Mclean Hospital

Ketamine Service


The Ketamine Service at McLean Hospital offers specialized treatment to adults suffering from depression, especially major depressive disorder and bipolar disorder. Although it has been used for years as an anesthetic, ketamine has been shown to be a highly effective treatment for severe depression, particularly for those who have not been helped by standard treatments. In addition, those who are experiencing symptoms that are threatening their health or safety may be good candidates for ketamine, which can often work more quickly than other treatments.

For more information or to make a referral, please call 617.855.2355.

We offer ketamine therapy as an outpatient or inpatient service. Ketamine infusions are delivered via IV, and patients remain awake during the treatment, which takes about 40 minutes. Many individuals opt to read, listen to music, or just relax, though napping is also an option. Patients are monitored before, during, and after the treatment.

Patients meet with both an anesthesiologist and a psychiatrist at each infusion. The presence of dedicated psychiatrists and anesthesiologists together ensures that the treatment is administered in the safest setting possible. Our dedicated nursing staff have both medical and psychiatric training and are uniquely equipped to assist our unique patient population. The Ketamine Service works alongside McLean’s Electroconvulsive Therapy (ECT) and Transcranial Magnetic Stimulation (TMS) Services, and patient treatment plans are customized to meet the needs of the individuals and may include the options for any of these interventions.

McLean’s Ketamine Service, located within the ECT/TMS suite in the de Marneffe Building on McLean’s Belmont campus, is a data-driven, evidence-based service that applies available cutting-edge research to clinical practice. Although the service uses ketamine in a nontraditional manner, ketamine infusions are increasingly used in clinics throughout the US, and personalized treatments are based on thorough, scientific evaluations and administered following the highest standards of safety.

Treatment Approach

Ketamine has been shown to be an effective intervention for severe depression, with or without anxiety, particularly for individuals who have struggled with standard therapies. In recent years, research efforts and reports from ketamine clinics have demonstrated success in using the drug to quickly and effectively address severe depression.

At McLean, ketamine is used to help depressed individuals who have not responded to at least two courses of medications most often prescribed for depression, or are suffering from acute suicidal thoughts or behaviors and urgently require a fast-acting intervention. Ketamine therapy may also be used, in consultation with a patient’s prescribing psychiatrist, to assist patients who must discontinue medications and remain off these medications for an extended period—a so-called “wash-out” process—in preparation for starting a medication from a different class of drugs. In these cases, ketamine therapy is referred to as a “ketamine bridge.”

Staff at McLeanPatient consultations determine whether ketamine infusions, electroconvulsive therapy (ECT), or transcranial magnetic stimulation (TMS) is the appropriate course of treatment for the patient’s psychiatric symptoms, diagnoses, and treatment goals. If a thorough evaluation indicates that ketamine is the right approach, an appointment is made with the service for a ketamine infusion.

Depending on individual goals, patients coming to the Ketamine Service may receive a single infusion of ketamine, engage in a course of 2-3 infusions (a so-called “ketamine challenge”), or take part in a series of 8 infusions (“acute phase”), with subsequent treatment tapered according to individual need.

At an infusion appointment, the patient arrives at the service and meets with a specialized nurse who updates the patient’s history. The patient also fills out a self-report form. Two doctors meet with the patient to review medical history, discuss the infusion, and insert a small IV. Safety checks are administered, and the infusion process begins. The patient remains fully clothed while an IV delivers a precise infusion of ketamine, which lasts approximately 40 minutes. During this time, most patients remain fully awake and many choose to do a relaxing activity like listening to music or reading. A nurse stays with the patient during the infusion. When the infusion is complete, the patient is monitored for a period, and the doctor re-evaluates the patient before the patient is allowed to leave.

