For referring clinicians
Written for psychiatrists, psychiatric nurse practitioners, pain physicians and primary care physicians considering referral.
What we do
Sub-anesthetic intravenous ketamine for treatment-resistant mood conditions and chronic neuropathic pain. Dosing targets a modeled serum concentration rather than fixed weight-based dosing; patients undergo metabolic and, where indicated, pharmacogenomic assessment before treatment; infusions are physician-administered with continuous monitoring, one patient at a time.
What we ask of you
- Retain prescribing and ongoing psychiatric management. We do not take over medication management and we do not want to
- Send records and recent labs. We will not treat without them
- Tell us what you have already tried and what happened
- For a patient with active suicidal ideation, tell us that directly. We do treat these patients, but only on your recommendation and in ongoing co-management with you
What you get back
- A written assessment before treatment, including our view on candidacy — which is sometimes negative
- Serial symptom scores at defined intervals, sent to you
- A note after each course, and notification of any adverse event
What the evidence supports, and what it does not
We think it is worth being direct with colleagues about where the literature actually sits. The acute antidepressant effect of ketamine is well replicated. Durability, optimal maintenance strategy, real-world effectiveness outside trial conditions, and the adequacy of blinding in the trial literature are all genuinely unsettled.
Our own outcome data is a single-site retrospective case series presented at meetings, not peer-reviewed work, and we describe it that way. We would rather you referred with an accurate picture than an enthusiastic one.
Our outcome data, with its limitations → · Our full contraindication list →
To discuss a patient
Call 800-850-6979. Dr. Grass will speak with you personally about a patient before referral.
Related pages
The RESTORE Method · Conditions We Treat · Safety, Risks and Limits · Our Results · Fees
