J. John Mann
Growing evidence shows the potential of ketamine for depression. Research has demonstrated that ketamine provides rapid relief from depressive symptoms and a significant reduction in suicidal ideation, and early this year the FDA approved esketamine nasal spray, combined with an oral antidepressant, for adults with treatment-resistant depression.
In late 2018, Columbia University department of psychiatry announced the Columbia Ketamine Program, which offers safe and comprehensive ketamine treatment for eligible adults with treatment-resistant depression at ColumbiaDoctors Midtown in New York City.
To learn more about the program, Healio Psychiatry spoke with J. John Mann, MD, Paul Janssen Professor of Translational Neuroscience (in psychiatry and in radiology) and director of the Columbia Ketamine Program, and Joshua A. Berman, MD, PhD, assistant professor of psychiatry at Columbia University Medical Center. – by Savannah Demko
Healio: When did the program begin?
Mann: The program began earlier this year. Intranasal ketamine has been approved by the FDA as an antidepressant for depression that has not responded to at least two other antidepressant medications. More data exist supporting the antidepressant efficacy of IV ketamine including from two controlled clinical trials conducted by Columbia researchers and funded by NIMH.
Healio: What does the program offer patients?
Mann: Our program offers a review by an expert psychiatrist to see if the patient is likely to benefit from ketamine treatment. A psychiatrist then monitors the patient throughout the ketamine treatment program to optimize the match between response of depression and the schedule of ketamine treatments. The psychiatrist also optimizes the other medications that the patient is receiving for their depression.
Healio: How is the program doing currently? How many patients are currently being treated?
Berman: We are off and running, seeing several new patients present for evaluations each week, and are treating six to eight patients per week who are in various stages of treatment (induction, taper, maintenance).
Infusion bay at ColumbiaDoctors Midtown in New York.
Source/Credit: Columbia University
Healio: Has the FDA approval of esketamine nasal spray affected the number of patients seeking ketamine infusions at Columbia?
Berman: The FDA approval of esketamine has definitely increased awareness of ketamine as an option for depression treatment.
Healio: Is Columbia Psychiatry currently conducting any ketamine-related research?
Mann: We are doing several funded studies in bipolar and unipolar depression.
Healio: What are the plans for the future of the program?
Mann: We expect to add other rapidly acting antidepressants as they become available.
Berman: We hope to learn more about how to integrate ketamine with other treatments and increase our understanding of how ketamine can be leveraged in patients’ overall treatment programs in order to produce long term recovery.
Healio: What advice would you offer to other institutions who may want to start a ketamine program?
Mann: Make sure psychiatrists determine the need for the treatment and monitor response and dosing plan.
Berman: Take a comprehensive approach to the evaluation and treatment of patients. We are not just here to deliver ketamine. Pay attention to safety, quality, patient experience, logistics and collaboration with each patient’s treatment team.
Columbia Ketamine Program. https://www.columbiadoctors.org/specialties/psychiatry-psychology/our-services/ketamine-program.
Columbia Psychiatry Launches Its Next Generation Brain Therapeutics Program with Ketamine Treatment. https://www.columbiapsychiatry.org/news/columbia-psychiatry-launches-its-next-generation-brain-therapeutics-program-ketamine-treatment. Accessed on April 29, 2019.
Disclosure: Mann reports two NIH grants and one Brain & Behavior Research Foundation grant to fund work related to ketamine. Healio Psychiatry was unable to confirm any relevant financial disclosures for Berman at the time of publication.
Editor's Note: This article was updated on May 2.