OBJECTIVES: This nationwide survey investigates the effectiveness of off-label use of ketamine for treatment-resistant depression (TRD) and other mental disorders from the perspective of providers and examines the current state of ketamine clinics, provider characteristics, and variations in treatment processes.

METHODS: The study employed a 47-item, self-constructed, psychometrically validated, and IRB-approved online survey. Convenience sampling techniques were used to distribute the surveys electronically to over 1000 ketamine providers nationwide, all members of two national psychiatric care organizations (ASKP3 & Osmind) and an online community of global ketamine providers (Big-Tent Ketamine). The survey questions tapped into clinic operational aspects, organizational factors, treatment processes, provider characteristics, guideline usage, financing, and patient outcomes.

RESULTS: 71 usable responses were obtained, and the data was utilized to assess key relationships among study variables and test previously formulated research hypotheses. The sample included physicians (44.12%), psychiatrists/psychologists (30.88%), RNs/NPs/LPNs/CRNAs (25%), and other clinical personnel (33.82%). Most clinics (89.71%) were standalone, treating conditions like TRD, PTSD, OCD, and SI. Ketamine types offered were IV (72%), IM (52%), and Sublingual (44.12%).Equal representation of male and female patients was observed (59.2%). The typical patient seen in clinics was a middle-aged adult (36-64 years old), mostly a white male. Patients typically experienced strong treatment effects after a single ketamine infusion, noting symptom reduction in hours (25.00%), about a day (17.31%), 24-48 hours (21.15%), and 48-72 hours (19.23%). The primary payment method was out-of-pocket (69.23%) and private health insurance (17.31%).

CONCLUSIONS: Ketamine clinics are growing in numbers and popularity nationwide. The survey provides a comprehensive overview of the multidisciplinary nature of the practice, the range of treatment options, and products of various forms. High adherence to treatment protocols underscores the commitment of clinics to standardized and evidence-based practices. The findings pave the way for understanding improved methods for treating mental disorders with ketamine in community settings.