A qualified healthcare professional remains present
- Patients are observed after the infusion until medically stable
Patients must arrange transportation home and should not drive or operate machinery until the following day.
Treatment Course
A typical initial course may include multiple infusions over several weeks. The number and frequency of treatments are determined by clinical response and physician assessment.
Maintenance treatments, if considered, are individualized.
Potential Risks and Side Effects
When administered in a controlled medical setting, IV ketamine is generally well tolerated. However, risks may include:
Common, short-term effects:
- Temporary dissociation (altered perception)
- Dizziness
- Nausea
- Fatigue
- Elevated blood pressure
Less common but possible risks:
- Psychological distress during treatment
- Cardiovascular effects
- Potential for misuse or dependency with improper use
Long-term safety data for repeated use in depression are still evolving.
Ketamine may not be appropriate for individuals with:
- Uncontrolled hypertension
- Certain cardiovascular conditions
- Active psychosis
- Untreated substance use disorders
- Pregnancy
All risks, benefits, and alternatives are reviewed prior to treatment.
Coverage and Fees
IV ketamine therapy for depression is not covered by OHIP (Ontario Health Insurance Plan).
As this treatment is not publicly funded for this indication, services are typically provided on a private, fee-for-service basis. Patients are responsible for associated costs unless private insurance coverage applies.
Patients are encouraged to verify coverage with their individual insurer.
Important Information
IV therapy is not a cure for depression. It may reduce symptoms in some individuals, and results vary.
This treatment should be part of a comprehensive mental health care plan, which may include psychotherapy, medication management, and ongoing psychiatric follow-up.
If you are experiencing thoughts of self-harm or are in crisis, call 911 or attend your nearest emergency department immediately
