Intravenous (IV) Ketamine Therapy
In 2015, after moving to San Diego, we (Drs. Jessica and Jake Hollingsworth) helped pioneer the use of IV ketamine therapy for depression. We began this work because we saw so many patients continuing to suffer from depression and/or medication side effects, for months and years. We thought then, and have continued to see since, that much of that suffering was unnecessary.
We have administered nearly 5000 IV ketamine infusions as of summer 2020, and have repeatedly seen patients’ symptoms rapidly improve with the use of ketamine after other treatment modalities failed to bring relief. We have also confirmed a lack of ongoing side effects when following our protocols.
Ketamine can be an alternative to psychiatric medications, or be used to minimize or simplify medication regimens. Based on each patient’s history and current issues, our recommendations are focused on providing appropriate options for the patient’s consideration. We also recognize that psychoactive medications are not “set and forget.” Follow up and monitoring are critical.
The patient’s experience with an intravenous medication used in psychiatry relies not only on the chemical composition of the compound, but also is affected by the experience and skill of the clinician administering it. One of the reasons that we began using IV ketamine was that, as a board-certified anesthesiologist (Dr. Jessica) and psychiatrist (Dr. Jake), respectively, we knew that we could do so safely and effectively.
Dr. Jessica developed the protocols that we use to deliver ketamine treatment in the safest and most effective way. With diverse experience (she began her career as a nurse), and a caring presence, she administers ketamine infusions for depression and other psychiatric conditions if/as appropriate.
Dr. Jake ensures that only appropriate patients receive this treatment, at optimal intervals in our office.
A recent landmark study, published in the American Journal of Psychiatry, discusses IV ketamine infusion protocols for treatment-resistant depression.
The cited research was the first study to specifically test maintenance protocols. This study supports the protocols that Pacific Psych uses. We also monitor new research as it is published, or presented, to ensure treatment that is evidence-based and safe.
Psychiatric Consultation Fee
*Directly billable to insurance
Assessments last approximately 1 hour
$450 each, without prepayment discount
Infusions last approximately 1.5 hours
Ketamine infusions are not eligible for insurance reimbursement because ketamine, a generic drug, has not been submitted for FDA approval to treat depression. Therefore, ketamine is considered investigational and experimental by most insurance plans. If it is not possible for you to consider a non-reimbursable treatment, you may wish to consider a nasal spray, Spravato™ (esketamine), which is FDA-approved for treatment-resistant depression, and that is a “cousin” to ketamine. Let us know if you would like to discuss these and other alternatives.
To ensure that IV ketamine is a safe and appropriate treatment for you, we administer a one-hour evaluation for all new IV ketamine patients, and the fee for this service is $250. The consultation appointment can be done via telepsychiatry. Please contact our office for details.
If we are “in network” with your insurance plan, the fee for the consultation evaluation can be billed directly to the insurance company. For these patients, co-payments, co-insurance, and deductibles apply.
If you have insurance but we are out of network, we can provide a “superbill” that you can submit to your insurer; however, the full payment for the consultation/office visit will be required at time of service.
For patients that do not have insurance that we accept, and for patients that choose not to use their insurance for whatever reason, the full fee will be collected on each day of service.
Intravenous (IV) Ketamine Infusions for depression or other psychiatric indications are $450 per treatment.
Initial ketamine therapy consists of 12 IV infusions over the course of 10 weeks, split into two phases. The details of this protocol are discussed in detail during the initial evaluation. Infusion appointments generally take an hour and a half. If the symptoms are successfully controlled with these initial treatments, then follow-up evaluations will be conducted to determine long-term treatment plans.
Maintenance treatments usually consist of one infusion every 2-5 weeks.
Maintenance pricing is for patients who complete six infusions at our clinic, and then return for ongoing ketamine treatments within six weeks from their last treatment for subsequent treatments. If more than six weeks elapses between infusions, maintenance pricing will not apply to the next infusion, but can be reinstated. Maintenance treatments are discounted by $100.
For patients that have not had a ketamine infusion or a psychiatric evaluation at our clinic for over four months, a 20-minute psychiatric evaluation is required prior to the next ketamine infusion. For patients that have not had an infusion or a psychiatric evaluation at our clinic for over a year, an hour-long psychiatric evaluation is required prior to the next ketamine infusion. Follow-up psychiatric evaluations are not required if you have infusions with less than four months between treatments. Fees for these visits, for returning patients looking to resume ketamine treatments, are waived.
For questions, please contact our office. We would be happy to explain pricing, infusion scheduling, and other details.