Ketamine IV · Rapid-acting · Monitored
When there is no time to wait four weeks.
Given slowly at a sub-anaesthetic dose under continuous medical monitoring, intravenous ketamine can lift severe depression and, crucially, suicidal thinking within hours rather than weeks. It is not a recreational experience and not a first-line antidepressant: it is a rapid-acting rescue and bridging treatment for patients who have not responded to standard medication, or who are too unwell to wait for one to work.
Neuromodulation Suite · Bhavnagar
Forty minutes in a quiet room, with blood pressure, pulse and oxygen watched throughout.
How it works
The science, without the mystery.
A different receptor altogether
Standard antidepressants act on serotonin and noradrenaline. Ketamine blocks the NMDA glutamate receptor, setting off a surge of synaptic growth signalling that conventional drugs reach only indirectly and far more slowly.
Synapses regrow within hours
Chronic stress and depression thin out prefrontal synaptic connections. Ketamine rapidly promotes their regrowth, which is why mood and hopelessness can shift the same day.
Specific action on suicidal thinking
The anti-suicidal effect appears earlier and somewhat independently of the antidepressant effect — making it valuable exactly when risk is highest and time is shortest.
Who it is for
Where this treatment genuinely helps.
Who we offer it to
- Treatment-resistant depression after two or more adequate medication trials
- Acute, active suicidal ideation needing a response in hours, not weeks
- Severe depression where mBPT is refused or medically unsuitable
- Bipolar depression not responding to mood stabilisers, with cover in place
- Severe PTSD and refractory obsessive symptoms, in selected cases
How we keep it safe
- Sub-anaesthetic dose calculated by body weight, infused slowly over ~40 minutes
- Continuous blood pressure, pulse, ECG and oxygen saturation monitoring
- A doctor present in the room for the entire infusion
- A quiet, dimly lit setting with a trained nurse and an escort home
- Nothing to eat for four hours beforehand; no driving for 24 hours
- Antidepressants, therapy and follow-up continue alongside — never instead
What a course looks like
Step by step, start to finish.
- 01
Screening
Psychiatric assessment, blood pressure and cardiac review, urine screen where relevant, and a clear explanation of the dissociative sensations you may experience. Written consent is taken.
- 02
The infusion
An IV cannula, then a slow 40-minute infusion. Many patients feel pleasantly detached, floaty or notice sounds and colours differently; this fades within 20–30 minutes of the infusion ending.
- 03
Induction series
Typically six infusions over two to three weeks, with mood and suicidality re-rated before each one. Non-responders after the first three are told honestly, and we change plan.
- 04
Maintenance and handover
Responders are transitioned onto oral medication, therapy and relapse-prevention work, with spaced booster infusions only where clearly needed.
Safety
Side-effects and limits, stated plainly.
Possible side-effects
- Dissociation — feeling floaty, detached or dreamlike during the infusion
- Rise in blood pressure and pulse while the drug is running
- Nausea, and occasionally vomiting, managed with pre-medication
- Blurred vision, dizziness and unsteadiness for an hour afterwards
- Headache and tiredness for the rest of the day
When we will not do it
- Uncontrolled hypertension, unstable angina or recent myocardial infarction
- Active psychosis or mania
- Raised intracranial pressure or untreated glaucoma
- Ongoing ketamine or other substance misuse
- Pregnancy, and significant uncorrected liver disease
Please read this
Ketamine is a controlled drug with genuine misuse potential. It should only ever be given in a monitored clinical setting with a defined protocol and a written exit plan — never by prescription for home use, and never as an open-ended series of infusions.
Frequently asked
What patients and families always ask.
Find out if you are a candidate.
A 30-minute eligibility consultation at Kalanala, Bhavnagar. Honest answers, written costs, no pressure.