Daily Camera: BCH now offers ketamine therapy, other therapies for treatment-resistant conditions

The Daily Camera recently featured a news article on the Center for Interventional Psychiatry (CIP) at Della Cava Family Medical Pavilion, which offers Electroconvulsive Therapy (ECT), Transcranial Magnetic Stimulation (TMS) and ketamine infusions for mental health disorders, including depression, bipolar disorder, obsessive compulsive disorder, manic illnesses or schizophrenia.

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Boulder Community Health now offers ketamine therapy, other therapies for treatment-resistant conditions

By Amber Carlson | acarlson@prairiemountainmedia.com

UPDATED: January 29, 2025 at 9:27 PM MST

Ketamine therapy has become known for its ability to combat depression and other mood disorders. There’s a growing body of research suggesting it can be especially effective against types of depression that don’t respond well to medications.

In recent years, ketamine therapy has surged in popularity, and it has arrived and begun expanding in Boulder. There are numerous private clinics and places where people experiencing persistent depression can go to receive the treatment. But as of last year, it’s been added to the menu of service options at the Center for Interventional Psychiatry, operated by the nonprofit Boulder Community Health.

The center, known as the Guerra Fisher Institute until its rebrand last August, offers several different therapy options for difficult-to-treat behavioral health conditions. Ketamine is the newest addition to the list, arriving in spring of last year.

Nadia Haddad, a physician and medical director of BCH’s Department of Behavioral Health, said ketamine can have make a big difference even for people with treatment-resistant depression. People with depression who have previously tried at least two antidepressant medications and felt little or no improvement from them meet the criteria for treatment-resistant depression.

Haddad said treatments like ketamine provide options for patients who may not be getting relief through more traditional treatments.

“We have for so long, in the treatment of mental illness, been struggling with all of these societal challenges around functioning with depression, and we continue to do the same things over and over again,” Haddad said. “… I think more and more research is supporting that … having these options is the most effective thing we can be doing.”

Ketamine is a dissociative drug that is sometimes used as an anesthetic. But at the Center for Interventional Psychiatry, patients receive a sub-anesthetic dose of ketamine through an intravenous needle over the course about 40 minutes, said Bill Kromka, an attending psychiatrist at BCH who administers the therapy.

While receiving the ketamine, people may experience a wide range of effects, such as altered consciousness, perceptual distortions, or even out-of-body-type experiences. Some people report feeling reduced physical tension. Others have sometimes reported anxious feelings.

But Kromka said ketamine is unique partly because it has physiological effects in the body, but it can also be used “synergistically” with psychotherapy to treat mental health conditions. He also said having treatment-resistant depression isn’t terribly uncommon.

“(There are) more people than you would think that have tried two or more antidepressants … and there’s limited or no response,” he said. “Trying additional medications is still very much a consideration and an important part of treatment, but these other treatment modalities, like ketamine, … offer opportunities with potentially higher likelihoods of response and remission.”

Ketamine comes with some risks and side effects, and it is a substance with potential for abuse, doctors say. However, Haddad said, the drug is safe when used at a controlled dose in a supervised clinical setting.

And ketamine isn’t the only option the clinic offers for treatment-resistant mental health conditions. The Center for Interventional Psychiatry also offers two neuromodulation therapies, which use electrical or magnetic currents to stimulate the brain.

One of these options, transcranial magnetic stimulation (TMS), is noninvasive and stimulates specific areas of the brain using magnetic fields. The other, electroconvulsive therapy (ECT), delivers an electrical impulse to the brain and induces a medically controlled seizure in people while they’re under anesthesia.

Haddad said ECT has gotten a “bad rap” but is very safe and effective, and it can also be used to treat conditions like bipolar disorder (particularly manic episodes), psychosis and catatonia. It can even be used to treat people who are actively suicidal.

The clinic has offered TMS since November 2023 and ECT since 2011. A BCH spokesperson said that, as of Wednesday, the clinic has provided 68 ketamine treatments, 521 TMS treatments and 28,402 ECT treatments in total. These treatments are administered at the Della Cava Family Medical Pavilion, 4801 Riverbend Road.