Expand Your Practice with Ketamine Therapy
Ketamine therapy is one of the most significant advances in treatment-resistant mental health and chronic pain care in decades. This resource is for Canadian clinicians exploring how to integrate it into their practice.
Why Offer Ketamine Therapy?
For patients who have exhausted conventional options, ketamine therapy can be transformative. For providers, it represents an opportunity to offer a genuinely novel mechanism of action to a population that is often underserved.
Treatment-resistant depression, PTSD, and chronic pain affect millions of Canadians — and a significant proportion do not respond adequately to first- and second-line treatments. Ketamine's glutamatergic mechanism is fundamentally different from SSRIs, SNRIs, and opioids, giving clinicians a new tool where existing options have failed.
The evidence base is growing rapidly. The 2021 JAMA Psychiatry randomised controlled trial demonstrated a 67% reduction in PTSD symptom severity. Multiple meta-analyses confirm rapid antidepressant effects in treatment-resistant depression, with response rates of 50–70% in patients who have failed multiple prior treatments.
Health Canada approved esketamine (Spravato) nasal spray for treatment-resistant depression in 2020, and IV ketamine is increasingly used off-label under physician supervision. The regulatory and clinical landscape in Canada is well-established for qualified providers.
50–70%
Response rate in treatment-resistant depression
Across multiple meta-analyses of IV ketamine in patients who have failed 2+ prior antidepressant trials
Hours
Onset of antidepressant and anxiolytic effect
Compared to 2–6 weeks for conventional antidepressants — clinically significant for patients at acute risk
67%
PTSD symptom reduction vs. placebo
2021 JAMA Psychiatry RCT — the first positive pharmacotherapy RCT for PTSD in over 20 years
4–6
Infusions in a standard initial course
Typically administered over 2–3 weeks; maintenance infusions as needed to sustain remission
Conditions You Can Treat
Treatment-Resistant Depression
Patients who have failed 2+ adequate antidepressant trials. The most established indication for IV ketamine in Canada.
PTSD
Combat trauma, first responder PTSD, sexual assault, and complex trauma. Particularly relevant for veteran and first responder populations.
Bipolar Depression
Depressive episodes in bipolar disorder, where conventional antidepressants carry switch risk. Requires careful patient selection and monitoring.
Suicidal Ideation
Ketamine's rapid onset makes it a clinically valuable option for patients with acute suicidal ideation, where waiting weeks for an antidepressant to work is not acceptable.
Anxiety Disorders
GAD, social anxiety, panic disorder, and OCD — particularly where comorbid with depression or PTSD and where first-line treatments have been inadequate.
Chronic Pain
CRPS, fibromyalgia, neuropathic pain, and other refractory pain conditions. IV ketamine has a well-established role in pain medicine.
Training & Certification in Canada
There is no single mandatory certification for ketamine therapy in Canada, but several training pathways are available and recommended. Providers should ensure they have appropriate training in ketamine pharmacology, patient selection, infusion protocols, and emergency management.
Canadian Psychiatric Association
The CPA provides continuing medical education resources on ketamine and esketamine for psychiatrists, including patient selection criteria, monitoring protocols, and integration with psychotherapy.
Ketamine Academy
An internationally recognised training programme offering online and in-person courses covering IV ketamine protocols, patient assessment, infusion management, and practice setup. Accepted by many Canadian providers.
American Society of Ketamine Physicians, Psychotherapists & Practitioners (ASKP3)
Offers certification and a code of ethics for ketamine providers. Increasingly recognised in Canada as a credential demonstrating commitment to evidence-based practice.
Provincial College Requirements
Providers should review their provincial college's guidance on off-label prescribing and any specific requirements for ketamine administration. Requirements vary by province and by whether you are administering IV ketamine or prescribing Spravato.
Integrating Ketamine Therapy into Your Practice
Ketamine therapy can be integrated into a range of clinical settings — from standalone ketamine clinics to psychiatry practices, anaesthesiology offices, and multidisciplinary pain clinics.
Assess Your Setting
IV ketamine requires appropriate monitoring equipment (pulse oximetry, blood pressure, emergency medications) and a trained clinician present throughout the infusion. Spravato (esketamine) has specific REMS requirements including a 2-hour post-dose observation period in a certified healthcare setting.
Develop Patient Selection Criteria
Establish clear inclusion and exclusion criteria. Contraindications include uncontrolled hypertension, active psychosis, certain substance use disorders, and pregnancy. A thorough psychiatric and medical assessment is essential before initiating treatment.
Build Your Protocol
Standardise your infusion protocol (dose, duration, monitoring intervals, rescue medications), consent process, pre-treatment assessment, and follow-up schedule. Many providers use 0.5 mg/kg IV over 40 minutes as a starting point, with adjustments based on response and tolerability.
Consider Integration Therapy
The neuroplastic window following ketamine infusion is a therapeutic opportunity. Consider pairing infusions with psychotherapy (EMDR, CBT, somatic therapy) to maximise and sustain outcomes. Ketamine-assisted psychotherapy (KAP) protocols are increasingly supported by the evidence.
Support Resources for Providers
List Your Clinic
If you are already offering ketamine therapy, submit your clinic to our directory. We verify all listings against your published website and include only clinics actively accepting patients.
Patient Referral Pathway
Our directory helps patients and referring clinicians find verified ketamine providers across Canada. Listing your clinic increases your visibility to patients who are actively seeking treatment.
Clinical Resources
We maintain a library of evidence-based articles on ketamine therapy for clinicians and patients. Our blog covers the latest research, clinical guidelines, and practical guidance for Canadian providers.
Provider Community
Connect with other Canadian ketamine providers through professional associations including the Canadian Psychiatric Association, the Canadian Pain Society, and emerging ketamine-specific networks.
Get in Touch
Whether you are exploring ketamine therapy for the first time, looking to list your clinic in our directory, or seeking to connect with other Canadian providers — we would like to hear from you.
This page is for informational purposes only and is directed at licensed healthcare professionals. It does not constitute medical, legal, or regulatory advice. Providers are responsible for ensuring their practice complies with all applicable provincial and federal regulations, college requirements, and Health Canada guidelines.