Summary of the service

Ketamine is a licensed anaesthetic drug.  It can also work as an antidepressant but has not been licensed for this use.  A closely related version, nasal esketamine, does have a licence but has not been approved for routine NHS use, mainly because of cost.

We provide a self-pay, ketamine treatment service for people who have depression which has not responded to other treatments.  It is based at the Warneford Hospital, Oxford, OX3 7JX.

Before offering you an assessment we assess your suitability for treatment by reviewing a referral letter from your GP or psychiatrist and other required documents.

If we can offer you an assessment, you will complete several questionnaires before the assessment meeting.

Assessment meetings are usually online, but we can meet face-to-face if you prefer.

Initial treatment consists of three to six ketamine infusions over three to six weeks.  We recommend that you join two preparatory group sessions before treatment and an integration group after each treatment.  These are optional.

About 50% respond well and want to continue treatment.  The majority relapse at some point but then respond again with further treatment.  As with conventional antidepressants, regular treatment over several years is often needed.

About 10% have an unpleasant experience with their first infusion.  For the remainder it is pleasant or neutral.

For information about NHS treatment, click here.

To see our feedback from a recent survey, see our FAQ: Why should I come to Oxford rather than elsewhere?

 

Overview

Summary of the service

We provide a self-pay service for people who have depression which has not responded to other treatments.

Before offering you an assessment we assess your suitability for treatment by reviewing a referral letter from your GP or psychiatrist and other required documents.

If we can offer you an assessment, you will complete on-line daily mood monitoring and questionnaires before the assessment meeting.

Assessment meetings are usually online, but we can meet face-to-face if you prefer.

Initial treatment consists of three to six ketamine infusions over three to six weeks.

About 50% respond well and want to continue treatment.  A large majority relapse at some point but then respond to regular, longer-term, maintenance ketamine treatment, which can continue for several years.

About 10% have an unpleasant experience with their first infusion. 

Where is the service provided?

Oxford Health NHS Foundation Trust’s ketamine service is based at Warneford Hospital, Oxford, OX3 7JX.

Is it available on the NHS?

The service described here is a ‘self-pay’ or ‘private’ service which is provided by Oxford Health NHS Foundation Trust (OHFT).  All potential patients must establish their own funding arrangements.

Patients who live in Oxfordshire or Buckinghamshire and who are formally referred to the service by a consultant psychiatrist who is employed by Oxford Health NHS Foundation Trust may be considered for treatment funded by OHFT, ie ‘on the NHS’.  The processes for this group are similar to those described in this website except that direct referral by a GP is not possible.  The referral for OHFT-funded treatment must come from an OHFT consultant psychiatrist.  If you then have ketamine treatment, you will remain under the joint care of the OHFT psychiatrist.

A very few patients from areas outside Oxfordshire and Buckinghamshire have been able to secure NHS funding for a trial of ketamine using an “Individual Funding Request”.  This is made by the patient’s treating psychiatrist or GP to their local Integrated Care Board (ICB), which replaces the Clinical Commissioning Group.  It is described here.  Extracts from this website, including information in the FAQs about likely cost-effectiveness, can be used to support such applications, but we cannot get involved beyond this.  Treatment cannot start until we have a commitment in writing from the ICB to pay for the treatment and the details of the person who will process our invoice.  It is important that patients realise that almost all  such applications are unsuccessful because the patient’s problems are not judged to meet the criterion of ‘exceptionality’.  Sadly, it is not exceptional for depression to be very resistant to treatment.

What is Ketamine?

Ketamine is used for depression which has not responded to other treatments.

Its brief rapid antidepressant effect has been confirmed in many several clinical trials over the last 20 years.

Is ketamine a licensed treatment?

Drugs receive a licence if the MHRA approves them as safe and effective for a particular condition. Ketamine is not a licensed treatment for depression. It is used in depression as an ‘off-label’ treatment. Ketamine is licensed as an anaesthetic and for analgesia.  A version of ketamine,  Spravato esketamine nasal spray, has a licence for use in Treatment Resistant Depression alongside an SSRI or SNRI.  It has not been approved by NICE and is therefore not available on the NHS.  It is expensive.  We are happy to provide this for those who would prefer it.  Some details about this are provided in the FAQs.

Non-urgent advice: Referrals

Your psychiatrist or GP should send the required documents, preferably by email to: KetamineClinic@oxfordhealth.nhs.uk

or by post to:

Referrals
Ketamine Clinic
Warneford Hospital
Headington
Oxford
OX3 7JX

We provide this service at the lowest cost possible.  All of the income from the self-pay service described on this site is used to fund NHS care within Warneford Hospital and other NHS sites across Oxfordshire, Buckinghamshire, Wiltshire, Swindon, Bath and North East Somerset where Oxford Health NHS Foundation Trust operates.

Non-urgent advice: Downloadable information

This PDF contains all the text on the website, used for consent.

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Page last reviewed: 28 November, 2022