Before Marie tried ketamine for her mental health, she said she was deeply depressed and anxious, struggling to get out of bed in the morning and passively suicidal — she would often think about taking her life, though she didn’t make plans. She’d tried everything. At 16, Prozac. When that didn’t work, Zoloft. Then, she was hospitalized. Once she got out, Paxil — and that failed, too.
“I’ve been on less antidepressants than I have diets.” Marie joked on a Zoom call with WGLT. “But I also have diet-resistant fat,” the Peoria resident added while laughing.
After just six infusions of ketamine via intravenous injection, Marie said her depression and anxiety began to improve.
“I had this panic attack,” Marie recalled. She is identified by middle name because she does not want potential employers to know of her treatment. “And not only was it not as intense as my panic attacks usually were, but it was also not as long… I was able to pull myself out of the panic attack so much faster.”
Mental health providers in Central Illinois offering ketamine say it has changed patients' lives, like Marie's, for the better. Still, only a handful of clinics offer the service, and additional barriers — time commitment, cost, insurance — can prevent access for people who need the treatment most.
‘It’s absolutely not enough’
Classified as a dissociative anesthetic and a Schedule III drug by the Drug Enforcement Administration [DEA], ketamine is often used for short-term sedation in the clinical setting, but can also have mental health effects. The Anxiety and Depression Association of America has called it a "breakthrough treatment for anxiety, depression and suicidality."
However, it’s not widely available or prescribed because the Food and Drug Administration [FDA] has not approved its use for mental health treatment. People can still find the drug at clinics with DEA approval for treatment.
WGLT found five providers in Central Illinois that offer ketamine to treat mental health at the time of publication.
“It’s absolutely not enough,” said Dagny Michel of Occult Mental Health in Tremont, which she emphasized has nothing to do with satanism or witchcraft. Her clinic offers both ketamine and Spravato, a nasal spray of esketamine with slight molecular differences from traditional ketamine, but which has similar effects.
Michel is a dual board-certified nurse practitioner in psychiatric mental health and a family nurse practitioner. She also works in a local hospital and said she encountered many inpatient clients, which got her thinking about ways to prevent people from entering that setting in the first place.
“What is the best options for my patients to help them tackle treatment-resistant depression or depression in general?” she said she asked herself. “And the research is showing it’s ketamine.”
A last resort
Bloomington-based Carle psychiatrist Dr. Rachel Immen said she often refers her clients with treatment-resistant depression to try ketamine. She defines that as when “someone has had at least two sets of very good, kind of more aggressive medication management without any response, and also during that time having had counseling… and still not seeing improvement of their depressive symptoms.” Marie, for example, fits the bill.
It’s a definition psychiatrists and insurers have come up with, not necessarily a taught medical term, she said, and is often used as a criterion for establishing patients as candidates for Spravato, since the FDA approved that specific form of the drug for mental health in 2019. Immen said she will refer her clients who meet the definition to at least try a ketamine treatment.
“I still see myself as the primary manager for that individual,” she said. “A lot of times, there is improvement from esketamine or ketamine.”
Effects vary by individual, but Immen said it still shows change where other methods have failed to.
The way Michel explained it, ketamine is a “last resort” for people who have exhausted essentially all of their other options for treatment.
Of the clients who visit Occult for ketamine services, Michel said none have gone into remission — meaning they’ve gone without a depressive episode since starting the drug. She added that she has seen ketamine do wonders for people having suicidal ideation.
“Usually, within 20 minutes of an infusion, those thoughts have kind of subsided,” she said. “So it's pretty exciting, because there's nothing else on the market that does that.”
That includes Marie, who goes to Genesys Infusion Center, which only does intravenous ketamine. Janet Albertson is a co-owner and operator of the clinic, and is also the only provider who brings her services to Bloomington-Normal. She hosts her clinic in Bloomington once weekly, which she said she started doing because several of her clients were coming from there already.