Treatment Team

Program Leadership

Robert C. Meisner, MDRobert C. Meisner, MD, Medical Director

Dr. Meisner is also an attending psychiatrist in the Acute Psychiatric Service at Massachusetts General Hospital. He graduated from Princeton University, attended Harvard Medical School, and served as a resident in internal medicine and in anesthesia, critical care, and pain medicine prior to training in psychiatry. Dr. Meisner has previously held many roles at Harvard College, including as acting residential dean at Currier House, and he continues to consult at the college.


Stephen J. Seiner, MDStephen J. Seiner, MD, Medical Director, Electroconvulsive Therapy (ECT) Service

Dr. Seiner serves as director of McLean’s Psychiatric Neurotherapeutics Program, which includes ketamine, electroconvulsive therapy, and transcranial magnetic stimulation. He is also the director of Medical Student Education at McLean Hospital and an assistant professor of psychiatry at Harvard Medical School.


Paula Bolton, MS, APRN-BCPaula Bolton, MS, APRN-BC, Program Director

A nurse practitioner in the Internal Medicine Department at McLean Hospital for more than 25 years, Ms. Bolton has focused on health promotion and disease prevention for psychiatric patients. She was instrumental in both the expansion of the inpatient and outpatient Electroconvulsive Therapy (ECT) Service and the development of the Transcranial Magnetic Stimulation (TMS) Service.
 

Staff & Associates

Our multidisciplinary team of clinicians and support staff includes doctors and nurses with extensive training and experience in both psychiatry and anesthesiology. Working in close partnership with patients and families, we provide high-quality care tailored to each individual’s needs.

This well-trained team has an extensive background in the treatment of severe depression and related conditions. Our staff has experience working with patients from diverse cultural and socioeconomic backgrounds from across the country and around the world.

Admission & Cost

Admission

McLean’s Ketamine Service provides treatment to adults with depression, with or without accompanying anxiety or other symptoms, especially patients with major depressive disorder or bipolar disorder. The program is ideal for individuals who have previously struggled with standard therapies or who are at risk to themselves or others and require urgent intervention.

For more information about our program or to make a referral, please contact our administrative staff:

Phone: 617.855.2355

Cost

Generally, consultations are covered by insurance. Most insurance companies do not cover ketamine infusions. However, some McLean patients have had success in securing reimbursement. The out-of-pocket cost for each infusion is $800.

For patients who choose to seek reimbursement for ketamine treatment from their insurance providers, McLean can assist by providing requested documentation.

McLean Hospital accepts Medicare, Massachusetts Medicaid, and many private insurance and managed care plans. More information on insurance providers accepted by McLean Hospital may be found on the Partners HealthCare website. You may also find it beneficial to review McLean’s patient billing and financial assistance information.

FAQ

Where is the Ketamine Service located?

The program is located on the Belmont campus, in the de Marneffe Building. For more information on directions, parking, and local accommodations, please visit our Maps & Directions page.

Who benefits most from ketamine treatment?

Ketamine therapy is an outpatient or inpatient service that focuses on treating individuals suffering from severe depression who are not responding to standard treatments. In addition, those who are experiencing severe symptoms of depression or other mental illness that are threatening their health or safety may be good candidates for ketamine, which can often work more quickly than other treatments.

Is family involved in treatment?

Family can be involved in the consultation for ketamine and are welcome in the suite. Family members are invited to join meetings with the doctor after each treatment to review the treatment plan.

Is smoking permitted?

Smoking is allowed in designated outdoor areas only. No smoking is allowed inside any of our buildings.

Are cell phones and other electronics allowed?

Cell phones are allowed in the suite, but the cell signal is poor. There is a cordless phone in the recovery room, or staff can place a call. Additionally, we are just below the cafeteria—which does get a better signal—and family members who want to wait there can take a pager from the suite and will be paged when the treatment is complete.

Can former patients access their medical records?

All requests for medical records should be directed to McLean’s Health Information Management Department.

Are support groups offered?

To complement our programs’ services and encourage individuals’ initiatives in their own treatment course, many self-help groups are hosted by McLean.