Ketamine clinic opens in Aspen with aim to fight severe depression
October 2, 2017
As ketamine continues to see an increase in acceptance by the medical community, two local doctors have opened a clinic at Aspen Valley Hospital to administer the drug to patients with severe depression and other conditions.
An anesthesiologist with privileges at local hospitals for more than two decades, Dr. Giora Hahn is well-versed in ketamine and the science behind it. He and Dr. Craig Bushong recently launched Aspen Comprehensive Health Interventions, the first ketamine-infusion clinic in the mid- to upper-Roaring Fork Valley.
"The one thing that started the process in my head was American Psychiatric Society released a report talking about what is happening with ketamine infusion, and that kind of started the wheels turning in my head," Hahn said during an interview at the clinic this week. "This is something I would be perfect at offering, being an anesthesiologist who has used ketamine."
The hospital, which is the leaseholder for the clinic, ultimately agreed. CEO David Ressler and Chief Medical Officer Dr. Eric Stahl said the proposal was vetted by physicians while the hospital's board of directors also was made aware of it.
"We understand that (ketamine) is demonstrating effective results, and we know there's a population in Aspen that it will help," Ressler said.
Stahl said "all of the physicians are in favor of this. And I think it's becoming more and more accepted. The FDA is fast-tracking this use to the general public because they've seen compelling evidence for its effectiveness."
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Ketamine was discovered in the 1960s and approved in the United States in 1970. It was used in the Vietnam War as an anesthetic for Americans soldiers injured in the battlefield. Also a hallucinogenic, the drug gained popularity in the club scene as a recreational drug in the 1990s, earning such street names as "Special K," "horse tranquilizer" and "cat Valium."
While it is not FDA-approved as an anti-depressant, ketamine is used in surgical anesthesia, through an IV, to put patients to sleep. But as a treatment for depression and anxiety, among other conditions including PTSD and OCD, it is considered an "off-label" use, meaning insurers won't cover the expenses associated with its administration.
Yet studies continue to trickle in giving the drug heightened credibility as a breakthrough medication to quickly, and safely, treat those with depression where other methods failed over time. One of the main drawbacks, however, is there is not enough data to show those findings to be conclusive.
"Several studies now provide evidence of ketamine hydrochloride's ability to produce rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant to treatment," according to an abstract of the studies offered in April by The Jama Newtwork. "Despite the relatively small sample sizes, lack of longer-term data on efficacy, and limited data on safety provided by these studies, they have led to increased use of ketamine as an off-label treatment for mood and other psychiatric disorders."
At the Aspen clinic, the IV treatment lasts about 40 minutes, with doses of ketamine significantly lower than in aesthesia, Hahn and Bushong said. Ideal candidates for the treatment are those who are suicidal and in need of quick results, or others who tried antidepressants that didn't achieve the desired results. Generally speaking, patients would go through four or six rounds of infusions with follow-up treatment.
"That's really the advantage of this IV therapy, and that's why it's come to a head," Hahn said. "It is unlike an antidepressant medication that might take two to three weeks before it hits your system. This medication will work within 20 to 30 minutes. It is short-acting, meaning it's in your system in about an hour or two and during that hour or two, it's actually fixing things that may have taken a significantly longer time" with other antidepressants.
He added, "The facts of the matter is, it's a very, very low dose of this drug that is infused over a long period of time and still is extremely effective."
Bushong has the clinic's role as the psychiatric evaluator and supervisor of the patients.
"I've always been involved in hard-to-treat cases" of depression, he said.
Hahn said, "Most of the doctors I have spoken to are very interested to see how this would be as an adjunct treatment for their patients. Everyone I've spoken to has been very upbeat and willing to do this."