FAQ2018-06-27T14:42:50+00:00

Frequently Asked Questions

How can I be assessed for eligibility for ketamine therapy?2018-06-27T14:51:57+00:00

A referral can be made by your healthcare provider at our referral page. Staff at the CRTCE will conduct a comprehensive assessment of your psychiatric history, medical history and family history. Moreover, a full list of all previous treatments taken will need to be determined to ensure you have a treatment resistant disorder. Once you have been determined to be eligible for ketamine therapy, an appointment time will be scheduled for you at the Canadian Rapid Treatment Center of Excellence (CRTCE).

How is ketamine delivered?2018-06-27T14:44:55+00:00

Ketamine is delivered through intravenous infusion. A physician, who is trained in anesthesia, as well as a nurse, will oversee the infusion of the treatment.

What is ketamine?2018-06-27T14:39:47+00:00

Ketamine is a pharmaceutical that was originally developed for the purpose of assisting in anesthesia. It is referred to as a dissociative anesthetic. The term dissociative anesthetic has more than one definition. One of the most commonly referred to definitions for a dissociative anesthetic is an agent that can cause dissociative symptoms, which loosely means that “reality can be somewhat blurred”. In other words, images may appear unreal or slightly distorted and/or create other perceptual disturbances.

Who is the lead physician at the Canadian Rapid Treatment Center of Excellence?2018-06-27T14:43:31+00:00

The lead physician is Dr. Roger S McIntyre, Professor of Psychiatry and Pharmacology at the University of Toronto, Head of the Mood Disorder Psychopharmacology Unit University Health Network, Chairman and Executive Director Brain and Cognition Discovery Foundation, and President of the Canadian Rapid Treatment Center of Excellence.

How does ketamine work?2018-06-27T14:39:59+00:00

The mechanism of how ketamine alleviates depressive symptoms is not known. It is generally agreed that there are multiple mechanisms that likely contribute to ketamine’s ability to relieve depressive symptoms. It is hypothesized that these mechanisms include, but are not limited to, targeting glutamate, dopamine, serotonin, opiates, as well as molecules in the brain responsible for brain cell growth and development.

How long do the infusions take and how long do I need to stay at the clinic?2018-06-27T14:45:02+00:00

Based on the available evidence, individuals receiving ketamine begin to report relief of depression within one day of administration of the first infusion. Others may take longer but the overall majority of people who are going to benefit from ketamine benefit within 1-2 weeks.

Is the CRTCE licensed by the CPSO?2018-06-27T14:43:43+00:00

Yes. The Canadian Rapid Treatment Centre of Excellence has been inspected and approved by the College of Physicians and Surgeons in Ontario. The CRTCE is mandated to maintain its professional practice in accordance with the standards of care that are listed on the CPSOs website for Out-of-Hospital Premises Inspection Program, OHPIP, Program standards (Guidelines and Standards PDF).

Who can make the referral and how can they make the referral?2018-06-27T14:52:49+00:00

Any one of your doctors may be able to submit a referral for an assessment to our clinic. To submit a referral, your doctor can visit www.crtce.com/refer-a-patient

For what psychiatric disorders is ketamine best proven to be effective for?2018-06-27T14:40:18+00:00

Intravenous ketamine is a drug that has abuse liability. That being said, the doses of ketamine that are being used for the treatment of mood disorders are a relatively small dose. Moreover, there is no evidence those individuals receiving ketamine for treatment resistant mood disorders in carefully supervised and specialized centers are at risk of abusing ketamine and other substances, as a consequence of ketamine treatment (e.g. opiates).

How many treatments of ketamine will I require?2018-06-27T14:45:29+00:00

The protocol for administering ketamine is still being refined. Nonetheless, at this point in time, most individuals will receive 4 infusions (i.e. 2 infusions per week for 2 weeks). These 4 infusions represent an acute treatment trial.

How quickly can I be seen?2018-06-27T14:52:57+00:00

Your referral will be assessed by the treatment team at the CRTCE within 2-3 business days. Subsequent to that, if eligible, an appointment for an initial assessment will be made for you within 2-6 weeks.

Is ketamine available at the CRTCE in other formulations i.e. routes of administration?2018-06-27T14:44:03+00:00

Ketamine is offered at the CRTCE as an intravenous infusion. The CRTCE will also be evaluating ketamine through intranasal delivery. Indeed ketamine is available through other routes (e.g. oral, but this is not offered at the CRTCE).

How does ketamine differ from regular anti-depressants?2018-06-27T14:40:56+00:00

Ketamine differs from other anti-depressants in many ways. What’s most apparent about ketamine, as a different treatment, is that it begins to demonstrate efficacy within 1-2 days. Most anti-depressants require 2-4 weeks before they begin to show significant improvement in symptoms.

How long does it take before ketamine begins to work? How many infusions do I need?2018-06-27T14:50:00+00:00

Based on the available evidence, individuals receiving ketamine begin to report relief of depression within one day of administration of the first infusion. Others may take longer but overall the majority of people who are going to benefit from ketamine benefit from 1-2 weeks.

What are the hours of operation?2018-06-27T14:44:10+00:00

The Canadian Rapid Treatment Center of Excellence will be serving treatments Monday to Saturday, mornings, afternoons and evenings.

Does the initial assessment at the CRTCE cost money?2018-06-27T14:53:27+00:00

No. Your initial assessment at the CRTCE would be covered by OHIP. The overarching aim of your referral of the initial assessment is to clarify and confirm what your diagnosis is to determine the appropriateness of your current and past treatments, as well as to consider appropriate treatment avenues for you. It is fully expected that many individuals may not be considered appropriate candidates for ketamine and/or will be recommended alternative treatments to ketamine.