“When I first started, there was quite a bit of resistance and just lack of knowledge. But now, word has gotten out,” she said. “I draw patients from Decatur, Champaign and Springfield.”
The same was true for StrIVeMD Wellness and Ketamine, which originally opened in St. Charles, but has since started clinics in Ohio, Texas and nearby in Champaign. Co-owner and operator David Kleiss said people “were traveling two, three-plus hours just to get treatment” prior to that — many from Central Illinois.
Both Genesys and StrIVeMD said they get spill-over patients from Carle Health in Urbana-Champaign, one of two Spravato-only providers in Central Illinois. The other is Grit and Grace Therapy in Mahomet.
Immen with Carle said she’ll refer to Genesys when Carle is backed up or when she thinks intravenous may be preferred over Spravato.
Accessibility issues
There is no research on which method is better, although Yale University researchers are looking into it, but both methods can be hard access. One the one hand, intravenous ketamine is expensive because clients must pay out of pocket for the service. Genesys, Occult and StrIVeMD all charge under $450 — cheaper than some, but still a high cost for many.
Marie said she wishes the cost were lower, so that more people could access the drug treatment method, but the benefits to her health make the cost irrelevant to her and her family.
“You only get one chance at life, and laying in bed all day wishing you were dead isn't a very fun way to spend it,” she explained as part of her rationale.
Albertson argues that insurance coverage could make it harder to treat her patients. She and Kleiss at StrIVeMD were against the idea of having intravenous ketamine covered right now. They worry insurance may restrict who qualifies or the number of infusions a person can have, making care difficult.
“I don't have anyone telling me, ‘Well, they can only have eight treatments in six months,’” Albertson said as an example. “Some people need more than that.”
Spravato is covered by insurance, but it’s not as precise as the IV method. A patient has to take the entire prescribed dose at once and since esketamine has hallucinogenic properties, it can cause people to have, in layman's terms, a bad trip.
Albertson said this is one of the reasons she doesn’t offer the nasal spray.
“They just have to ride it out,” she explained, adding that intravenous gives her “full control. If someone starts getting a little overwhelmed, I can stop it immediately and it starts easing up in just a couple of minutes.”
At Grit and Grace, Jessica McClellan said she finds the insurance coverage for Spravato highly appealing, and she has her clinic monitor patients throughout their experience. While she admitted insurance can be confusing and hard to navigate, “typically if somebody wants it, we do get it approved,” she said.
A potential detractor for either treatment is the time commitment. A session takes a minimum of two hours and a driver is needed to take the client home from their appointment. While that can force some away from the option, McClellan said she also sees it as a sign that people are committed to getting better.
She added that people who think someone may just be trying to get high or use drugs legally are misguided.
“It's just so much more than that,” she said.
Ketamine as a tool
Unlike Matthew Perry, the Friends actor whose 2023 official cause of death was ruled as “acute effects of ketamine,” patients like Marie in Central Illinois are taking acceptable amounts of the drug, under supervision and don’t have access to alcohol or other substances while undergoing treatment.
Marie said she laments the actor’s death or “Special K” — the street drug ketamine — are people’s immediate thoughts when they hear she is on ketamine. She said she wishes people could recognize it as the resource it is.
“Medications are a tool, and the ketamine, it’s a tool,” she said, as is talk therapy and any other form of mental health treatment.
She pointed out that this particular tool happens to help in a way no other has. It’s how she can get out of bed, go to the mall and sing. She said she’s always wanted to sing publicly but has previously been too anxious.
“I was scared to death,” she said. “But for Valentine’s Day, my husband got me singing lessons and I said, ‘I can do it, because I’m not afraid anymore.’”
Soon, Marie will be taking her talents to the stage for a public concert.
“But I'm not scared. I'm gonna do it. I'm gonna stand there, up there, and I'm gonna sing in front of people that I don't know, and that, for me, is probably going, I mean, it's, it's going to boost my self-confidence so much more,” she said.
