Intravenous Treatment FAQ
What Medications can Provide Benefit?
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Several medications have emerged in research studies that have shown benefit in treating conditions like Refractory Depression and Major Depressive Disorder when conventional therapies fail or are considered to have inadequate response. In accordance with Heatlh Canada section 70 of the Narcotic Control Regulations, specific drug names cannot be used on a public website. Please speak to your psychiatrist for more specific details.
How do Intravenous Medications work for Depression?
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Research is ongoing into the mechanism of action for specialized medications having an anti-depressant effect. Although the exact mechanism for their anti-depressant effect is not delineated, these medications are thought to act at the NMDA, AMPA, and opioid receptors in the body which have been the basis of its understanding and use in anesthesia and pain relief. Studies have also demonstrated that they can modify and increase connectivity in parts of the brain implicated in mood control.
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How effective are Intravenous Medications for Depression?
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Based on existing and evolving literature, for patients that will respond to therapy, symptom relief may be observed before the first dose is complete (within the first hour) but commonly takes 6-8 treatments to determine if a response will occur. Several studies have shown that more than 50% of patients with treatment resistant depression who receive appropriate treatment have an improvement in their mood while placebo arms in those studies only saw about a 2% mood improvement. For those that don't respond during their first dose, studies have shown they may respond during a subsequent treatment.
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When should Intravenous Therapy be considered for Depression?
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Intravenous therapy should only be initiated when deemed appropriate by a psychiatrist. It should be used for those who do not have adequate mood control when traditional treatment modalities have been tried for an appropriate period of time (traditional anti-depressants, psychotherapy, others). Intravenous therapy may be considered before ECT ('electro convulsive therapy') given the invasive nature of ECT treatment. Additionally it can be used following ECT therapy if patients have ongoing mood concerns.
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Who is involved in Intravenous therapy?
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Safe and appropriate usage of an intravenous medications involves a team approach between two physician specialties. Firstly a psychiatrist is needed for long term care of a patient's mood condition and to determine a patient's eligibility and likelihood of them benefiting. Secondly an anesthesiologist is needed to determine a patient's eligibility for an intravenous therapy that may have systemic effects based on a patients medical history. Additionally, anesthesiologists are needed if a treatment is administered intravenously to monitor the patient and treat any side effects. Anesthesiologists are physicians who specialize in providing anesthesia for surgeries and have vast experience with intravenous medications and monitoring patients. It is critical that both physician specialties work together to ensure the best possible outcome for patients. ​​
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What is the Referral Process?
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Please see our Referral Section.