What is the age eligibility for ketamine?2018-06-27T14:52:14+00:00

The age eligibility for ketamine at the Canadian Rapid Treatment Center of Excellent is 18-65 years of age.

How long will the effects of ketamine last?2018-06-27T14:41:16+00:00

The long-term efficacies of ketamine in individuals who have responded to this treatment modality are not yet fully known. Emerging evidence indicates that some individuals remains well for several months. Undoubtedly, there will be some individuals who remain well for longer periods of time. It’s also known that other individuals will require booster sessions to maintain their feelings of wellness. The booster sessions are typically administered approximately once per month.

What is the usual dose of ketamine administered for treatment resistant mood disorders?2018-06-27T14:51:17+00:00

Generally speaking, the dose of ketamine administered is 0.5mg/kg. This dose results in a blood concentration of ketamine of about 10%-20% of what is usually used in anesthesia.

Will there be research studies conducted at the Canadian Rapid Treatment Center of Excellence that I may be able to participate in?2018-06-27T14:44:27+00:00

Yes. The Canadian Rapid Treatment Center of Excellence is associated with the Mood Disorder Psychopharmacology Unit, one of the world’s leading centers for identifying causes and cures of mood disorders. There are many research protocols that will be conducted in addition to offering ketamine treatment for mood disorders.

Can I eat during an infusion?2018-06-27T14:47:33+00:00

You’ll be asked to not eat or drink during the infusion and approximately 6-8 hours before the treatment.

Is ketamine safe?2018-06-27T14:41:25+00:00

Ketamine has been used for many years in anesthesia and other medical conditions (e.g. pain disorders). The U.S. FDA approved ketamine in 1970 as an agent for anesthesia. During the last two decades, a growing body of evidence supports its use in treatment resistant mood disorders. When ketamine is administered at a center where the personnel are experts in the delivery of ketamine and where that center has appropriate safety monitoring and surveillance of patients, ketamine appears to be safe and generally well-tolerated. As ketamine has not been studied in mood disorders for longer periods of time (i.e. a year or longer), its long-term safety remains to be established, and it is currently a focus of research.

Can ketamine reduce thoughts, plans, attempts, or completed suicide?2018-06-27T14:41:33+00:00

Available evidence indicates that ketamine may reduce thoughts of suicide in individuals who are suffering from mood disorders. It remains an open question whether ketamine reduces attempts of suicide or whether it reduces the overall suicide rate.

What are common side effects?2018-06-27T14:47:53+00:00

The most common side effects of ketamine are dissociation, which is when images appear somewhat distorted. Dissociation can affect up to a third of people during the first infusion. The overall number of people who experience dissociation decreases with each subsequent infusion. It is also noted that some people may have an increase in blood pressure or heart rate during infusion therapy. That will be monitored closely during by your health care team. Although it is rare, some people may experience changes in liver or kidney function, and/or notice blood in their urine. These are considered rare events and more typically associated with much higher doses of ketamine for longer periods of time and/or people who abuse ketamine.

Can I get addicted to ketamine?2018-06-27T14:42:19+00:00

Ketamine is a drug that has abuse liability. That being said, the doses of ketamine that are being used for the treatment of mood disorders is a relatively small dose. Moreover, there is no evidence those individuals receiving ketamine for treatment resistant mood disorders in carefully supervised and specialized centers are at risk of abusing ketamine and other substances as a consequence of ketamine treatment e.g. opiates.

What if I experience side effects after going home?2018-06-27T14:48:00+00:00

You’ll be provided with the phone number and contact information of the medical staff at the CRTCE. You’ll be able to call them to discuss any side effects or safety concerns. The contact will be available during business hours. After hours, you’ll be encouraged to go to your local emergency room.

How much does an acute treatment trial of ketamine cost at the Canadian Rapid Treatment Center of Excellence (CRTCE)?2018-09-25T10:44:15+00:00

The cost of an acute treatment trial (i.e. 4 infusions in two weeks) is $3000. This price includes the harmonized sales tax (HST). This fee represents the cost of professional services and the administration of this treatment. All individuals will need to pay the full cost of an acute treatment trial prior to having a first infusion schedule.

Is it safe for me to drive home after ketamine treatments?2018-06-15T18:36:13+00:00

No. You’ll need to be accompanied on your way home following the infusion of ketamine treatment.

Is ketamine treatment for depression paid for by the public health plan of Ontario (i.e. Ontario Health Insurance Plan, OHIP)?2018-05-31T16:29:32+00:00

No.

Are there any medications that interfere?2018-06-27T14:48:42+00:00

Drugs that may interfere with ketamine treatments may be determined by your health care team at the CRTCE during assessment.

Are there any contraindications for ketamine?2018-06-27T14:42:01+00:00

Individuals who are abusing ketamine and/or other illicit substances would not be candidates for ketamine treatment. At this point in time, ketamine has not been studied for individuals who have psychotic symptoms (e.g. delusions and hallucinations), and as such, that would also be a contraindication. Any person who has unstable cardiovascular disease, renal or liver diseases, or for that matter any other unstable medical disorder would not be eligible for ketamine treatment. Every person’s eligibility and contraindications will be discussed on a case-by-case basis on during the initial intake.

Will my insurance company cover my treatment?2018-06-15T18:37:34+00:00

You’ll need to speak to your insurance company regarding the matter. These decisions are made on a case by case basis, as the use of ketamine in treating mood disorders is relatively new avenue of care.

Contact Us

1100 Dundas St W, Unit #6,  L5C 4E7.
Mississauga, ON, Canada
416-943-6284

Please remember, all individuals must be referred to CRTCE by their doctor prior to visiting our clinic. To be referred, please ask your doctor to send a referral for an initial assessment on our refer a patient page.