Dr. Abraham Nunes (right) with Lisa Herritt, who received ketamine therapy at the QEII for the treatment-resistant depression she has been living with for more than 20 years.
Dr. Abraham Nunes is a QEII psychiatrist and lead of the ketamine therapy program. Since March 2023, the Mood Disorders Clinic at the QEII Health Sciences Centre has been providing ketamine therapy on a compassionate basis to one person every two weeks. Yet the need is far greater. With donor support, more people living with treatment-resistant depression can access this life-changing treatment.
What is ketamine therapy?
Ketamine therapy is a proven treatment for people living with treatment-resistant depression.
Ketamine infusion therapy involves administering ketamine through an IV in a safe, monitored clinical setting. A physician administers ketamine through an IV and the infusion takes between 40 and 60 minutes.
Is ketamine therapy safe?
In a supervised clinical setting, for patients who have been carefully assessed before starting, it is a very safe treatment. Ketamine is not a new treatment option. It has been established for quite some time as a rapid-acting antidepressant. The evidence is incontrovertible now that it works.
When a patient is taking part in the treatment, they are monitored for dependence on the drug, as well as for other potential side effects. Before they start treatment, they receive an assessment of their risk for addictions and other medical problems that might make ketamine treatment less safe.
In my role as ketamine therapy program lead, I have developed protocols, run all the related local research trials and work directly with patients receiving infusions.
What will donor funds make possible?
Donor funding will support two nurses: one for infusions and one for post-treatment recovery. It will also provide resources for space set up, including a treatment chair and equipment, as well as administrative support for patient booking and scheduling. These resources will enable me and my colleagues to expand the program, offering more treatment to patients in need. Our goal is to show ketamine’s efficacy over the next two years with the goal of securing long-term, sustainable funding to make ketamine therapy more accessible for every Nova Scotian who could benefit.
Until ketamine is more broadly available, private clinics are the only option for people who can afford it. Each infusion costs between approximately $500 and $650. Donor support will ensure mental health care is accessible and inclusive for patients.
How many people have been treated through the ketamine therapy program so far? What’s possible with donor support?
Since March 2023, we’ve treated 18 people on a compassionate basis through the Mood Disorders Clinic, and we’ve administered more than 100 treatments to these people. We treat about one patient every two weeks if the resources are available. With donor support, we should be able to treat eight patients each day.
How many people are living with treatment-resistant depression in Nova Scotia?
Between approximately 17,000 and 25,000 people, but that could be a low estimate as the population grows. It is very common for me to see people who have been depressed for more than 20 years and have tried dozens of different treatments that do not work for them.
In your experience, how is ketamine therapy making a difference in people’s lives?
One of the main factors that causes people a lot of suffering is essentially the hopelessness that things can never get better. The rapid relief brought about by ketamine treatments can often bring people some hope that indeed things can get better. That can inspire them to make other important changes in their lives to progress toward wellness.
Another thing that's particularly painful for people with depression, especially those who have kids, is that they feel like they should be enjoying their kids a lot more. It's painful for them that they don't have that feeling of enjoyment of anything. Ketamine has been shown to be effective for improving this feeling of lack of enjoyment, which we call anhedonia.
Some patients who we treat will say that 30 minutes into the infusion, they feel much lighter and everything lifts. You can see it in the way people move and the way they walk; they have a bit more spring in their step and a bit more life in their facial expressions. It's amazing.
How long do the effects of ketamine last?
The length of time people feel the benefits of treatment varies depending on the person. Some people relapse quickly and may need ongoing “booster” or “maintenance” treatments, whereas others may remain well for a longer amount of time. Fifty per cent of people will have a 50 per cent reduction in their depression severity level with one to three infusions.
The vast majority of the patients that I see say that they feel much better than they did before, because sometimes, even though you're not reducing all of their symptoms, you're reducing some symptoms that are really important to them.
Ketamine is quite good at reducing suicidality, in particular. This is important because treatment-resistant depression is the biggest risk factor for suicide. Depression is already a major risk factor for suicide, and treatment resistance multiplies that risk by approximately 10 times.
To learn more or donate, visit QE2Foundation.ca/ketamine.
